Chapter 145: A Twist in the Ranks

Dr. Zou was the only one too shy to greet Zhou Can first.

During a patient’s surgery, he messed up, and Zhou Can had to cover for him—even getting an earful in the process.

Now, with Zhou Can inserting all the spring coils flawlessly, the threat posed by the patient’s cerebral aneurysm is neutralized. The skill gap between him and his colleague is blatantly obvious.

“Who is your training supervisor now, Xiao Zhou?”

Director Wen’s question hinted that he already had designs on this talent.

Top doctors aren’t the only ones drawn to promising young talents; even those with weaker surgical abilities crave exceptional trainees.

After all, securing a reliable subordinate could ease many burdens.

Their value was undeniable.

“I’ve been working in the Inpatient Department with Dr. Cheng Gang—doing rounds and following up on surgeries,”

Zhou Can replied truthfully.

“Cheng Gang? The resident in charge of beds?”

One could only imagine Cheng Gang spitting blood upon hearing that.

After all, he was a resident capable of independently managing patients, yet the department’s chief barely remembered his name.

The General Surgery Department didn’t have many doctors to begin with.

For someone like Cheng Gang, spending years in this department only to be overlooked was truly disheartening.

Unlike interns or trainees, a resident was a full-fledged staff member, sharing in achievements and bonuses. One would expect a bit more recognition.

Moreover, not long ago, patient in Bed 22 developed postoperative complications—epileptic seizures.

Cheng Gang even phoned Director Wen to report the situation.

Compared to other departments, the doctors in the General Surgery Department maintained a noticeably cold distance from one another.

There were invisible barriers between them.

“That’s right, Cheng Gang manages the beds in the ward,”

Dr. Ou answered in place of Zhou Can.

It was clear from Dr. Ou’s sidelong glance that he was eager to curry favor with Director Wen.

“Cheng Gang’s academic and surgical skills are rather average. Stick with me—after joining my team, you’ll assist in surgeries, hold consultations, and manage beds,”

Director Wen was clearly eyeing Zhou Can.

Zhou Can’s expertise in device implantation alone was a huge asset for countless interventional procedures.

The best part? A talent like his came at no cost.

Trainees didn’t get a share of surgical commissions or departmental bonuses.

They couldn’t even have their names on orders or records.

It was like hiring a free laborer.

With such advantages on offer, Director Wen would be loath to pass it up.

“Thank you, Director Wen, for your mentorship!”

Zhou Can grinned ‘happily’ in thanks.

Truth be told, he hoped for a chance to work under Wu Baihe for a couple of months.

Director Wen’s surgical skills were merely average, offering limited learning opportunities.

For now, his only option was to agree eagerly.

Director Wen hadn’t even bothered to ask his consent.

A decision had already been made.

Had he objected, Director Wen’s displeasure would have been as long as a mule’s face.

For a mere trainee, showing ingratitude would come with serious consequences.

Zhou Can had no choice but to lower his expectations—secure his position first, then plan for further progress.

Under Director Wen, there was still a chance to catch Wu Baihe’s eye.

If that opportunity never came, then fate had spoken.

He’d have to wait for another chance to train in General Surgery.

“Dr. Ou, is that Cheng Gang one of your residents?”

“Yes! I’m normally responsible for him,”

Dr. Ou admired the top trainee under his wing—snatched away on his first day in General Surgery—and couldn’t help but feel envious.

He secretly hoped Director Wen would pick him instead.

Not every attending had a superior shielding them.

Dr. Ou was one of those so-called ‘wild ones.’

If his patients had issues, he could report them to any senior in the department without hesitation.

Yet, no one mentored him as a protégé.

Day in and day out, he clung to any opportunity—sneaking into a major surgery today and shadowing another chief tomorrow.

Progress was a struggle.

“I’ll explain this to Cheng Gang later,”

Dr. Ou volunteered once again.

“Alright, thank you!” Director Wen nodded in satisfaction.

Securing such a promising talent clearly lifted his spirits.

At that moment, the patient, roused by the anesthesiologist’s call, began to wake up.

Normally, about ten minutes after stopping the anesthetic, a light tap on the shoulder and a call of the patient’s name was enough to bring them around.

General anesthesia was akin to deep sleep.

Post-examination indicated that although the patient had awakened from anesthesia, nausea, headaches, and neck stiffness persisted.

It seemed as though the patient’s condition hadn’t improved post-surgery.

But that wasn’t the case.

Once the bleeding stopped, no new blood rushed into the aneurysm, allowing it to shrink somewhat.

This process wouldn’t take long—not even twenty-four hours.

Soon, the patient’s intracranial pressure would drop.

Moreover, any intracranial blood would gradually be absorbed by the brain tissue, further reducing the pressure.

Barring unforeseen issues, the patient’s condition would improve rapidly.

Gradually, all symptoms would subside.

It wasn’t that the surgery had failed or been useless, as some families might suspect.

Many relatives who lack medical expertise, combined with the minimally invasive nature of interventional surgery, might think they were conned out of tens of thousands.

They might even believe that without the surgery, recovery in a couple of days was possible.

But that wasn’t the case at all.

Medical staff would explain everything thoroughly.

Most families remained skeptical at first, but once their loved ones recovered and were discharged, they eventually accepted the doctor’s explanation.

In this respect, a hospital’s reputation was crucial.

Renowned institutions like Tuyu Hospital naturally earned patient trust with little explanation.

……

After the surgery, Zhou Can followed Director Wen straight to the doctors’ office.

What was on the agenda?

The complications in Bed 22, a surgery performed by Director Wen, needed to be urgently addressed.

A team consultation was essential.

From the hallway of the Inpatient Department, Cheng Gang saw Director Wen leading a throng of doctors.

He immediately stood at a respectful distance, plastering on a smile and preparing to greet them.

“Good morning, Director Wen! I heard the surgery on Bed 31 was a great success! The family was extremely grateful once the patient returned to the ward!”

“Haha, indeed! Relieving a patient’s suffering is our duty. Just advise the family and patient to follow our postoperative care instructions,”

Director Wen responded with warmth and humor.

Flattery never fails.

Cheng Gang’s sycophantic praise left Director Wen beaming.

At that moment, Cheng Gang noticed Zhou Can had somehow merged into Director Wen’s team.

His eyes locked onto Zhou Can.

“Xiao Zhou, finish up in the OR and get to the ward. The patient in Bed 27 shows signs of infection. You need to address it immediately,”

Cheng Gang’s tone was obsequious before Director Wen, but turned into a commanding order toward Zhou Can.

Seniority in rank can crush anyone—not just in politics.

This rule applied in hospitals as well.

Zhou Can glared defiantly.

He thought, I won’t listen to you, and so be it.

“Xiao Cheng, Zhou Can has already been reassigned to my team for training,”

Director Wen’s words struck Cheng Gang like a bolt from the blue, leaving him flustered.

Incredibly, he stammered, “He—he’s been transferred directly to your team?”

“What? Do you have a problem with that?”

Director Wen’s tone turned icy.

When dealing with an insignificant resident like Cheng Gang, Director Wen had no patience or humor.

“No, no—I truly am happy for him!” Cheng Gang scrambled to explain, noticing Director Wen’s displeasure.

“Xiao Zhou’s transfer to your team is a monumental opportunity. You must work hard under the new residents, understand?”

In Cheng Gang’s mind, Zhou Can’s recognition by Director Wen was pure luck.

At best, Director Wen would have a resident mentor him.

But clearly, Zhou Can had soared solely on merit, earning Director Wen’s high praise.

Otherwise, with Director Wen’s standing, not even an attending—let alone a trainee—would receive personal instruction.

Director Wen ignored Cheng Gang’s shocked envy and led the team into the office.

In his eyes, Cheng Gang was nothing more than roadside weeds.

Zhou Can only gave Cheng Gang a dismissive glance.

Surely, the days of Cheng Gang bossing him around were over. From now on, whenever their paths crossed, Cheng Gang would likely be groveling for favor.

Once inside, Zhou Can took his seat at the very back of the group.

Even behind the three graduate students.

Staying low was both an attitude and a form of self-cultivation—it brought gentle impressions, increased goodwill, and minimized the chance of making enemies.

The only hurdle was overcoming inner vanity and the urge to show off.

“Tang Li, project the data for Bed 22 and the latest EEG on the screen for everyone to examine,”

Director Wen instructed his female attending.

“Got it!”

She promptly displayed the latest EEG.

“This patient underwent surgery for a cerebrovascular malformation yesterday—most of you might recall. Postoperative complications, like epilepsy, are common. The patient has experienced two episodes of coma and severe convulsions. The family’s emotions are running high. Let’s review the recent EEG and the enhanced head CT.”

Director Wen was visibly irritated by the situation.

While complications after surgery were common, they could also be attributed to subpar surgical performance.

In terms of accountability, Director Wen could hardly dodge blame.

Labeling it a medical accident didn’t apply, since consent was given prior to surgery.

After all, no doctor can guarantee a surgery’s success, whether it’s open-brain or a minor procedure.

Even a simple suturing of a wound—a procedure any local practitioner might perform—carries a risk of infection days later.

Who would take responsibility then?

Doctors were always reluctant to accept blame, leaving patients to foot the bill.

On the other hand, a bit of turmoil by the family could sometimes push the hospital to act—if the family’s anger was loud enough, treatment quality might even improve, albeit at the patient’s expense.

Sometimes, a little commotion served everyone’s best interests.

Those who were too soft would end up suffering even more.

Most doctors had already reviewed the case file for Bed 22 in detail.

Before surgery, everyone was familiar with the patient’s history, condition, and reports.

So when the file reached Zhou Can, he was the last to view it and read it intently.

At present, his skills in pathology diagnosis were only at a lower resident level—perhaps only marginally better than three graduate students.

The competency among the three residents remained uncertain.

There was no doubt about the quality of an attending’s diagnosis.

Director Wen’s skills needed no discussion.

Anyone capable of earning a top title at Tuyu Hospital was far from mediocre. Director Wen’s average interventional skills did not diminish his other abilities.

After reviewing the latest EEG and head CT scans, a wide discussion erupted among the doctors.

Yet, Zhou Can remained focused on the patient’s records, undistracted by external chatter.

“Gao Zongyi, Male, 46, exhibits signs of cognitive decline. He has a history of epilepsy, which has been worsening…”

It turned out the patient had a prior history of epilepsy!

The aggressiveness of the family’s complaints confirmed they were no pushovers.

Zhou Can mentally categorized them as one of those troublesome families.

The patient was found to have an intracranial venous malformation. However, its location was perilously close to the internal capsule.

Not many might know, but the internal capsule is a crucial passage for nerve fibers connecting the cerebral cortex, brainstem, and spinal cord—it lies between the basal ganglia and thalamus.

Both motor and sensory fibers radiate upward from here in a fan-like distribution.

Thus, the internal capsule serves as a vital link between the cortex and the brainstem.

Its danger in neurosurgery is second only to the brainstem.

Operating near the internal capsule is so risky that even well-established tertiary hospitals would discreetly admit they couldn’t perform such procedures.

The risk was just too high.

Tuyu Hospital, at least in theory, claimed to have no forbidden zones in cranial surgery.

Although this was partly for show.

When it came to the brainstem, even Wu Baihe would have a chill.

I recall the hypertensive pregnant patient in the Emergency Department—thankfully, her aneurysm was pseudo and Wu Baihe himself admitted he had less than a fifty percent chance of success.

Frankly, Tuyu’s General Surgery Department wasn’t considered particularly strong.

Even within the province, hospitals like the Provincial People’s Hospital or certain numeral-designated hospitals boasted superior neurosurgery teams.

The Renhe Hospital in the capital needed no introduction.

Furthermore, Magic City featured two major hospitals with neurosurgery teams as capable as, if not exceeding, Tuyu’s—equalling the prowess of Renhe’s team.

Director Wen’s willingness to undertake this operation demonstrated that his traditional surgical skills were top-notch.

Perhaps his interventional talents, however, were limited.

Zhou Can’s newfound evaluation of Director Wen began to take shape.

The operation record clearly stated that the diseased venous segment had been excised.

So why was the patient’s postoperative epilepsy worsening?

Zhou Can glanced up at the latest test reports.

The EEG showed marked abnormal discharges.

Essentially, epilepsy is usually triggered by abnormal brain discharges.

Determining the exact cause requires a comprehensive investigation—after all, it isn’t solely an arteriovenous malformation that can lead to such discharges.

Varicose veins, capillary dilation, and cavernous hemangiomas can all provoke abnormal brain activity.