NovelsAlex Chapter 1399 Debut
Chapter 1399 Debut
Chapter 1399 Debut
The main gate of the Municipal People's Hospital is a bit older than that of Sanbo Hospital. Xiao Wu stood at the gate, looked up at the several buildings, and took a deep breath.
He left from here, and he never expected that after so many years, he would come back and serve as the head of the department. Xiao Wu really never thought that he would have this day.
"Let's go," Zhang Lin said behind him, "Let's go report for duty first."
The personnel department's procedures were swift. Dean Chen personally received them. Dean Chen was over fifty years old, with gray hair and wearing gold-rimmed glasses. He spoke slowly and deliberately, but with great authority.
"Director Zhang, Director Lu, welcome, welcome." Dean Chen shook their hands firmly. "Our hospital has always wanted to make orthopedics a key department for development. We have good equipment and talented people, but we lack leadership. You come from Sanbo Hospital with a prestigious reputation, and I expect you to lead this orthopedics department to new heights."
Zhang Lin nodded: "Dean Chen, we will do our best."
Xiao Wu added, "We will work diligently and practically."
Dean Chen paused for a moment, then smiled: "Alright, get familiar with the environment first, rest for a few days, and I'll take you to your departments in a few days and announce your appointments at the same time."
Xiao Wu waved his hand: "No need to trouble Dean Chen, we'll go for a stroll ourselves first."
"Tomorrow, let's officially start work tomorrow." Zhang Lin couldn't wait.
"I'll go with you from the medical department."
"No need, no need. We just wanted to talk to the doctors and nurses in the department."
Well, Dean Chen didn't insist on accompanying him. Anyway, he would go back to his department tomorrow morning to officially announce the appointments. Right now, the two directors clearly wanted to go on an incognito visit to understand the people's conditions, so it wouldn't be good for him to accompany them.
The orthopedic center is located on the seventh and eighth floors of the inpatient building. The seventh floor houses the spinal surgery department, and the eighth floor is the joint trauma surgery department. They are separated by one floor but connected by an internal staircase. Zhang Lin and Xiao Wu went to their respective floors separately and agreed to meet at the cafeteria at noon.
When Zhang Lin entered the spinal surgery department on the seventh floor, several nurses at the nurses' station were chatting idly. Seeing him come in, a slightly older head nurse greeted him: "You must be Director Zhang? I'm Head Nurse Liu Min."
"Hello, Head Nurse Liu," Zhang Lin said with a smile, extending her hand. "Please take care of me in the future."
"Director Zhang, our department currently has twenty doctors: two chief physicians, three associate chief physicians, six attending physicians, and nine resident physicians. We have forty-five beds, and forty-one patients are currently hospitalized," Liu Min explained as she walked. "The doctors' offices are this way, and your private office is at the end of the corridor."
Zhang Lin nodded. He now has his own private office, but he still prefers to spend most of his time in the large office with his colleagues; he likes that atmosphere.
In the large office, seven or eight doctors were either sitting or standing. When they saw him enter, they all stood up. Zhang Lin glanced around; their ages varied, the oldest looking to be in his fifties, and the youngest probably just graduated.
"Hello everyone, I'm Zhang Lin," he said in a low but clear voice, "I'm from Sanbo Hospital, and I'll be working with you all from now on. Please take good care of me."
The oldest doctor spoke up: "Director Zhang, I'm Wang Shunye. I've been working here for over twenty years. You come from Sanbo, so your skills are definitely superior to ours. We'll learn from you."
Wang Shunye, the deputy director of the department, was somewhat unhappy with the newly appointed director.
The words were polite, but Zhang Lin sensed a distance in them. Wang Shunye said "we'll learn from you" instead of "we'll work together," and Zhang Lin caught the subtle difference.
"Director Wang, you're too kind," Zhang Lin said. "I'm new here and not familiar with the hospital. There are many things I need to ask you. I'll treat everyone to dinner sometime, and we can get to know each other while we chat."
Wang Shunye was somewhat surprised, clearly not expecting the young director to be so humble. He nodded, "Thank you, Director Zhang."
Xiao Wu's situation on the eighth floor was similar to Zhang Lin's.
The joint trauma surgery department has 21 doctors and 55 beds, making it slightly larger than the spinal surgery department. The deputy director, surnamed Zhao, is named Zhao Quan. He is a short, stout middle-aged man with a loud voice, and his eyes squint into slits when he laughs.
"Director Lu! It's an honor to meet you here!" Zhao Quan warmly shook Xiao Wu's hand. "Sanbo Hospital? That's the leading hospital in our province! It's a blessing for us on the eighth floor that you've come here!"
Xiao Wu felt a little pain from Zhao's grip, but smiled and said, "Director Zhao, you're too kind. My surname is Lu, you can just call me Xiao Wu. That's what my colleagues called me when I was at Sanbo."
Xiao Wu knows half of the doctors here; they all came from here before. But he doesn't know Zhao Quan; Zhao Quan must have been recruited after Dean Chen came in.
"That won't do, you're the director..."
"Let's call him Xiao Wu," Xiao Wu insisted. "A name is meant to be called; you'll get used to it."
Zhao Quan was taken aback for a moment, then burst into laughter: "Great! Director Wu, that's straightforward!"
Xiao Wu followed Zhao Quan on his rounds of the wards. There were 55 beds, with 48 patients, resulting in a high turnover rate. As Xiao Wu walked around, he reviewed the medical records and noticed several issues: the preoperative assessment was not detailed enough, the postoperative rehabilitation plan was rather haphazard, and the use of antibiotics was somewhat chaotic.
This patient had a femoral neck fracture. The preoperative cardiopulmonary function assessment was only one page long, without blood gas analysis or echocardiography. The surgical risk was very high for this elderly patient.
Hip fractures in elderly patients carry a high perioperative mortality rate, making comprehensive preoperative assessment essential to prevent complications during surgery. This patient is 82 years old and also has hypertension and diabetes; at a minimum, blood gas analysis, echocardiography, and lower extremity venous ultrasound are necessary to rule out the risk of thrombosis.
However, Xiao Wu kept it in mind and didn't say it out loud yet. He had just arrived and wanted to get along well with everyone first. It would be annoying if he started to boss people around right away.
At noon, Zhang Lin and Xiao Wu met at the cafeteria. The city hospital cafeteria was smaller and had simpler dishes than Sanbo's, but it was cheaper. The two got their food and found a corner to sit down.
"How is it?" Zhang Lin asked.
"It's alright," Xiao Wu said, taking a bite of rice. "But I've noticed quite a few issues. The pre-operative assessment and post-operative management were a bit haphazard. I haven't brought it up yet, afraid of causing offense since we're new here. We'll address it gradually later."
Zhang Lin nodded: "It's the same on my end. The deputy director has been doing this for over twenty years; he's more senior than me. I have to be careful in handling relationships. We're new here, so we can't just start bossing people around. We have to integrate first, and then gradually make changes."
“I know,” Xiao Wu said, “it’s just that seeing those non-standard procedures makes me anxious. Back at Sanbo, Professor Yang often said that a surgeon’s bottom line is never to let a patient die because of you. These non-standard procedures will inevitably lead to problems sooner or later.”
“Let’s take it slow,” Zhang Lin said. “Let’s observe for a month, get a clear picture of the situation, and then find a starting point. By the way, I plan to check out the training room this afternoon. I heard the hospital has a skills training center, but it’s not used much.”
“I’ll go too,” Xiao Wu said. “Let’s practice together for a while and get a feel for it.”
The city hospital's skills training center, located in the basement of the administration building, was quite spacious, but the equipment was outdated. Several mannequins lay in a corner, covered in a layer of dust. The laparoscopic simulator was a ten-year-old model with a very low screen resolution. There was almost no orthopedic surgical simulation equipment, only a few foam boards and suture models for practicing knot tying. Zhang Lin looked at all this, feeling a heavy weight in his heart. At Sanbo, skills training was a daily, unwavering commitment, and the training rooms were fully equipped, offering everything from basic suturing to robotic surgical simulations. This place, however, had clearly been abandoned for a long time.
“We have to start all over again,” Xiao Wu said. “We can add equipment gradually, but we need to create the right atmosphere first.”
Zhang Lin nodded: "I'll talk to the dean tomorrow and apply for some funding. It doesn't need to be much, just enough to get the basic equipment."
The two picked up a relatively clean sewing model from the corner and began practicing.
After practicing for an hour, Zhang Lin's phone rang. It was Wang Shunye calling: "Director Zhang, the emergency room has admitted a patient with a lumbar vertebral fracture, suspected spinal cord injury. Could you come and take a look?"
"Okay, I'll be right there."
Zhang Lin and Xiao Wu went upstairs together. Although they belonged to different departments, emergency patients sometimes needed consultations, and the two were used to discussing cases together.
The patient was a 35-year-old male who fell from scaffolding, landing on his lower back. A CT scan showed burst fractures of the L1 and L2 vertebrae, with more than two-thirds of the spinal canal occupied, and his lower limb muscle strength was only grade 2.
“Emergency surgery to relieve the pressure is necessary,” Zhang Lin said after reviewing the scans. “If we delay any longer, the spinal cord injury will be irreversible.”
Wang Shunye was also there. He frowned, somewhat hesitantly, and asked, "Director Zhang, should we try conservative treatment first and observe for a few days?"
“We can’t wait,” Zhang Lin pointed to the X-ray. “Look here, the kyphosis angle has exceeded thirty degrees, and two-thirds of the spinal canal is occupied. If we delay any longer, the spinal cord will become ischemic and necrotic; even a miracle couldn’t save us. The golden time for this kind of surgery is eight hours after the injury, and four hours have already passed.”
Wang Shunye was intimidated by his imposing manner and stopped speaking.
Zhang Lin began arranging the surgery, simultaneously calling the operating room and instructing the resident physicians to prepare for preoperative examinations. He spoke quickly but clearly, each instruction precise and accurate, fully demonstrating the authority of a department head.
In addition, Zhang Lin liked to show off, so he had the air of a department head, which made all the doctors have to admit his superiority.
"Dr. Zhang," a young resident physician asked in a low voice, "is there any chance of this patient recovering after surgery?"
Zhang Lin glanced at him; he was a young man in his late twenties, with worry and expectation in his eyes.
“We don’t have absolute certainty. We’ll do our job well. Whether or not the patient can recover is not something we can decide; we can only create conditions for recovery,” Zhang Lin said honestly. “Without surgery, the patient will be 100% paralyzed; with surgery, there’s a 60% chance of regaining the ability to walk. As surgeons, we need to find a balance between risk and benefit. This surgery is worthwhile, and it must be done.”
Zhang Lin reported to Dean Chen about the emergency room patients who were about to undergo surgery. After all, it was only the first day of work, not yet the official start date, and the appointment of the department head had not yet been announced.
Dean Chen greatly admired Zhang Lin's style, and to support Zhang Lin, he put aside his work and personally went to the operating room.
Once inside the operating room, Zhang Lin displayed his talent for showing off to the fullest extent; anyone who didn't know better would think he was one of the top professors in the country performing the surgery.
He stood tall and straight, unhurried and composed, exuding an air of authority.
The surgery lasted more than two hours. Zhang Lin's surgical style, as he himself said, was unpretentious but solid. Every step was performed with meticulous care, ensuring thorough but not excessive decompression, and secure fixation without damaging adjacent segments. When the last screw was inserted, the monitor showed improvement in the patient's neurophysiological monitoring.
“There’s hope,” the anesthesiologist said. “The motor evoked potentials are better than before the surgery.”
Zhang Lin breathed a sigh of relief, only then realizing that his back was soaked with sweat. He checked his watch; it was nine o'clock at night.
"Director Wang, will you be handling the finishing touches?" Zhang Lin asked.
Wang Shunye, who had been acting as his assistant, nodded and said, "Okay, you can go and rest now."
Zhang Lin didn't leave. He stood to the side, watching Wang Shunye suture the incision, occasionally reminding him, "The fascia layers must be aligned, otherwise dead space can easily form." "Use absorbable sutures for subcutaneous sutures to reduce scarring."
At first, Wang Shunye was a little impatient, but gradually he found that Zhang Lin's reminders were very practical. They were not the kind of condescending guidance, but rather exchanges between peers.
Moreover, he discovered that this young Director Zhang was indeed capable and not just a show-off; it seemed that those who came from the Sanbo Research Institute were indeed different.
Previously, Director Wang had heard some rumors about the two new directors. He heard that they stayed at the institute by currying favor with Professor Yang, and that they were just doing odd jobs at the institute.
Judging from this surgery, their skill level as general assistants is quite remarkable.
When Zhang Lin was about to take off his surgical gown, he discovered that Dean Chen had been standing in the operating room the whole time.
"Director Zhang, thank you for your hard work. It's my first day here, and you're already on the operating table. I feel so bad about it." Dean Chen immediately stepped forward to untie the bandages behind Zhang Lin's back in the operating room.
"Not at all, I'm here for surgery," Zhang Lin said politely.
Seeing Dean Chen's actions, Xiao Wu thought to himself, "It seems the atmosphere at the Municipal People's Hospital is really different from before."
After the surgery, the patient was returned to his ward. Zhang Lin waited outside the ICU for the patient to wake up, and Xiao Wu stayed with him.
"How was it?" Xiao Wu asked.
"It's alright, the stress relief was thorough, now we'll see how the post-operative recovery goes," Zhang Lin said, rubbing his eyes.
“I just went to the operating room next door to watch them perform surgery. It was a hip fracture that required a replacement,” Xiao Wu said. “I noticed their surgical technique wasn’t quite up to standard. I wanted to teach them on the spot, but I refrained.”
Zhang Lin laughed: "You know, take things slowly. We're not in Sanbo anymore; we're outsiders on their turf."
“I know,” Xiao Wu nodded.
The two men smiled at each other, a habit they had developed at Sanbo Hospital: after each surgery, they would sit together, review the proceedings, and discuss what they had gained and lost. They planned to continue this habit at the city hospital as well.