124: Chapter 124 Genius? She'd seen far too many fallen geniuses!
The next morning.
Director Li Sen called the Department of Hand Surgery.
The one who answered was Director Xu Minhua herself.
"Old Li, what's the matter?"
Director Xu Minhua's voice was crisp and decisive. For a woman in her fifties, she was full of energy.
"Yesterday, the Emergency Department performed an emergency Vascular Anastomosis, repairing the distal brachial artery and the proximal radial artery. The postoperative results are quite good. I'd like to invite you over to help evaluate the quality of the surgery."
There was a brief silence on the other end of the line.
"Since when did your Emergency Department start performing Vascular Anastomosis?"
"Recently."
"Who was the lead surgeon?"
"Lu Chen."
Silence again.
Director Xu Minhua had heard this name more than once lately.
He was a young Resident Physician who was the talk of the hospital—some called him the Suturing God, some praised his god-tier looks, and others called him a technical genius.
Every time she heard these words, Director Xu Minhua would only give a cold snort.
A genius?
She had seen too many so-called geniuses who were praised to the skies only to come crashing down in the end.
Young people were impetuous and lacked stability. Being lauded after performing just a few surgeries did no favors for their professional careers.
"A Resident Physician performing a Vascular Anastomosis?" Director Xu Minhua's tone carried obvious skepticism.
"Yes."
"Who authorized it?"
"It was an emergency procedure. The patient was successfully resuscitated after cardiac arrest, and immediate surgery was required to stop the bleeding and perform repairs. There was no time to wait for a consultation."
"So, in the absence of a senior physician from Vascular Surgery or the Department of Hand Surgery, a Resident Physician independently completed a brachial artery anastomosis?"
"Yes."
Director Xu Minhua's voice turned cold.
"Old Li, do you know what this means in terms of operating protocols?"
"Emergency surgeries have special clauses. There are no issues regarding operating protocols."
"I'm not talking about protocols; I'm talking about the risk. A Resident Physician performing a Vascular Anastomosis—if something goes wrong with the anastomosis site, leading to distal ischemic necrosis, who will take responsibility for the amputation?"
Director Li Sen's voice remained calm.
"That's why I'm asking you to evaluate it. If there's an issue with the quality of the surgery, I'll handle it immediately. If there isn't, then it proves his ability is worthy of the procedure."
Director Xu Minhua was silent for a few seconds.
"Fine, I'll be there at two in the afternoon."
"Good, I'll make the arrangements."
The call ended.
Director Xu Minhua put down the phone and leaned back in her chair.
A Resident Physician performing a brachial artery anastomosis.
To be honest, she didn't believe it.
To be precise, she didn't believe a Resident Physician could perform a Vascular Anastomosis to a competent standard.
Vascular Anastomosis wasn't something you could do just because you knew how to sew a few stitches.
The depth of the needle, margin control, intimal alignment, and suture tension—every detail directly affected the patency rate of the anastomosis.
One slight oversight and postoperative thrombosis, anastomotic stenosis, or distal ischemia could occur. Any of these complications could lead to amputation.
She had worked in the Department of Hand Surgery for thirty years and had seen too many so-called 'beautiful' vascular anastomoses that developed problems post-surgery.
Looking good didn't mean it worked well.
She was going over today to take a good look.
To see if this young man, who was being praised to the heavens, actually had talent or was just being hyped up by a group of amateurs.
...
Two o'clock in the afternoon.
Director Xu Minhua appeared in the Emergency Department right on time.
A woman in her fifties, she wasn't tall, had short hair, wore no makeup, and walked with a brisk, purposeful stride.
A fountain pen was tucked into the pocket of her white coat, and the information on her ID badge was clearly visible: Department of Hand Surgery, Chief Physician, Xu Minhua.
Her expression was neutral, but her eyes were incredibly sharp.
Director Li Sen was waiting for her at the Nurse Station.
"Director Xu, thank you for coming."
"Let's skip the pleasantries and go straight to the patient."
Director Li Sen smiled and didn't say much more, leading her toward the ICU.
As they passed the Nurse Station, Sun Ji recognized Director Xu Minhua, and his expression changed slightly.
Once the two had walked away, he leaned over to Shen Xiaoning.
"This is bad. Director Xu from Hand Surgery is here."
"What's wrong?"
"It's Xu Minhua! She's famous throughout the hospital for being strict. She never sugarcoats her evaluations of surgical quality. Last time, she tore an attending from Orthopedics to shreds in front of his entire department over a tendon repair."
Shen Xiaoning's brows furrowed.
"Is she here to see Dr. Lu's surgery?"
"Probably."
Shen Xiaoning pouted slightly.
"Dr. Lu's surgery was so good. What fault could she possibly find?"
Sun Ji shook his head.
"You don't know Director Xu. Someone like her—forget a Resident Physician—she can find a pile of problems in a surgery done by an Associate Chief. In her eyes, there aren't many surgeries in the entire province that would earn a 'not bad' from her."
Shen Xiaoning was silent for a moment, then she took out her phone.
"What are you doing?"
"Messaging Dr. Lu so he can be prepared."
"Don't. Director Li must have already told him. Your message will just distract him."
Shen Xiaoning hesitated for a moment and put her phone back.
But the worry on her face was impossible to hide.
...
In the ICU.
Director Xu Minhua stood by the patient's bedside, put on gloves, and began the examination.
It was eighteen hours post-surgery. The patient's vital signs were stable, he was conscious, and he could already communicate simply.
The surgical site on the right forearm was wrapped in sterile dressing.
Director Xu Minhua first looked at the surgical records.
She took the medical chart from the Nurse and flipped through it page by page.
The surgical records were written in great detail.
From the Cardiopulmonary resuscitation process, defibrillation parameters, and medication use to the scope of Debridement, vascular injury assessment, anastomosis method, and Suturing layers—every step was recorded clearly.
As she read the surgical records, Director Xu Minhua's eyebrows twitched slightly twice.
"End-to-end anastomosis, 7-0 Prolene suture, Continuous interlocking suture for the posterior wall, and Interrupted suture for the anterior wall?"
Director Li Sen, standing beside her, said,
"Correct."
"Continuous interlocking for the posterior wall and interrupted for the anterior?"
"That was the Suturing method Lu Chen chose himself."
Director Xu Minhua looked up at Director Li Sen.
"The choice itself is correct. Continuous interlocking on the posterior wall ensures the seal of the anastomosis, while interrupted Suturing on the anterior wall makes it easier to observe vascular patency. It's a standard Vascular Anastomosis plan."
When she said this, there was no hint of praise in her tone; she was purely stating facts.
"But choosing the right plan doesn't mean it was executed well. The resulting effect is what matters."
She put down the chart and began checking the postoperative condition.
First, she checked the distal blood supply.
The five fingers of the right hand had normal color and temperature.
Director Xu Minhua pressed down on the nail bed of the right thumb with her finger; after releasing, the capillary refill time was less than two seconds.
"Distal blood supply is good," she said in a flat tone.
Then she felt the radial artery.
The pulse was strong.
"radial artery pulse is good."
Next, she used a Doppler ultrasound probe to detect the blood flow at the anastomosis site.
On the ultrasound screen, the blood flow signal at the anastomosis was continuous and smooth, with no obvious signs of turbulence.
"Anastomosis is patent, with no signs of stenosis."
Director Xu Minhua's expression didn't change, but her movement in putting down the ultrasound probe was just a tiny bit slower than before.
She admitted to herself that, based on the ultrasound results, the quality of this anastomosis was competent.
Not just competent.
It was very good.
Eighteen hours post-op, the anastomosis was patent, without leakage or thrombosis, and the distal blood supply was fully restored.
This result, if placed in a Vascular Surgery report, would be considered excellent.
But Director Xu Minhua didn't voice her approval.
"I want to see the wound."
Director Li Sen signaled the nearby Nurse to help uncover the dressing.
The layers of dressing were removed one by one.
The wound was completely exposed.
Director Xu Minhua lowered her head and looked closely.
Then her movements stopped.
The fifteen-centimeter-long wound had multiple layers of sutures, and the skin surface was closed using Subcuticular Continuous Suturing.
Eighteen hours after surgery, the Suturing at the wound edges was clearly visible.
No swelling.
No bleeding.
No misalignment whatsoever.
The skin on both sides of the wound edge was perfectly aligned, the sutures were hidden within the dermis, and no needle marks could be seen on the surface.
A fifteen-centimeter-long mangled wound.
This wasn't a neat six-centimeter incision.
It was a fifteen-centimeter, complex mangled wound with severe tissue loss.
To suture such a wound to this degree—the level of difficulty was on a completely different scale.