Chapter 137: Mastering the Manual Reduction

Dr. Zhou, Dr. Zhang, watch my manual reduction technique carefully!

Dr. Fu, after examining the patient’s temporomandibular joint, displayed a hint of concern on his face.

If the procedure were simple, he would have let Zhou Can try it for practice.

But as the situation seemed a bit more complicated and the patient was uncooperative,

he decided to handle it himself.

“Alright, sit with your back against the wall and your head pressed against it,” he instructed.

Dr. Fu guided the patient into position.

“Yes, just like that! Stay still in this posture.”

Once the patient was settled, Dr. Fu had a nurse bring two clean gauze pads, then wrapped his thumb and inserted it into the patient’s mouth.

“Notice this—the thumb should hook onto the patient’s masseter near the back teeth. Precisely here.”

After Dr. Zhou and Dr. Zhang confirmed the position, he placed all four fingers along the lower edge of the mandible.

“Use your fingers to lift here, then gradually press the jaw downwards and backwards. Meanwhile, lift the patient’s chin as if you were holding a bowl of soup.”

What an exceptionally vivid analogy.

Zhou Can watched intently.

He absorbed every operational detail and the purpose behind each movement.

“Did you all catch my technique?”

“We did!”

Both Dr. Zhou and Dr. Zhang nodded in agreement.

“Excellent! Now relax—really relax! Yes, that’s it!”

Seeing the moment was right, Dr. Fu gently pushed backwards, producing a faint cracking sound.

Immediately, he quickly withdrew his fingers from the patient’s mouth.

“It’s that simple! After you reduce the joint, always pull your hand away swiftly to avoid being bitten.”

When the temporomandibular joint dislocates, it can’t bite.

Once reduced, the patient’s pain reflex might cause an accidental bite on the doctor’s hand.

Zhou Can clearly understood the method.

The patient tested his jaw with a few cautious movements, and a beaming smile spread across his face.

“Ha ha, it’s really fixed! Fixed! Ha ha… uh, uh, uh…”

No sooner had he laughed a couple of times than his jaw dislocated once again in a twist of bad luck.

This unexpected turn left the doctors and nurses utterly stunned.

“A dislocation causes joint laxity. After manual reduction, you can’t laugh or open your mouth too wide. We just fixed it and now it’s dislocated again—what are we going to do?”

Dr. Fu was at a loss for words.

He had never encountered such an unruly patient.

“Doctor, normally when we buy a phone or TV and something goes wrong, we can claim a three-guarantee policy. My brother just finished treatment and hasn’t even left the room—now you all have to take responsibility!”

The patient’s brother, around forty, didn’t dwell on his brother’s fault but immediately invoked the electronics warranty.

Clearly, he wanted another free treatment session for his brother.

Such shrewd family members are not uncommon.

Whenever money is involved, they won’t hesitate to be unyielding with the doctors.

“Technically, we just reduced his joint successfully. For another treatment, you should re-register and pay again. However, I understand the situation between you two, so we’ll skip additional consultation fees; you only need to reimburse the consumable costs. Is that acceptable?”

Within his capacity, Dr. Fu ensured the patient received the utmost care.

“That works, thank you, Doctor.”

The patient’s brother beamed in satisfaction.

He repeatedly expressed his gratitude.

Next time, if he has to re-shoot an X-ray and pay treatment fees again, it will be a major ordeal.

“Dr. Fu, may I give the operation a try this time?”

Zhou Can had been watching intently and felt he had grasped the essence of the technique.

Seeing a perfect chance to practice, he decided to seize the opportunity and combine learning with hands-on experience.

“Alright!”

Dr. Fu agreed readily.

However, the patient’s family was slightly reluctant, saying, “Are you sure about this young doctor? Please don’t hurt my brother.”

“Don’t worry—he’s one of our department’s finest young doctors. You’re in safe hands.”

Dr. Fu lavished praise on Zhou Can.

The family said no more.

Mimicking Dr. Fu’s method, Zhou Can helped the patient sit up and proceeded to perform the manual reduction.

Under the watchful and skeptical eyes of both the patient and his family, he carefully pressed the patient’s jaw.

A cracking sound echoed once more.

The temporomandibular joint had been successfully reduced again.

“Excellent work!”

Dr. Fu enthusiastically commended him—Zhou Can’s aptitude for learning and his steady hands were the best he had seen.

After recovery, the patient dared not laugh heartily.

He had learned his lesson and became extremely cautious.

Dr. Fu used gauze to secure the patient’s jaw, explained some aftercare instructions, prescribed medication, and then dismissed him.

In the days that followed, although Dr. Fu rarely mentioned it, he clearly began to rely on Zhou Can even more.

Every day there were ample opportunities for practicing manual reduction, and Zhou Can gained experience by the handful.

His skill in manual reduction steadily improved.

The busy days flew by in a flash.

Before he knew it, Zhou Can’s residency in Orthopedics had come to an end. His bone-setting technique was nearing the level of an attending physician.

The evaluation from the Orthopedics department for his residency was outstanding.

He was the only one among eighteen residents to receive such high praise.

After work, Zhou Can went to a pharmacy and bought a stick of Old Ginseng.

The pricier variants, worth hundreds of thousands, were obviously out of his reach.

So he chose one in the three-thousand range.

After the purchase, he waited by the employee parking lot exit.

It wasn’t long before Dr. Fu, true to form, drove out in a white Honda.

Zhou Can quickly waved him down.

“Dr. Zhou, are you trying to catch a ride with me?” Dr. Fu joked.

Zhou Can opened the passenger door and climbed in.

“Our Orthopedics residency has ended! I’m off to the Neurosurgery Department tomorrow—soon, I might not see you again.”

After the Orthopedics residency, his next stop was the Neurosurgery Department.

This move wasn’t by his own choice but arranged by the hospital.

“Ha ha, after spending half a month with me, have you grown fond?” Dr. Fu said as he slowly drove out of the hospital.

Blocking the parking lot exit was unthinkable.

No hospital employee would dare pull such a reckless stunt.

“I’m not just being sentimental—I do feel something. When I was first transferred to the Orthopedics Outpatient Department, I felt like an abandoned child. You didn’t hesitate to let me learn manual reduction from you. I’m deeply grateful. They say it’s easy to add icing on the cake but hard to deliver help in a crisis. I noticed a few streaks of gray in your hair; you must be very tired. Please accept this Old Ginseng as a small token of my appreciation.”

Seizing the moment, Zhou Can placed the Old Ginseng in the console next to the driver’s seat.

“Oh, you’re giving me such an expensive gift? Take it back. I appreciate your thoughtfulness.”

Dr. Fu repeatedly tried to decline.

“It’s not worth much. I hear Old Ginseng can help rejuvenate the body—I only wish that a doctor as excellent as you stays young, so you can heal even more patients and train more new doctors.”

Zhou Can had put a lot of thought into the gift.

During the past half-month, Dr. Fu had practically imparted all his knowledge to him.

The bone-setting techniques he learned would serve him for life—even if he opened his own clinic.

Giving the Old Ginseng was his way of expressing his deep gratitude.

“I live in the hospital dormitory. It’s right outside the drop-off zone—please stop here.”

Zhou Can had finished all the gestures and words he needed to deliver.

He immediately got out of the car.

“If you ever want more practice in manual reduction, feel free to drop by the manual reduction room.”

Dr. Fu gradually eased the car to a stop by the roadside.

The Old Ginseng Zhou Can gave had clearly made its mark.

At least, Dr. Fu now knew he was a thoughtful person.

“Remember what you said—half a month isn’t enough to master manual reduction techniques. If I ever need further practice, I’ll be sure to visit your room again.”

Zhou Can was overjoyed, seizing the opportunity as soon as it arose.

It appeared the seniors weren’t wrong: true refinement isn’t just about academic prowess—it’s also about knowing how to win favor with your superiors. It felt like he had found his niche.

At the very least, the Old Ginseng was a well-received gift.

“Ha ha, no problem. With such a capable assistant by my side, I’m always ready to share my knowledge. Just say the word, and I’ll teach you everything I know.” Dr. Fu parked the car, and Zhou Can got out.

“On the day you were transferred to the Orthopedics Outpatient Department, Chief Resident Shen actually had a word with me, along with Dr. Chi and Dr. Shan. He asked us to look after you and not waste your talent.”

Dr. Fu shared another heartwarming piece of news that lifted Zhou Can’s spirits.

The hospital wasn’t all about backstabbing and power struggles.

There were still plenty of conscientious doctors.

“Someday I’ll properly thank Chief Resident Shen. I really appreciate you letting me know about this.”

Zhou Can waved goodbye.

“Drive safely! Goodbye!”

After closing the car door and watching Dr. Fu’s vehicle pull away, Zhou Can smiled and turned to leave.

Many doctors lose contact with their seniors after residency.

Some feel inferior and hesitate to reach out, while others find their seniors too aloof to approach.

Not surprisingly, Zhou Can’s excellence combined with his humility had earned him much favor.

In contrast, very few medical practitioners were as calculating as Director Xie.

At Tuyu Hospital, even the slightly competent doctors earned very good incomes.

When they encountered promising talent, they genuinely appreciated it.

Zhou Can had now rotated through two departments in his residency.

In the Emergency Department, he had earned the admiration of Director Lou and Dr. Xu. In Orthopedics, he won the favor and friendship of Chief Resident Shen, Dr. Fu, Dr. Shan, and Dr. Chi.

His network within the hospital was quietly expanding.

This would undoubtedly benefit his future career.

……

The next day, Zhou Can and Jin Mingxi reported for duty at the Neurosurgery Department.

“Old Jin, our fates have really intertwined! We’ve been through the same residency rotations—from the Emergency Department to now—with remarkably similar experiences,”

Zhou Can joked with a smile.

“Heh, indeed our fates are intertwined. The Orthopedics residency was just too short. It would be great to learn more from experts in the joint field if given the chance,”

Jin Mingxi complained.

“You’re the only one daring enough to expect mastery in every field. Just getting into the Operating Room is already a huge stroke of luck. If you want to delve into joint surgery and advanced theories, once you become an attending, you should apply for further training in Orthopedics!”

Zhou Can offered him advice.

It appeared Jin Mingxi had already mapped out his career path.

“So, have you decided on your specialty?”

Zhou Can asked with a smile.

Jin Mingxi nodded. “Yes! Last night I made up my mind. When I first joined Tuyu, I hoped to learn a bit of everything and be a generalist. But these three months of residency have opened my eyes. Life’s energy and talent are finite; mastering even one niche can take a lifetime.”

Jin Mingxi’s high level of insight showed that his knowledge and skills had advanced considerably in just half a year.

“That’s the spirit! So, which field will you specialize in?”

Zhou Can asked, smiling.

Jin Mingxi answered in four simple words, “Surgical Procedures!”

“I’ve always had a knack for surgery. With my limited academic background, residency almost ruled out Internal Medicine. Specializing in surgery is my only way forward.”

He must have thought it over deeply.

Reality forced him to make the most rational choice.

“I think choosing surgery is a smart move. At least after work, I wouldn’t be stuck sitting around practicing the basics of a steady hand. Your daily dedication shows genuine passion. But surgery itself is subdivided into many fields—sounds like you haven’t entirely given up on being a generalist!”

Although Zhou Can had a system to track his medical experience, he wasn’t confident enough to call himself a generalist.

In the future, Jin Mingxi might have to narrow his focus further, yielding to reality.

“I’ve already given up on Internal Medicine. Which surgical subspecialties to pursue? I guess I’ll figure it out step by step.”

As they talked, they arrived at the Neurosurgery Department of Tuyu Hospital.

This time, they found the doctors’ office with little difficulty.

Following the usual procedure, they first filled out forms.

The resident coordinator, Liu Yongquan, a man in his early forties, was tall and lean with abundant, slightly yellowish hair on his face and hands—a reminder of an imperfect evolution with some simian traits.

“Everyone, fill out your forms carefully. There are twenty residents in total—you’ll be split into two groups, alternating between the Inpatient Department and the Operating Room for standardized training.”

Generally, residents without a practicing certificate are seldom assigned to the Outpatient Department.

In theory, after graduating from medical school, it takes about a year and a half to pass the licensing exam—assuming everything goes smoothly.

The Neurosurgery Department is renowned as the pinnacle of surgical departments.

Its operations are known for being high-end and precise.

Though its surgical volume is not as high as Orthopedics, its revenue is equally impressive.

A single aneurysm operation in Neurosurgery can cost over a hundred thousand.

During his internship, Zhou Can encountered an unlucky patient with four aneurysms that cost over 540,000 in total.

The diseases treated in Neurosurgery can be roughly categorized as follows:

Cranial injuries, such as skull fractures, brain contusions, and cerebral hematomas.

Many assume that craniotomies are solely within Orthopedics’ domain, but that would be an underestimation.

Orthopedics primarily deals with bone trauma, joints, and ligaments. Asking them to perform brain surgery is like expecting a child to solve a university-level problem.

It’s simply too much to ask.

The second category covers vascular diseases—aneurysms, arteriovenous malformations, etc.

The third category includes functional disorders—trigeminal neuralgia, glossopharyngeal neuralgia, epilepsy, and convulsions.

This illustrates how top-tier departments are deeply interconnected.

Orthopedics’ surgeries often involve the spine and neck, where nerves are present, necessitating the collaboration of neurosurgeons.

In vascular procedures, neurosurgeons might call on other surgical specialists for help.

When treating functional disorders, they may even require assistance from neurologists or urologists.

Thus, the field of medicine has never been truly compartmentalized.

All specialties are intricately linked.

“Have you all finished? Now, I will randomly assign tasks. With twenty residents, you’ll be paired up, each team responsible for roughly ten beds. In our Neurosurgery Department, there are 125 beds in total, including four intensive care units with 20 beds. You will be in charge of the remaining 105 general beds.”

The patient numbers in Neurosurgery are relatively low.

However, the length of hospital stays is considerably longer.

In General Surgery, many patients are discharged after two to three days, whereas in Neurosurgery, a stay of ten to fifteen days is considered fortunate.

“For the beds assigned to you, if the patient hasn’t undergone surgery, you must follow up. And when the patient is in surgery, you’ll have the opportunity to observe in the Operating Room. Whether you get a chance to assist depends on whether the lead surgeon is willing to delegate responsibility.”

Different departments have distinct residency training mechanisms.

The Neurosurgery Department requires its residents to follow a patient through every stage.

From admission to discharge, they are responsible for the entire hospitalization.

This system actually works quite well.

It assigns clear responsibility and makes management more precise.

“A special note: Even if a Neurosurgery patient is in a general bed, never let your guard down—danger can strike at any moment. If something goes wrong, the attending, the admitting doctor, and the department head will all share the blame. And the resident assigned to that bed won’t escape any penalty. In our department, the minimum punishment for such an incident is the cancellation of your residency qualification.”

Dr. Liu spoke very seriously.

His words weighed heavily on every resident.

Cancellation of residency essentially means the end of one’s career.

In other words, there is zero margin for error.

“Zhou Can and Jiang Xiaohua, you’re in the first group—responsible for beds 21 through 31. Jin Mingxi and Chen Hao, you’re in the second group—handling beds 32 to 42…”

There are 105 general beds in total.

The first five groups are assigned 11 beds each.

Their workload is slightly heavier than that of the later groups.

Zhou Can didn’t mind—in fact, more beds meant more opportunities to assist in surgery.

Every extra bed was a chance to hone his skills in the Operating Room.

Having already elevated many advanced medical techniques to a near-attending level, plus his natural gift for nerve anastomosis, if Director Xie ceases to hold him back, these next two months in Neurosurgery might offer him plenty of hands-on opportunities.

In short, he was quite confident.