Chapter Seven: Matters of Orthopedics — Little Zhang Calls the Shots

After the surgery, Nur wanted Zhang Fan to take care of the patient, but Zhang Fan declined. Although money was tight, performing more surgeries was more urgent. Chen Qifa would probably be pleased if Zhang Fan only did surgeries without managing patients—the surgical hardware commissions were split three ways, but the medication commissions went solely to Chen. Zhang Fan still needed Old Chen as his assistant; he couldn’t rely on Nur.

Orthopedic surgeries were unpredictable—some days no patients arrived, while on others, there were surgeries every day. Zhang Fan’s position in orthopedics was now firmly established. Old Nur trusted him completely and hadn’t come to the hospital for days, nearing retirement and largely neglected by the director. After completing surgeries, they signed off with Old Nur’s name. Despite consecutive surgeries over several days, Zhang Fan was still far from meeting the criteria to open a new specialty, so he reviewed trauma and rehabilitation again, gaining many new insights.

Before performing surgeries, Zhang Fan had to humble himself, begging doctors in other departments to let him assist. Now it was different; others regarded him as a lead surgeon. After several days of continuous surgeries, there followed long stretches with no patients. Quark County’s population was small—just over a hundred thousand—and many distrusted the county’s medical standards, preferring to seek treatment for serious illnesses in the city.

With no surgeries to perform, Zhang Fan focused on rehabilitation, which still required hands-on practice. Like a door-to-door salesman, he asked everyone, including hospital doctors and nurses, “Anyone with disc protrusions or hypertrophy? Need a massage?” The system’s rehabilitation involved practical treatments such as hands-on manipulation for herniated discs, repositioning for lumbar bulges, and massage therapy for lumbar muscle strains.

Most older nurses suffered from lumbar spine issues, a common occupational ailment. The head nurse of the External Medicine Department was Zhang Fan’s first rehabilitation patient. “Doctor Zhang, my waist and legs are numb and sore. When I sit, I can’t stand up; when I stand, I can’t sit down. Can you take a look?”

“Nurse, you have a herniated lumbar disc pressing on a nerve. It’s not severe. I’ll give you a course of rehabilitation; you should feel better. Try not to sit for long periods or lift heavy objects to avoid recurrence,” Zhang Fan examined Guli’s CT scan.

“Huda, if it eases the pain, I’ll thank the heavens,” Guli said, clearly without high hopes. She had already visited a hospital in the frontier capital, where they recommended surgery, but she was too afraid and opted for conservative treatment before returning. Normally she endured the pain, but recent fatigue worsened the discomfort. Since Zhang Fan was asking around, she came to him for a try.

Western rehabilitation massage differed significantly from traditional Chinese principles, which emphasize meridians and acupuncture points. Western methods were simpler and more forceful. For lumbar disc herniation, different postures and external force were used to press the protruding disc back into place. Zhang Fan had Guli lie on her side, hands behind her head. His left hand gently pushed on her pelvis while his right hand softly pulled her shoulder, creating a torsion that gradually repositioned the disc.

After more than an hour, Zhang Fan helped Guli off the bed to see if there was improvement. She moved slowly, cautiously stretching her waist. Then she turned her head, eyes wide, grasping Zhang Fan’s hand. “My brother, it’s clearly much better than before.” She kissed his cheek. Guli was in her forties, and among the Uyghurs, family members often exchanged affectionate cheek-to-cheek greetings. Her waist had tortured her terribly; any relief was wonderful news. Zhang Fan’s face flushed instantly.

“Haha, my brother is shy now. How about I introduce you to a ‘yanggangzi’ [wife or girlfriend]?”

Married women, regardless of ethnicity, were equally feisty. Zhang Fan was a bit overwhelmed and quickly escaped the treatment room, retreating to the doctor’s office. Guli laughed heartily as she watched him flee.

With Guli as an example, more elderly nurses came to Zhang Fan for lumbar treatment. Though exhausted, Zhang Fan was delighted, feeling closer to opening the next specialty.

“Ah, our friend of middle-aged and elderly women has finally returned. I thought someone had dragged you home,” Li Hui joked, lighting a cigarette. Many nurses had sought Zhang Fan’s help recently, giving Li Hui reason to tease.

“Stop talking nonsense. Why didn’t you go see Sasha today?” Zhang Fan replied casually, knowing Li Hui meant no harm.

“I was waiting for you.”

“For what? To borrow money? My pockets are cleaner than my face; don’t have any ideas about me.”

“Am I the one short on cash?” Li Hui scoffed.

“You used to smoke 10-yuan Snow Lotus cigarettes; now it’s 5-yuan Red River. If you’re not short on cash, that’s odd.”

“Ah! I can’t help it—Sasha limits me to fifty yuan a month on cigarettes; not a cent more. But don’t worry, I won’t borrow from you. A few days ago, Sasha and I found a Han Chinese restaurant with great flavors. Their braised pork was authentic—after eating the hospital’s beef and lamb, I was about to be sick of it. Today neither of us is on duty; eating just the two of us feels dull, so we want to invite you along.”

Zhang Fan immediately refused. “You two lovebirds’ world is not for me, a lonely dog. I’d just be heartbroken.” He didn’t want to intrude on their couple time, and besides, his meals at the hospital were subsidized and cheap. Going out to eat—especially if Li Hui was treating—would mean reciprocating next time, and Zhang Fan was saving for his sister’s tuition.

“Stop whining. Let’s go!” Li Hui dragged Zhang Fan out without argument. Li Hui’s invitation had ulterior motives: Zhang Fan’s skills were well-known, and being close to a dorm mate had its benefits; also, Li Hui and Sasha hadn’t been intimate since arriving at the hospital nearly two months ago. Zhang Fan was single and not the type to gossip, so getting closer meant Li Hui could enjoy private time with his girlfriend in the dorm without worrying about Zhang Fan.

The three chatted and ate, the atmosphere pleasant. Li Hui and Sasha didn’t tease Zhang Fan too much. Mid-meal, an orthopedic patient arrived: a 15-year-old Han boy from the pastoral area with syndactyly. Due to limited contact with the outside world, he hadn’t received treatment as a child. Only after relatives persuaded him did he come to the county hospital.

Today, Tuxun was on duty in the External Medicine Department. Seeing the patient, he immediately called Deputy Director Shi Lei. Transfers from the county hospital required the department head to seek approval from the director; since this wasn’t a neurosurgical case, Tuxun didn’t want trouble and called the deputy directly. Director Nur was unreliable and likely already unconscious from intoxication.

On the phone, Shi Lei told Tuxun, “For orthopedic matters, start with Xiao Zhang.”