Chapter 124: A Critical Turn in the OR

Du Leng seethed with anger inside, yet his smile never faltered.

After all, as a PhD who studied overseas, he wouldn’t risk quarrelling with Zhou Can over such baseless accusations.

“Dr. Shan, have you brought a new trainee with you?”

Du Leng’s gaze casually fell on Zhou Can’s face.

Dr. Shan turned to Zhou Can and introduced him with a smile.

“He’s a newly rotated trainee in Orthopedics. Whether I get to mentor him remains to be seen!” If Zhou Can is as outstanding, there’s even a chance the Director might personally train him.

After all, she was just recently promoted to Attending; it was plausible for her to be given ordinary trainees.

But someone as extraordinary as Zhou Can might not even fall into her rotation.

“Oh, I see! I actually know Dr. Zhou— we even joined the same trainee recruitment process. I must say, I admired him back then. He once risked being late for an exam to save a patient suffering an acute heart attack. The hospital even boosted his ethics score by 10 points, helping him clinch the top spot in this year’s trainee exam.”

Du Leng spoke admiringly, though his face betrayed no true respect.

His words dripped with malice.

It was all to imply that Zhou Can’s top score was merely due to bonus ethical points, not his real ability.

“No matter what, it’s no small feat for an undergraduate to top the overall score.”

Sure enough, Du Leng’s hidden agenda was clear.

After much beating around the bush, he essentially belittled Zhou Can.

After mentioning the ethics bonus, he drove home the point about Zhou Can’s low academic background.

“Sigh, undergraduates these days generally have little potential. Such a pity…” Du Leng shook his head and sighed, putting on a false act of sympathy for Zhou Can.

“Dr. Shan, I have other matters to attend to. I’m off.”

Du Leng’s calculated actions had one purpose: to lower Zhou Can’s standing in Dr. Shan’s eyes.

A trainee with no potential or real skill hardly makes an impression on his mentor.

The treatment they received was worlds apart from that of the elite trainees.

As Du Leng passed by Zhou Can, he smiled and said,

“Dr. Zhou, don’t worry too much. Even if you learn little in other departments, it won’t affect your future. You’re bound to return to the Emergency Department anyway—where the demands on doctors are minimal.”

Zhou Can remained expressionless, only letting out a soft hum through his nostrils.

That was as much deference as Du Leng could claim.

In his eyes, even a returned overseas PhD was no threat—true ability meant being a real contender.

If one only relied on scheming with no real skills, they didn’t even deserve the title of opponent.

He preferred dealing with rough-mannered individuals who spat curses.

Than wasting time with sanctimonious hypocrites.

Du Leng left with a self-satisfied, sinister smile, convinced his ploy had succeeded.

Little did he know, he had underestimated Zhou Can’s capabilities.

Having spent less than two days in Orthopedics, Zhou Can had already made an impression. His real skill had earned early praise from both Dr. Shan and Chief Resident Shen.

His chances of being sidelined had really diminished.

……

After a quick meal, the four quickly returned to the Operating Room to continue the surgery.

Du Leng’s words had no impact on Zhou Can.

Dr. Shan still assigned him as First Assistant.

Throughout the surgery, Zhou Can performed superbly. The other trainees, realizing they couldn’t compete if they didn’t seize any opportunity, scrambled for chances to prove themselves.

They all began vying for any role in the operation.

Dr. Shan would at most delegate tasks like hemostasis or suturing to them.

In the end, after several rounds, Dr. Shan stopped giving them any chances.

Simply put, compared to Zhou Can, the five other trainees were far behind. Why use an attending-level first assistant when you could let in less experienced trainees making messes, unless you were out of your mind?

Around five in the afternoon, Dr. Shan pointed at the monitor’s report and said to the trainees, “This is a patient with avascular necrosis of the femoral head. It’s clear that the blood supply has been lost, and like a withered tree, it will soon shrivel and collapse.”

Zhou Can listened intently.

He considered his knowledge of Orthopedics rather meager.

Yet three months of orthopedic training would surely compensate for that gap.

It would familiarize him with most orthopedic diseases, their treatments, pathology, and mechanism.

He hoped that by the end of the remaining 33 months of training, he’d return to the Emergency Department fully capable of helping it expand rapidly.

That was also his promise to Director Lou and Dr. Xu.

“How should we treat femoral head necrosis? Anyone know?”

Dr. Shan posed the question to the six trainees.

“Total hip replacement!”

“With necrosis, replacement is the only option, isn’t it?”

After listening to their answers, she gently shook her head.

“I’ve read about another method in medical texts—I grasp the general principle, though I’m not clear on the exact procedure.”

Zhou Can answered.

“Oh? What method is that?”

Dr. Shan was curious to see if Zhou Can’s knowledge was deep enough.

“Artificial hip replacement is the last resort. There’s a less costly salvage method called bone grafting. There are two approaches: one uses a vascularized bone flap implanted into the necrotic femoral head—a procedure that’s very challenging; the other involves drilling and packing the area with bone fragments to reduce intraosseous pressure and stimulate blood supply restoration, if the necrosis isn’t too severe.”

Zhou Can realized that his habit of reading paid off greatly at critical moments.

As the old saying goes, ‘Reading enriches the mind.’

Dr. Shan announced, “Our surgery today will involve transplanting a vascularized bone flap to salvage the necrotic femoral head.”

Her face brimmed with pride as she outlined the high technical demands of the procedure.

The name alone suggested immense complexity.

For a newly promoted Attending to perform such a challenging surgery was truly a matter of pride.

The patient was swiftly wheeled into the Operating Room.

The Anesthesiologist hurried over as well.

In Orthopedics, the Anesthesiologist was in high demand.

There was no way around it; many of their surgeries were major operations.

Both spinal and general anesthesia had to be administered by specialists.

At this level of surgery, the risks were very high.

The patient, a petite woman in her mid-thirties, was modestly covered by a blanket on her lower body.

In the doctors’ eyes, gender was irrelevant. In her case, even her undergarments were removed during surgery, no doubt causing her some embarrassment.

But compared to relieving her pain, such details seemed trivial.

After a swift examination, the Anesthesiologist proceeded with general anesthesia.

Perhaps considering the patient’s comfort was why general anesthesia was chosen.

Normally, an epidural would also have sufficed for this procedure.

“Anesthesia’s in place—vital signs are stable. We can begin surgery,”

the Anesthesiologist reported routinely.

Dr. Shan, having performed several surgeries, normally appeared relaxed.

Yet now her expression was gravely serious.

“This operation has two significant steps. First, assess the degree of necrosis in the affected femoral head. If it’s mild, drilling and filling with bone graft might work. However, with a case as severe as this, simply reducing intraosseous pressure won’t suffice. We need to rebuild the blood supply.”

As she taught while operating, the intricate procedure captivated not only the six trainees but also Dr. Tang and another intern, who watched intently.

Thanks to his role as First Assistant, Zhou Can had front-row access to every surgical step.

“First, determine the size of the area to graft, then isolate one or two sets of vessels.”

She picked up a scalpel and cut through the patient’s skin and fat layer.

Zhou Can quickly assisted with hemostasis.

Once the collapsing femoral head was exposed, Dr. Tang stepped in to retract, offering a clearer view.

The most challenging part was isolating the two sets of vessels.

She proceeded with great caution.

Isolating the first arterial vessel went relatively smoothly.

However, while helping with retraction, Zhou Can noticed that her technique was rather weak—barely at an intern’s level, nowhere near that of an Attending.

After all, vessel isolation was a high-level skill that was difficult to master and improve quickly.

That said, her current proficiency was still commendable.

Many Attending physicians might even be less adept than her at isolation.

When she attempted to isolate the second venous vessel, the severe collapse of the femoral head greatly increased the difficulty.

Time ticked by slowly.

Sweat streamed from her forehead as the Attending Nurse continually dabbed her brow.

Despite wearing a head cover, the strands of hair at her temples were soaked with sweat.

“This vessel’s isolation is too challenging. I’m afraid we need Chief Resident Shen to take over.”

After several attempts, progress was slow and the isolated vessel was carelessly handled; at one point, the vessel’s wall almost tore.

“Please call Chief Resident Shen for me!”

She instructed the Attending Nurse.

Momentarily, she halted the surgery.

The phone connected quickly.

“Professor, I’ve hit a snag. The patient’s femoral head necrosis is far worse than expected. I can’t handle the vessel isolation—my skills aren’t adequate. I need you to take over.”

This highlighted the necessity of having a capable mentor around.

In critical moments, calling on your own teacher was the safest and most reliable option.

Bothering another superior could violate hospital norms, and you might end up being reprimanded severely—or even demoted, losing future access to similar surgeries.

After all, Zhou Can’s mentor was Dr. Xu.

His direct line was given to him, with assurances that even at three in the morning, he’d be there to help.

Who else would you call at 3 AM?

“Alright then, I’ll wait for you!”

With a tinge of resignation, she ended the call.

Zhou Can, listening nearby, caught most of the conversation. Chief Resident Shen seemed tied up with an important surgery and couldn’t come immediately.

This complicated the matter.

Chief Resident Shen wouldn’t arrive for a while, leaving the patient exposed with an open wound and little cover.

Facing a surgical impasse, Dr. Shan, constrained by her own limitations, could do nothing but wait.

Time slipped by.

Anxiously, Dr. Shan’s face grew more worried as she wondered when Chief Resident Shen might arrive.

She hadn’t expected the surgery to be so demanding.

Now, caught in a bind, she was beside herself with worry.

“Dr. Shan, may I have a go?”

Mustering his courage, Zhou Can asked.

He was well aware that Dr. Shan wouldn’t even let him cut the skin normally.

How could she possibly allow him to handle such a critical vessel isolation?

Dr. Shan glared at Zhou Can sharply.

“What did you say?”

“I’m asking if I can isolate the vessel. In the Emergency Department, I’ve even isolated intestines before.”

Quickly, Zhou Can recounted his successful experiences.

“What surgery requires you to isolate intestines?”

She stared directly into his eyes.

“Appendectomy!”

Though she hadn’t performed that surgery herself, she was familiar with its steps.

It indeed requires separating the mesentery from the intestines—a procedure not without its challenges.

“Are you sure you can manage it?”

“I wouldn’t claim perfect certainty, but I’m more than 90% sure!”

Dr. Shan weighed her options, torn about whether to let this eager trainee proceed.

After all, Zhou Can had consistently proven his excellence.

In the end, she decided to take a calculated risk and let him try.

It was risky but within manageable limits.

If Zhou Can faltered, she would immediately step in.

“Go ahead—but be extremely careful. If you lose control at any moment, stop immediately. Try to show off, and I’ll cancel your training privileges on the spot.”

Her harsh warning sent a clear message.

Though she had no real means to cancel Zhou Can’s training, punishment would be inevitable.

After all, Zhou Can hadn’t done anything unforgivable.

“Dr. Shan, are you really willing to let him try? He’s only a trainee!”

Dr. Tang tried to dissuade her.

Any mishap would also implicate him, after all.

“There’s no better alternative right now. A man’s eyes never lie—his gaze exuded unyielding confidence. Let him try!”

Dr. Shan explained.

Zhou Can moved to Dr. Shan’s position, taking the scalpel from the instrument nurse, and began isolating the venous vessel.

An expert’s touch reveals true skill.

The onlookers, impressed by Zhou Can’s composure, began to believe he truly possessed the talent.

With one swift cut!

The vessel remained intact—he had successfully isolated a short segment.

Dr. Shan’s heart nearly sank.

As Zhou Can made a second incision, her anxiety spiked. Every movement of his scalpel had her holding her breath, prepared to call a halt at the first misstep.

“Uh… is this really vessel isolation? It almost looks like you’re peeling sugarcane.”

She noted how Zhou Can’s cuts were decisive, in stark contrast to her own overly cautious approach.

Her heart raced like a roller coaster with every rise and fall of his scalpel.

She couldn’t help but feel anxious—any mistake and the responsibility would fall squarely on her shoulders.

Zhou Can’s pace quickened. That once-difficult venous vessel practically yielded to his expert hands. In only about five minutes, he had successfully isolated it.

Remember, Dr. Shan had taken nearly half an hour for the first arterial vessel.

The difference in skill was stark.

After all, she was the lead surgeon and an Attending physician!

Moreover, vessel isolation was an art that tested one’s finesse.

“Dr. Shan, the vessel has been isolated!”

Zhou Can signaled his readiness to step aside and hand back the scalpel to the nurse.

“Excellent work! But we’re not done yet, Dr. Zhou—keep going,” Dr. Shan said with a smile.

It was only then that everyone recovered from their stunned silence.

They looked at Zhou Can as if beholding a marvel.

“I’ve been in the OR for four years and never seen such talent from a trainee. Tell us the truth, Dr. Zhou—are you really just a trainee?”

Dr. Tang, already a senior intern, was equally amazed.

After witnessing Zhou Can isolate that challenging venous vessel so masterfully, he was convinced that even Chief Resident Shen might not match his speed.

“We’re done for as a trainee group! With someone this extraordinary, how can we compete?”

A fellow trainee lamented, his words echoing the group’s sentiment.

“We’re not competing against another trainee—we’re up against an Attending,”

another dejected voice added.

Zhou Can smiled modestly and defended himself, “I just happened to be skilled in vessel isolation.”

“Dr. Zhou is good at a lot of things—puncture, hemostasis, suturing, vessel isolation… and that’s only in one day. Who knows what else he’s capable of? I give up. It’s not that I’m scared—it’s just that our opponent is too strong.”

One particularly talented trainee said dejectedly.

“Alright, enough flattery. Let’s hold our tongues until this surgery is done. No more idle chatter—it could jeopardize Dr. Zhou’s work.”

Dr. Shan commanded silence sharply.

Otherwise, with back-to-back praise for Zhou Can for half an hour, who knows if the surgery might go awry?

Vessel isolation was too risky.

Any slip-up that compromised Zhou Can’s work would have dire consequences for her.

Zhou Can continued isolating vessels.

One after another, he worked steadily.

Just as he was about to finish isolating the final vessel, Chief Resident Shen rushed in to assist his mentor, Dr. Shan.

Barely inside the OR, a glance nearly made him wet his pants.

A young, unfamiliar male doctor was now the lead surgeon?

“Dr. Dan, what’s going on?”

“Professor, you’re here!” Dr. Shan greeted him quickly. “Dr. Zhou’s isolation skills are exceptional—I wasn’t sure when you’d finish your surgery, so I let him try. And as you saw, he did remarkably well.”

Chief Resident Shen’s eyes remained fixed on Zhou Can’s scalpel, and his astonishment was evident.

“I hadn’t completed my own surgery—only the most critical part—before I had my assistant step in. I was planning to help finish isolating that vessel. Instead, I got an unexpected delight. Dr. Zhou truly lives up to his reputation. No wonder even Director Xie has mentioned him several times.”

His tone grew heavier on the mention of Director Xie.

It wasn’t praise so much as irritation that Zhou Can was outperforming expectations in the Emergency Department, doing far too many surgeries.

Perhaps Director Xie and other Surgical Department heads would soon conspire behind closed doors.

They wouldn’t let such discussions leak out.

“His fame is such that even Director Xie knows him?”

Dr. Shan asked in surprise.

“His monthly surgery count in the Emergency Department exceeds a thousand—last month it was over 1,200. Can you imagine that kind of reputation?”

Chief Resident Shen eyed Zhou Can as if sizing up a marvel.

He used to think Director Xie’s findings were exaggerated—a mere three-month trainee couldn’t be that exceptional.

But now, seeing it with his own eyes, he was utterly convinced.