The new trend in the morning was more limited to the flow of ideas on paper or a small amount of operations, looking for some new development directions for surgery through the flashes of inspiration of doctors.
The surgical report in the afternoon was much more practical, and the content was all about the detailed surgical process. The doctor giving the report will start with the causes of the disease one by one, and then analyze the entire operation process in detail.
The program list has been compiled and selected by the College of Surgery. Even if the program is not an outstanding masterpiece within three months, it must have a certain degree of "famousness" to be included in the list.
If the surgery itself has no flash points, then you have to see the surgeon, so the selection will definitely be biased and some novices will be excluded.
The list has already started queuing up after the last meeting. It is a competition mechanism that seems simple but is actually not very difficult. The basic guideline is to comply with the ratio of 1:3:1, which is the same as filling in the blanks.
There are often two or three high-quality surgical procedures in a single quarterly meeting, which basically take turns in the hands of ambitious surgical director-level doctors such as Ignatz, Edinson, and Waterman.
What follows are some mid-to-high-level surgeries, the number of which is hard to say.
Sometimes there are many letters of recommendation in the hands of judges, and sometimes there are only seven or eight letters. They need to select surgeries that meet the conference standards from a large number of surgeries, and then squeeze out 2-3 surgeries to leave them to those veterans with a certain prestige.
Even if the surgery they perform is simpler, they still have to warm it up for the sake of human kindness.
Of course, you are the tallest among the shortest, and these ordinary surgeries are not something you can get into casually. You have to have some shining points.
As early as the end of the last regular meeting, that is, at the end of December last year, Waterman had already started preparations for the March regular meeting. He and the academy's jury have reviewed thousands of surgeries and continuously improved this list.
According to the original plan and order scheduling practices, the order can be closed after Ignatz's cesarean section and inguinal hernia are completed at the end of February. As long as one of the two stations succeeds, it can be included in the program list as the press station. If both fail, it doesn't matter, at least it can be queued for a warm-up.
As a result, Ignatz's cesarean section failed and the inguinal hernia repair was successful, so the jury included inguinal hernia surgery.
Closure sheet...
After the surgery, the judges did seal the form.
Because those doctors who give lectures all year round do not have major surgeries in early March, based on usual experience, closing orders early can also send invitation letters earlier, so that the selected doctors can prepare in advance to give speeches on stage.
As a result, as soon as the letter was sent out, Laszlo was so angry that the city was filled with uproar.
Laszlo is involved in many investment projects and has his own traffic, and the onlookers present are all doctors who can be ranked. The surgery itself is difficult and topical enough. The key was successful in the end. For this reason, Laszlo not only invested additional money in the Municipal General Hospital, but also spent money to expand the hospital area.
It really doesn’t make sense if it can’t be entered into the form.
The meeting time was limited, and one had to be removed as soon as one was added, so after hearing about the operation process, Waterman picked up a quill and wrote a letter of dissuasion to some unlucky guy. 【1】
According to unwritten rules, he needs to protect the interests of certain people, so he can only target the middle ratio.
In the letter, he tried his best to attribute the reason for the withdrawal to force majeure, and at the same time he praised the other party. After writing it, Waterman always felt that he had personally stifled the enthusiasm of a young doctor, but there was nothing he could do about it. Sometimes he couldn't help it.
But things have just begun.
The next step was the cesarean section. According to Ignatz, the operation time was scheduled around the due date, which was mid-March. If you succeed, you will enter the regular meeting of the next quarter. If you fail, you will enter the warm-up session just like this time.
No one could have guessed that the delivery would be early, no one could have guessed that Ignatz would miss the operation, and no one could have guessed that not only did the cesarean section end successfully, but the mother and child were also safe in the end.
Simply a miracle!
If this miraculous operation is not included in the list, wouldn’t it mean that we look down upon the difficulty of cesarean section with an infinitely close 100% failure rate?
Just when the judges were still hesitating whether to make a substitution, Waterman was keenly aware that something was wrong.
He once again reviewed the entire process of the inguinal hernia repair, compared the success rate of previous operations, and learned about the sudden preoperative preparations for the recent Ignatz operation. Waterman made a bold guess:
There may be an interesting "monster" around his son.
In order to verify his conjecture, Waterman made a surprising decision. He took the newspaper report and shouted "Wunder (miracle)!" excitedly to the judges while preparing to write a letter to the second unlucky guy.
This time he touched someone's cake.
The judges expressed their objections one after another. The College of Surgery has its own personal connections. Without them, it will not be able to obtain research funds. In the end, it is the college's own interests that will suffer.
After several discussions, Waterman withstood the pressure and did not compromise. He seemed to have seen the future of surgery, and was ready to use Kawei to combat the pedantic atmosphere within the college.
It was still a letter of resignation, and it clearly compared the other party's surgery with a cesarean section. The content may seem a bit fancy, but after reading it, you will feel that the same sentence is written all over the page: "You can't do it." 【2】
Waterman's suspicion soon came to an answer. Just three days ago, his son performed another appendectomy for him.
Subhepatic mutation, extra long appendix, cancer cell infiltration, roundworms, this appendix is covered with weird labels, and it will definitely be included in the list. According to the judges, it was postponed to the next quarter. After all, there was already a cesarean section at this regular meeting.
Unfortunately, Waterman disagreed. He had to use a victory to completely reverse the embarrassing situation of his son's absence from the cesarean section.
In order to pave the way for the next dean, and also to win over Kawei, he did not discuss it with the judges this time, but "tearfully" found the third unlucky person and wrote another letter. 【3】
However, this was not enough, because before he made a decision, Ignatz also told about another operation that was even more incredible. Let's call it surgery. Although there was no audience and no operating table, after all, the man had been stabbed four times and was still covered in blood, and he managed to survive at the hands of a certain young man.
Three surgeries, three unlucky men, completely shattered the authority of the judges at the regular meeting.
The jury panel never imagined that they would have to go back on their word three times in just half a month...
"You old stubborns! I changed my rhinoplasty surgery to the fourth from the bottom. Are you still not satisfied? Do you still think these surgeries are not enough?"
Waterman scolded them, but quickly hid his desire for reform and instead used the patients' dire straits to criticize:
"I understand that you care about the feelings of those doctors, the funds of the college, and the interests of certain political parties. But have you ever cared about the feelings of the women with dystocia who are waiting to die in the maternity ward? Have you ever felt that they died under the knife of the enemy? What are the feelings of the soldiers below! Are you still a doctor? How can you bear to watch them die one by one???"
Under moral torture, Waterman soon had the fourth and fifth letters in his hands.
The fourth letter was originally an old and unlucky guy, but Edinson stood up for the greater good and took the initiative to have his complete tonsils removed.
His sacrifice was not completely unrewarded. It was worthwhile to help the next dean, and he also safeguarded the interests of certain people. He looked like he would go to hell if I didn't, but in fact he was pleasing both sides and no one was left behind.
Of course, Waterman will not forget his "contribution". Not only did he get into the new trend with surgery, but he also handed over a copy of "Liszt's New Perspectives", allowing Edinson to take the lead in reform.
The fourth letter was thrown into the trash can, but the fifth letter was sent anyway. 【4】
This time he was a lucky one, at least on the surface, because he was specially invited to be selected for the afternoon surgery list. Although the time for the operation report is very tight, you can always squeeze out some. Besides, this person's tracheostomy only took 3 minutes from beginning to end, so it really doesn't take much time to waste.
His presence could at least pave the way for Kawei's two tracheotomies, especially the second one, which was by no means an operation that a normal surgeon could perform.
Reform requires opportunities and even more courage. In order to promote reform, Waterman offended many people and had to make a deal with Kawei. It was really difficult.
He looked at the empty dean's office, with a freshly written application letter for medical school admission in his hand. His heart was full of the sadness of the past half month and the anticipation of the afternoon surgical report: "I have done all this. , you have betrayed your old face, you have to behave well for me, don’t let me down..."
...
By the time Kawei and Ignatz returned to the conference hall, the report had already reached the beginning of the second session.
On the stage was another surgeon from St. Mary's Hospital, Hodge: "I am a colleague of Dr. Fermi. I mainly perform maxillofacial plastic surgery. I also participated in Dr. Fermi's surgery during the morning meeting. I originally wanted to I followed Dr. Waterman’s example and reshaped the patient’s nose, but unfortunately the patient died on the operating table.”
He scratched his head and smiled helplessly: "We really tried our best, but the patient couldn't survive the operation..."
Surgery is fraught with risks, and the surgeons in the audience know this very well.
What Hodge is going to talk about this time is a craniectomy he performed last month: "The patient is 35 years old. He was sent to our hospital for treatment on the 11th of last month by a mental hospital. His body temperature was very high and he had severe symptoms. He had a headache and was talking nonsense. After examination, it was found that his scalp was red and swollen, about the size of half my fist.
The swelling of the scalp was very serious. I applied gentle pressure and found obvious fluctuations. I suspected a subcutaneous abscess at that time, so I made a simple scalp incision in the clinic, and a large amount of yellow-green viscous pus and some bone fragments were discharged.
In fact, the skull had been severely damaged, and sinus tracts had formed in the middle. I could clearly see his brain. The final diagnosis I gave was suppurative cranial osteitis, which was a very clear diagnosis. "【5】
From symptoms to final diagnosis, there is not much logical problem in between.
Just because of the limitations of the time, he did not explain the cause of the skull inflammation, nor did he explain that the inflammation had penetrated the skull and caused the patient's mental disorder. Instead, he only talked about the subsequent surgical process:
"The patient was manic and had a very serious rejection reaction to the operation. We had to tie him to the operating table and anesthetize him with ordinary ether before shaving him bald. If it was an ordinary patient, he would have shaved his head first. Then for surgery, ether anesthesia was too unstable.”
The surgery is actually not difficult.
Remove the unnecessary bits of scalp, leaving some that can be used, and uncover the infection. While paying attention to hemostasis, first use a skull saw to cut off a large piece of skull, and then use tweezers to remove unnecessary bone fragments. 【6】
However, skull surgery at that time was always accompanied by a problem that ordinary people can think of. It was easy to accidentally injure the dura mater under the skull, and then damage the brain.
"The patient woke up half an hour after the operation." Dr. Hodge said. "I know clearly that the lesion has been removed and the operation was quite successful."
Although the difficulty of the operation was average, there was still some applause from the audience.
For this kind of warm-up surgery, the post-operative questioning is often skipped because the report itself is just a formality and there is no need to ask.
But this time an unexpected voice jumped out: "Excuse me, Doctor Hodge, has the patient been sent back to the mental hospital now?"
Hodge, who was about to step off the stage, stopped in embarrassment and looked at the young man who asked the question. He answered bravely: "Not really."
"Huh? Has the patient's mental disorder improved?"
After a few questions and answers, the topic immediately became interesting.
Mental disorders are difficult to treat, and the patient's behavior will become extremely strange, so it was once misunderstood as being bewitched by Satan. If insanity could be cured simply by cutting off the skull, that would be a joyful discovery.
"No...no improvement."
The young man said reluctantly: "Then why not send him to a mental hospital?"
"..."
Hotch sighed, looked at the eyes of the audience looking at him, and had to tell the truth: "Because the patient died the next day."
"I see."
The young man nodded and said nothing, leaving the surgeon, who had been working in clinical practice for more than ten years, on the stage. Hodge couldn't stand this kind of questioning and always wanted to defend himself: "The patient survived for a whole day, so this can't be considered a failure of the operation."
According to the common view at the time, as long as the patient wakes up after surgery, the responsibility should not be borne by the doctor. In fact, even if the operation does fail, the doctor does not need to bear any responsibility, because failure is very common.
However, for such a simple cranial removal operation, which was not difficult, the patient died again. According to the selection regulations, it should not be here.
Hoch looked at his silent colleagues and couldn't help but become angry. The target of his anger was the young man who just asked: "Who are you? Which hospital are you from? What's your name?"
"Kavi, Kavi Hines, a general surgical assistant at City General Hospital."
