Chapter 37: The Debut

The hospital was crowded with patients. Chasu City was too far from the capital, so residents had no choice but to seek treatment locally when they fell ill. After Zhang Fan joined the staff, Old Gao assigned him to the same team as Li Hongtu. Zhang Fan had actually hoped to rotate through different departments, but given Old Gao’s stance, that was impossible. Li Hongtu was a kind-hearted man with no strong desire for control; having Zhang Fan on his team was a perfect way to leverage the young man's strengths. Meanwhile, Wu Jinxi’s team had stopped accepting new patients. The morning meetings in the department had effectively become a battlefield between him and Old Gao.

Li Hongtu had admitted an elderly woman in her seventies with a fractured femoral head. She was in decent health but, unable to sit still at home, had fallen while mopping the floor. It required a hemiarthroplasty. "How are you with hip replacements? Have you done them before?" Old Gao asked Zhang Fan in the director's office.

"It shouldn't be a problem. I did them frequently during my advanced training in Qingniao."

"Alright then, you’ll be the lead surgeon today." An artificial hip replacement involves using a prosthetic made of metal—designed to mimic human joints—to replace a joint surface damaged by disease or injury. These procedures allow for better joint mobility and early ambulation, which helps reduce the complications associated with prolonged bed rest in elderly patients.

"Understood. I’ll go prepare."

"Good. For now, just use Li Qiong’s instruments; you’re not familiar with the others, and Li is easy to work with." A surgery like this required four doctors, making it a major procedure in orthopedics. Xue Fei and Zhou Chengfu served as the second and third assistants, with Li Hongtu as the first assistant. Although Old Gao had great confidence in Zhang Fan, this was a significant surgery and Zhang Fan's first since joining the municipal hospital. Not wanting any mishaps, Old Gao headed to the operating room early.

Xue Fei and Zhou Chengfu exchanged glances; this was bad news. A resident, and Old Gao had specifically set the stage for him to shine. Was he a relative? Xue Fei winked. Zhou Chengfu understood his meaning—don't help, but don't sabotage either. Although they were Old Gao’s protégés, the department's resources were limited. The arrival of a younger, more favored doctor put them in an awkward position.

The surgery began. They incised the skin and fascia layer by layer, then used blunt dissection for the muscles. When it came to bone cutting and acetabular reaming, the instrument representative—a young woman working under Li Qiong—had everything ready well in advance. Zhang Fan proceeded to ream the medullary canal in an orderly fashion. While Xue Fei and Zhou Chengfu didn't offer to help, they didn't dare interfere either. Li Hongtu, as the first assistant, watched Zhang Fan’s every move closely.

"Very proficient. Precise movements, no wasted motion. This is impressive," Li Hongtu thought to himself, astonished. Where did Old Gao find such a talent? He wasn't old, but his skill was profound. To be blunt, aside from Old Gao and Old Wu, no one else in the department could operate as skillfully as Zhang Fan.

"He’s improved even more. His grasp of detail is becoming increasingly precise," Old Gao thought as he watched the procedure, sighing with emotion. It had only been half a year since they last worked together. Zhang Fan’s surgical level had jumped several tiers; what used to be merely stunning was now truly astonishing. Xue Fei and Zhou Chengfu, holding the patient’s leg in various positions, felt utterly dejected. Even as first assistants, they found hip replacement surgery difficult, let alone as the lead surgeon. Yet, this guy was so young and already taking the lead. What would be left for them in the future?

"Dr. Zhang, your surgery is truly remarkable. Once your credentials are finalized, you’ll be ready to lead a team," Xue Fei said while holding the leg. While it sounded like a compliment, he was pointedly highlighting the fact that Zhang Fan lacked the necessary credentials, and that leading a team generally required at least an associate senior rank. He wanted to keep everyone on guard against Zhang Fan. No one was a fool; everyone understood Xue Fei’s motive. The department’s work couldn't be done by one person alone, but since Old Gao had set the stage for Zhang Fan today, he would now have to appease his two protégés.

"Future operations cannot be handled as they have been—trying to do everything at once. We need clear division of labor. We will split into joint and spine teams. The three-tier consultation system for associate seniors, attendings, and residents must be strictly observed. Anyone with thoughts on this can come speak with me later." By dividing the teams, he could reduce internal friction and improve management.

After suturing the skin and placing a drain, the surgery ended. Zhang Fan had no intention of competing with them. His main goal at the municipal hospital was to level up his system as soon as possible; as for the income, as long as he could pay for his sister’s university tuition, that was enough. Constantly fishing for kickbacks from instrument or drug sales was just too exhausting. "You’re too kind, Dr. Xue. I’m just a small resident, and you all are my superiors. I know the rules." Zhang Fan still needed to maintain good relations with them for the sake of the system.

"You’re too humble, Dr. Zhang," Xue Fei replied. Since Zhang Fan was being modest, he couldn't ignore the face of his mentor, Old Gao. Li Hongtu’s health wasn't great, and he managed fewer patients, resulting in lower income. Old Gao assigning Zhang Fan to his team was a form of compensation; after all, when Old Gao first became director, Li Hongtu had been very supportive and was one of the first to acknowledge his authority.

Back in the department, after writing his orders, Zhang Fan had to write his own medical records—in the county hospital, Old Chen and Li Liang had handled all that paperwork. Several doctors were rotating through the department, and the one assigned to their team was a female doctor who had just graduated this year. Being able to join a Grade A hospital right out of an undergraduate program meant she was no ordinary person. Since Zhang Fan was still a resident himself, he felt awkward asking her to do his chores.

In the doctors' lounge, Xue Fei lay on the bed and asked Zhou Chengfu, "Zhou, what are your thoughts? Old Gao is splitting the teams. Which one do you want?" The income and workload for the spine and joint teams were similar, though the spine team was slightly more demanding.

"I want to do spine. How about you?"

"I think I’ll go for spine too. Look at the newcomer—he’s already doing hip replacements. Is there any future for me in the joint team? How is this guy so good?" Despite his jealousy over Old Gao favoring Zhang Fan, he couldn't help but admire his skill.

"Tell me about it. He’s probably just a fresh graduate, yet he’s so strong. Old Gao has effectively cut off Old Wu’s retreat. In the future, if he handles the spine team and Zhang Fan takes over the joints, there won't be any room left for Old Wu to return."

"Sigh! Each generation is stronger than the last. I heard the hospital won't be hiring undergraduates in the future. If a few postgraduates join the department, our lives will be even harder," Xue Fei lamented.

"That’s why you shouldn't target Zhang Fan. It’s pointless and just makes enemies. Zhang Fan is an undergraduate too, just like us. As long as we keep a good relationship, it won’t matter if some PhDs join later."

"You’re just full of schemes. I bet you figured that out the moment you saw him perform today. Sigh, I’m the only fool here. I need to stay away from smart people like you. I wouldn't even know if I were being sold out."

"Cut it out. Are you free tonight? We’re Old Gao’s inner circle, so we should invite Zhang Fan to dinner. I don’t think he’s the arrogant type; he should be easy to get along with."