In the emergency department office, Director Zhang Ming stared at the X-ray with a deeply furrowed brow.
"Three tibial fractures. Clean breaks, in four segments," he muttered.
"Life is truly hard for laborers."
He sighed, setting the film down, then turned to the group of interns.
"Wang Xiaobei, notify the OR. Also, get in touch with Director Liu from orthopedics. The fractures are severe—I want him on the table with me."
"And have a nurse run a CBC. We'll need those results before surgery."
The patient was young, with no underlying conditions, and his cranial CT had come back clean. A simple blood test would suffice before proceeding.
Xia Tian glanced at Director Zhang and asked tentatively,"Director, how will we approach the surgery?"
Zhang Ming took a sip of tea from his cup, settling into a more professorial posture as he addressed the interns.
"Though the fractures are closed, the tibia has split into four sections. There's no way we can treat this conservatively."
"This requires an open reduction with internal fixation using steel plates."
"For this particular case, we'll need three plates."
It was a standard orthopedic procedure: stainless steel plates used to realign fractured bone segments. After about a year of healing, a second operation would be needed to remove the plates—only then would the recovery be considered complete.
The plates themselves came at a cost.Domestic ones ran around 3,000–4,000 yuan apiece.Imports? Easily 20,000–30,000.
Most patients opted for domestic options.Three fractures meant three plates—at least 10,000 yuan in materials alone.And let's not forget the pain of a second surgery.
As the surgical steps played out in his mind, Xia Tian hesitated, then finally spoke.
"Director, since this is a closed fracture, could we try manual reduction and casting instead? It would avoid surgery altogether—and there's no need for plates or a follow-up operation to remove them."
"The recovery time is comparable, and casting avoids incisions, which means less pain for the patient."
"So... I was wondering if we might consider manual reduction as a treatment option?"
Manual reduction, as the name suggests, involved realigning the bone fragments by hand—guiding the broken pieces back into place.
Steel plates hold the bone together externally; manual reduction achieves the same outcome internally—with less cost and less trauma.
Zhang Ming smiled, his voice warm.
"First of all, I want to commend you. Raising this shows you're truly thinking—putting the patient first."
"But three fractures make manual reduction extremely difficult."
"When Director Liu gets here, I'll run your idea by him. He's an orthopedic expert with over 20 years of clinical experience. If he thinks it's viable, we'll definitely go the manual route. It would certainly be better for the patient."
His tone was gentle, his gaze kind.
Xia Tian nodded earnestly. "Thank you, Director."
Just then, Wang Xiaobei shuffled over with a grin, asking,
"Director, about that tumor patient yesterday—the oncology department says it's cancer. If that's true, then—"
Before he could finish, Director Zhang's expression turned fierce.
"The tumor case is now under oncology. If you've got questions, ask the oncologists."
"Can't you see I'm busy?"
"And for heaven's sake, you've got a postgraduate degree—eight years of medical school under your belt. When you don't know something, go read the literature! Do your research. That's how you retain knowledge."
"Stop coming to me with every little thing. I'm not your damn nanny."
"Now get out of here, you're wasting my time."
Wait a minute...
Weren't you just encouraging us to ask questions?
This... wasn't the script anyone expected.
Same group of interns—yet such vastly different treatment.
Wang Xiaobei looked like he was on the verge of tears, clutching his plump little self in despair.
Ten minutes later, Yang the chubby intern returned with the blood report.
"Director, CBC is normal. Liver and kidney functions are good. No Hep B, no HIV."
"He's clear for surgery."
"Good." Zhang Ming rose slowly, took one last sip of tea, and removed his lab coat.
As he headed toward the OR, every intern in the room stood at attention, eyes blazing with admiration.
Moments like these turned fresh interns into wide-eyed dreamers, gazing at their surgical idols the way a lovestruck girl might gaze at her crush.
The Director would take two or three interns with him during surgery, explaining procedures in real time—a golden opportunity for learning.
Zhang Ming glanced at the sea of hopeful faces.
"Xia Tian, Fatty, Li Xiaohong—you three, come with me."
The chosen trio lit up, racing to scrub in and change.
The rest? Devastated.
Intern #1: "Why didn't he pick me? Is it because I'm short?"
Intern #2: "You're not just short—you're ugly. Director probably worried he'd throw up mid-surgery from seeing your face."
"Oh screw you!"
Intern #1 huffed. "Then why didn't he pick you, huh?"
Intern #2: "Because I'm too beautiful. In such a high-concentration environment, my looks would be a distraction."
"Blegh!"
They bantered a bit, then Intern #1 puffed his cheeks in frustration and muttered,
"Director totally plays favorites with Xia Tian."
"We all graduated together. We're all interns. How are we supposed to learn if he keeps choosing the same people?"
"I did the math—Xia Tian scrubs in twice a week. The rest of us? Once a week if we're lucky—sometimes once every two weeks."
"Why is the gap so big?"
"Seriously, what gives?"
The room fell silent.
He looked up to find everyone glaring daggers at him.
Terror seized his gut. He immediately changed course.
"Long live Brother Tian!"