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Chapter 46

Plague Doctor
     Chapter 46: Surgery, Dissection, Psychiatry

    On the morning of the first day of training, Zhou Jiaqiang taught the five students ligation.

    At noon they had a meal in the cafeteria of the training centre, took a break, then went back to continue the afternoon portion of training: ligation.

    Ligation was also one of the most crucial fundamental techniques in surgery. The methods of ligation, also known as sutures, were mainly divided into intermittent and continuous. Commonly used methods were simple intermittent suture method, double intermittent suture method (8-shaped suture), simple continuous suture, running locking suture, relaxation suture, interrupted inverted sutures, continuous inverted sutures…

    These different suture methods have different uses and need to be selected according to the type of injury.

    "You must take note that when dealing with deep wounds, do not sew at the deepest level. You should only sew at skin level. This is the main way to avoid the formation of surgical dead space."

    Zhou Jiaqiang used the projector screen to match his teaching and played some pictures of surgical sutures. "Dead space would not only prevent the edges of the wound from closing, but also lead to blood clotting, fluid accumulation, and even secondary infection. All these would delay the body's recovery, so they must be avoided at all cost."

    Just remembering the precautionary steps was enough to keep one busy, but it's not as though they could just skip these steps and begin ligation immediately. Even for Wang Ruoxiang and Sun Yuheng, they had to proceed one step at a time.

    Even for Gu Jun, he proceeded step by step as well, but it's just that the steps he took were faster than the others. He was basically familiar with all the procedures in one afternoon, but there was still a long way to go from mastering them.

    

    This day did not end there, and training continued at night. Zhou Jiaqiang taught them about thread trimming, suture removal and dressing change, some hemostatic operations, as well as the similarities and differences between tissue incision, separation, and dissection.

    "Is today supposed to overload us with information?"

    After ten o'clock just before dismissal of the classes, Zhou Jiaqiang gave the most solemn look today and preached to them, "Yes, the current situation means that there is no time for you to learn slowly. The Clinical Team is expecting you guys to quickly become the third and second assistants, and let the original third and second assistants to rise up and become the primary surgeon. Don't slack off, burn every information of your textbooks into your minds. In your spare time, take some fruits to practice sewing. Grapes or even bananas will do. The dormitories will provide them."

    Everyone nodded in agreement. Brother Qiang was merely a guide to help initiate them. The degree to which they can reach after entering this mysterious world depends on their own efforts.

    "First, lay the foundation using simulations, and then, we will conduct practical training on experimental animals in the second half. I hope you will be ready before then. Good luck!"

    When Brother Qiang officially announced the end of class, it was past 10:30 and everyone ended the day's training and returned to the dormitory together.

    During the quarantined training period, they were required to only have two destinations and one pathway between them. Their authority only sufficed for them to enter the training centre and dormitory building. There were no entertainment facilities, but there were gyms on the second floor of each dormitory. However, after training for the entire day and considering the fact that they still have to continue training early in the morning, most of them chose to go back to the dormitory to sleep directly.

    Gu Jun didn't go to sleep. Instead, he used surgical instruments to suture the grapes at the desk of his bedroom.

    First, cut the skin with a scalpel, then use tweezers to remove the seeds. Finally, use a needle holder to sew the needle using catgut and stitch it.

    The night sky outside the window was pitch-black, but Gu Jun was still intently practising over and over again and digesting what he learnt that day.

    ***

    For the next five days, Gu Jun and the others continued the rapid tempo of the first day of training. Following Brother Qiang to simulate the ligature methods of various tissues and organs, as well as specific operations of some surgical procedures. As for dissection, it was of even more importance.

    One's enthusiasm for learning would mutually inspire the other. Gu Jun's outstanding performance drove the others to work harder. Brother Qiang often sighed with emotion after seeing this.

    "You are the best batch of students I have ever taught!" Zhou Jiaqiang praised them regularly, which made Cai Zixuan and Jiang Banxia feel inordinately proud.

    Gu Jun had strong suspicions that Brother Qiang would say that sentence to every new batch of students.

    After the first phase of forensic surgical training had ended, the five of them rushed to proceed for the internal medicine training which was taught by another female instructor, Huang Ying.

    As for Zhou Jiaqiang, he took charge of the next batch of six students. All were medical "slaves" from the neighbouring cities of Eastern City and were selected from the skill competition.

    Everyone coincidentally bumped into each other when they were dining in the cafeteria and started exchanging numerous gossip. Sure enough, Brother Qiang had said that they were the best batch he ever taught.

    Gu Jun was also interested in the skill competition in their respective cities and inquired about their situation. They came from four different cities, and they only saw the Malformed Banyan after winning. Moreover, the dissection section of the contest was only for the malformed limb specimens from patients suffering from Malformed Banyan Disease.

    ‘It seems that the number of heterogeneous creatures with lamellar bones is not large,' Gu Jun thought, ‘and the students in Eastern City have been evaluated with the most stringent standards.'

    In the first few days after beginning internal medicine training, the itineraries of Gu Jun and the other four gradually diverged.

    He had more training items arranged. In addition to clinical training, he had to undergo anatomical dissection training as well.

    Gu Jun no longer required foundation training on the dissection table and received more theoretical questions regarding the heterogeneous creatures. When facing the unprecedented appearance of such creatures, there were still many limitations even with the help of modern technology.

    "Ah Jun, you have to prepare yourself for dissection in the wild sometime in the future," Yu Xiuyan, the anatomy trainer, told him. "There would be no help; just you and some anatomy tools. Matters such as how to bring back the anatomical structure of the creature will depend on your skills then."

    The wild? Gu Jun still couldn't understand the specific meaning behind these words.

    Anyway, learning about heterogeneous anatomy was precisely what he desired, but the scope of what he could know and learn was quite limited with the authority of an intern.

    Interns were not formal employees of the Phecda Department. Their contracts were not even signed yet.

    In addition to anatomical training, Gu Jun also received mental and psychological training and gained access to some elementary knowledge compiled by the Phecda Department. It consisted of information such as the mental impact of heterogeneous creatures like the Malformed Banyans on humans and the stress-induced obstacles that may occur as a result.

    Stress-related disorders referred to a type of mental disorder that had a clear causal relationship with the source of stress. The timing, symptoms, course, and prognosis were closely related to stress factors. It was perhaps most widely known as "post-traumatic stress disorder (PTSD)".

    The "source of stress" refers to the stimulant acting on the individual and causes it to produce a response. The sources of stress for humans were very diverse. Psychiatry divides stress sources into three categories according to different environmental factors: external environment, individual internal environment, and social psychological environment.

    The Malformed Banyan Disease and the Malformed Banyan was an example of a source of external environmental stress. After witnessing the terrifying form of the Malformed Banyan, not everyone could acclimate themselves. Their reactions ranged from being mild such as nightmares or the worst-case scenario of having acute panic attacks. It was not just vomiting.

    If not adequately handled over time, it would cause irreversible damage to the body's nervous system and even result in abnormalities in brain structure and function.

    If that happened, the employee could no longer work for the Phecda Department and may even no longer be considered a normal person.

    The focus of psychiatric trainer Luo Mingtao's teaching on Gu Jun was to let Gu Jun recognise the cognition, diagnosis, and emergency treatment of stress-related disorders.

    "Ah Jun, you have to learn how to deal with the stress response of personnel in the wild," Luo Mingtao also taught emphatically. "Those sources of stress may very well be the first time our Phecda Department encountered them. With your colleagues about to go crazy, how would you go about medication and psychotherapy? It depends on you."

    As Gu Jun learned these things, he was able to gain a better understanding behind the meaning of the test questions during the review. The people in this mysterious circle were still humans after all. They did not have three heads and six arms. If they can't keep a clear mind, it would only cause trouble.

    He also heard something curious in his words. What exactly was the wild?

    Teacher Luo and Teacher Yu's words almost mimicked each other. It seemed as if the interns were going to the wild in the future?

    Gu Jun asked Cai Zixuan when he returned to the dormitory, but Cai Zixuan was puzzled as well. "The wild? No. None of the teachers told us anything."

    How could Gu Jun not understand this time? The "wild" should be a special arrangement for him. He just didn't know what kind of arrangement it was.

    ***

    In the blink of an eye, half a month had passed. It was September.

    Gu Jun in the Medical Department of the Eastern Branch of Phecda Department got up early and went to bed late every day. Clinical, anatomy, mental, psychology. He was like a sponge, crazily absorbing medical knowledge in every aspect everyday.

    During this period, he had also completed 6 NORMAL missions. The missions were all related to forensic surgery such as completing 500 stitches and 300 ligations. He got 6 boxes of medicine as a reward. His Hands of Dexterity rose in proficiency as well. It was now at the second tier (3000/30000 proficiency).

    The 6 NORMAL missions added 1500 proficiency, while the remaining 500 were the fruits of his own training.

    Every time the proficiency exceeded the thousand point mark, his hands seemed to gain a new sensation, and he grew increasingly proficient in various surgical operations.

    The medicine box of foreign medicines was a source of headache for Gu Jun though. Gu Jun dared not leave it in the dormitory, so he hid them inside the cubicle of the bathroom after getting a box. He manually shredded the medicine box into ripped bits of paper, and then flushed everything down the toilet; not even leaving a trace of evidence.

    He similarly handled the 6 medicine boxes. No one had come to interrogate him, so he was rather sure that there were no pinhole cameras or any such surveillance devices in the bathroom.