The Godfather of Surgery

Dingdong! Mission completed with extra points! You've earned the third experience pack.

The interview had finished, followed by the written exam. As a former top-ten student, Yang Ping found the written exam easy to breeze through.

By noon, Sanbo Hospital provided a free lunch.

Afterward, Yang Ping decided to take a walk around the hospital.

The place was impressive—two towering buildings for surgery and internal medicine, each with over thirty floors, connected by skybridges on every level. There were other buildings as well: the administrative building, outpatient building, emergency building, medical technology building, and the Overseas Chinese building, all ranging from six to eight stories. The layout was well-planned, with everything arranged neatly.

The rooftops of the surgery and internal medicine buildings doubled as helipads, with a helicopter perched atop the surgery building, a grand sight and the hospital's signature feature.

Yang Ping also decided to visit the orthopedic department. Sanbo's orthopedic department had over a hundred beds, split into trauma, spine, joint, and sports medicine sections. Director Han Jianguo was the head of orthopedic surgery, also serving as the director of trauma orthopedics.

Orthopedics was a large department, and many big hospitals had subdivisions like trauma, spine, joints, and sports medicine. Some even had pediatric orthopedics and hand surgery. In some regional medical centers, bone tumors were treated as a separate specialty.

Top-tier hospitals even subdivided further. For example, trauma orthopedics could be divided into upper-limb and lower-limb specialists, while spine surgery could focus on cervical, thoracic, or lumbar sections. Joints could be divided into hip or knee specialties. This level of specialization was something ordinary hospitals could only dream of—only the best hospitals had this kind of setup.

There were even specialists at top hospitals focusing only on upper cervical spine fractures, like the skull base or the first and second cervical vertebrae. Such surgeries were so rare at most hospitals that they might only perform one or two cases a year, but at these hospitals, they were doing it year-round, drawing patients from all over the country.

After spending the whole day exploring Sanbo, Yang Ping had dinner at a nearby restaurant and took the subway back to his rental in the city.

Xiao Wu hadn't been around for several days, leaving Yang Ping with some peace and quiet. Out of boredom, Yang Ping decided to log into the system again, open the treasure chest, and use the new gift pack—X-ray Film Reading Training—with ten days of intensive training.

He entered the training space, and an electronic screen appeared, displaying a series of X-ray images—arms, pelvis, spine—bone fractures and diseases in abundance.

The next ten days were grueling, with Yang Ping studying thousands of X-ray images.

A few days later, he received a call—he had passed the interview and could start working at the orthopedic department. Yang Ping was so happy he almost jumped out of his seat.

On his first day at work, Yang Ping arrived early.

"Better to be early than late," he thought. He didn't consider himself a "late bird," but being early certainly didn't hurt.

He familiarized himself with the layout—duty room, male and female changing rooms, conference room, dining area, teaching room, treatment rooms, etc. He made sure he knew where everything was, especially the gender-specific changing rooms—you don't want to make that mistake.

Soon, more doctors and nurses arrived, and by 8:00 AM, shift change began. The doctors lined up in a U-shape, facing a projection. At the bottom of the U were the department head and team leaders, with doctors on the left and nurses on the right.

The doctors were all sharply dressed in shirts, dark slacks, black shoes, ties, and white coats.

The nurses had all been carefully selected, standing tall at over 160 cm in form-fitting blue uniforms, their hair neatly tied back in black mesh nets, exuding youth and vibrancy.

Among the doctors, there was one female doctor named Tang Fei. She wore blue jeans, a pale yellow T-shirt, and a white coat that fit perfectly. She stood out like a bright red flower among the male doctors.

After the shift change, Director Han Jianguo briefly introduced the new doctors, including Yang Ping. Everyone applauded to welcome them.

After a quick briefing, the nurses left the room to start their busy day.

The doctors began their morning meeting, reviewing the surgeries performed yesterday and discussing the cases for the day. X-rays were displayed, and each team took turns reporting on their cases.

One particular X-ray caught Yang Ping's attention—a patient with a fracture of the left femoral shaft, scheduled to undergo intramedullary nailing for fixation as the first surgery of the day.

However, as Yang Ping looked at the X-ray, he noticed something alarming: the femoral neck was also fractured, but this was completely absent from the shift report.

The choice of surgical procedure also indicated that the attending surgeon had missed this critical detail.

This type of fracture was known as a hidden fracture, and it was incredibly difficult to detect on X-ray and CT scans. It was almost impossible to spot with traditional imaging.

But Yang Ping had been through the system's training, where he had reviewed thousands of X-rays. His ability to spot even the smallest discrepancies was extraordinary. Even a hidden fracture was something he could catch.

If this was truly a hidden femoral neck fracture, the surgeon could easily fall into a trap. If the femoral neck fracture wasn't noticed before surgery, performing the standard procedure—approaching the femoral shaft for intramedullary nailing—could inadvertently make the femoral neck fracture worse. The fracture could go from hidden to obvious without the surgeon even realizing it.

Post-surgery, when they rechecked the X-rays, it would be a nightmare: "Wait, the femoral neck is fractured now!"

What could be done? Yang Ping imagined the scenario: the surgeon would have to explain to the patient that an additional femoral neck fracture was found after the surgery, and that another procedure would be required. This would lead to patient confusion and legal disputes.

As Yang Ping pondered this, he was notified of a new mission from the system:

Dingdong! Newbie mission three: Help a colleague avoid a diagnostic trap. Successful completion will grant the final newbie experience pack.

The system was being quite generous with its rewards!

After the X-rays were reviewed, Director Han Jianguo scanned the room: "Any questions? No? Then the meeting is adjourned."

Yang Ping had no doubt that there was a femoral neck fracture. His eyes had been trained by viewing tens of thousands of X-rays, and his diagnostic skills were honed to perfection. He needed to warn the surgeon to avoid a potential complication.

He raised his hand, and all the doctors turned to look at him.

"Yes, Yang Ping, what is it?" Director Han asked.

Some doctors had already turned to leave, but seeing Yang Ping's raised hand, they hesitated and came back.

Yang Ping thought carefully before speaking. "Could we please review the X-ray of He Jianmin's case?"

The X-ray and CT images were projected onto the wall.

"Is there an issue?" Director Han asked.

Yang Ping spoke humbly, "Sorry to take up everyone's time. I believe this patient may have a hidden femoral neck fracture. At my previous hospital, we encountered a similar case, so I'm particularly sensitive to this kind of injury."

There was a slight hesitation in the room, but the atmosphere stayed calm.

"Go ahead, Yang Ping," Director Han said.

Yang Ping continued, "I once handled a case where the femoral neck fracture wasn't visible on the pre-surgery X-rays or CT scans. But post-op, the follow-up images showed a femoral neck fracture. The patient wasn't happy about it and thought it was the surgeon's fault, leading to a legal dispute. Upon investigation, we concluded that the femoral shaft fracture had been caused by an impact from the dashboard, which transferred force through the femur. The continued impact led to the hidden femoral neck fracture. We now mandate that any femoral shaft fracture caused by such an impact mechanism must be checked with a hip MRI prior to surgery. This policy has helped us catch several hidden femoral neck fractures."

Yang Ping's words made the room silent, and several doctors were visibly nodding along.

The case in question had a small swelling in the soft tissue near the knee, which suggested a dashboard injury. Yang Ping's intuition kicked in, and he connected the dots—this was likely a hidden femoral neck fracture.

He continued, "Looking closely at the X-ray, I noticed slight disruption of the trabeculae in the femoral neck, and the CT scan showed a subtle fold in the cortical bone. I'm almost certain of it."

A few doctors in the room chuckled, but Yang Ping's seriousness gave the conversation weight.

The attending surgeon, Tian Yuan, stood up and walked to the computer connected to the projector. He reviewed the images closely.

"Hmm," he muttered, "there does appear to be some disruption of the trabeculae on the femoral neck. And this CT scan... there's a slight indentation in the cortical bone. I didn't catch that before."

At this point, Director Han Jianguo looked at Tian Yuan and said, "I think Yang Ping's right. We should double-check before moving forward with surgery."

Tian Yuan immediately grabbed his phone: "Xiao Bo, can you check if there's swelling or bruising in the soft tissue around the knee?"

Director Han gave a final command, "If there's any doubt, stop the surgery for now and confirm it first."

The doctors in the room were all craning their necks to look at the screen, trying to spot the hidden fracture, but none of them could see it clearly. They kept staring, hoping to find the same detail that Yang Ping had noticed.

The tension in the air was palpable.