Chapter 181: High-Stakes Decisions in the Operating Room

Those who dare take dangerous gambles are true masters.

Sometimes, what appears as a hasty or reckless decision actually reveals deep strategy—just like Zhou Yu of the Three Kingdoms, who could turn a mighty fleet to dust with a casual wave of his fan.

It’s the perfect blend of steadiness and wit that defines real brilliance.

Director Hu Kan assigned Zhou Can to care for the patient in Bed 19—a move that, though bold, balanced risk with prudence.

“Get on it immediately! Dr. Duan, make sure you comfort the family. Tell them that every surgery carries risks and we’ve put forth our best effort,” he ordered.

Director Hu Kan’s message was clear: the hospital won’t accept responsibility.

Kindness has no place on the battlefield, and compassion is no asset in business.

No one becomes a department head by being soft-hearted.

When a hard, resolute approach is needed, both families and staff must face it with an iron will.

Actions seen as cold-blooded by outsiders are sometimes desperate measures born of necessity.

For example, if a hospital openly admits fault and takes responsibility…

Do they really think that would placate the family?

They’re mistaken!

Human nature can’t withstand any test.

The more faults are admitted and weakness is shown, the more the family feels aggrieved.

Even if a doctor, with tears in his eyes and a smile, covers all costs and cures the patient, the family might not be grateful—instead, they could bring a lawsuit demanding compensation.

Why must the family sign an informed consent before surgery?

It’s all to safeguard the interests of the doctors and the hospital.

In this light, the patient is the vulnerable party, forced to rely on the doctor’s judgment.

Only when a patient is clearly killed, maimed, or when a doctor’s error is obvious, do we see so-called medical disputes.

But in today’s world, every form of shadow market exists.

Medical disputes have themselves become a black-market industry.

Countless hospitals suffer deeply because of it.

And inevitably, it’s the patients who pay the highest price. Once a hospital suffers a setback, policies tighten to leave no room for troublemakers.

Imagine a day when a doctor finds a tumor in a patient but dares not operate.

Or during a colonoscopy, when a polyp or tumor is spotted—he could remove it on the spot, yet hesitates because he won’t take the risk.

If post-surgery the patient only pays for the colonoscopy, who will cover the surgical fees?

And if the patient, ungrateful, protests, ‘I only had an exam, not surgery. I never signed a surgical consent form!’—what then?

Now that medical disputes have evolved into a black-market chain, specialists even exist to find cases and coach families on how to stir up trouble. After collecting the compensation, the organizers take the lion’s share while the family gets next to nothing.

This situation harms both doctors and patients.

In the end, it’s the disturbance teams who truly benefit.

In such a hostile environment, Director Hu Kan would never let his junior doctors admit fault to families.

They must be told: the doctors are not at fault.

The patient’s rare postoperative complication prompted the hospital to express sympathy and immediately draft a treatment plan to save his life.

“Director Xue, I heard you’re on good terms with the family. Make sure you stand with us on this!”

Director Hu Kan’s eyes turned to Xue Yan.

“Don’t worry—I understand the stakes. The family and I are mere acquaintances. Even if they press me, I’ll speak for the hospital. I’m not about to pick a fight after dinner,” she replied confidently.

Director Xue’s stance on the matter was unequivocal.

Had she told the family that a surgical mistake led to massive tissue necrosis and sepsis, it would have triggered an all-out uproar.

The fallout would have meant penalties for Dr. Duan and Dr. Zhao, a tarnished reputation for the hospital, and the family demanding exorbitant compensation.

It might even escalate to legal battles and regulatory scrutiny.

If things went that far, the hospital would certainly have issues with Director Xue.

She wouldn’t sacrifice her future for that.

……

After leaving the meeting room, Zhou Can was trailed obediently by Dr. Duan and Dr. Zhao.

As they stepped into the corridor outside the Cardiothoracic Surgery ICU, the beautiful wife of the patient in Bed 19 rushed forward.

She must have been in tears earlier—her eyes red and puffy.

Terrified at the thought of becoming a widow, she was anxious and heartbroken at her husband’s sudden decline.

“Dr. Zhao, Dr. Duan, has my husband’s consultation result come out?”

“After a joint review by several senior physicians, we’ve determined that the patient’s condition is very severe. He’s developed a rare postoperative complication and needs an immediate second surgery, along with intensive anti-infection treatment and immune support…”

Dr. Duan wasn’t just skilled in surgery—his smooth-talking had also managed to frighten the family into agreement during their meeting in his office.

The terrified family had no choice but to consent.

Their greatest fear was the loss of their loved one.

Even the prospect of permanent disability was unacceptable.

While Dr. Duan was conving with the family, Zhou Can headed into the ICU to check on the patient.

The patient had a high fever, was confused with chills, though his heart rate, blood pressure, and respiration remained within moderate ranges. However, his urine and blood tests were alarming.

Immediate surgery was essential.

Examining the patient’s chest wound, Zhou Can noted that while suturing wouldn’t be a problem, healing was an issue.

Furthermore, necrosis was developing inside; if not treated now, it wouldn’t be as simple as debridement later on.

After leaving the ICU, Zhou Can returned to the doctors’ office.

By then, Dr. Duan had nearly finished his conversation with the family.

“Dr. Duan, can we schedule a surgery today for the patient named Yang Tie?”

“Yes, yes. The family has already signed the consent form. Let’s rearrange the OR schedule and give Yang Tie priority.”

Dr. Duan, pleased to have the family on board, must have felt a surge of relief.

He dreaded any persistent family objections that might lead to a probe into the doctors’ responsibilities.

At that moment, the anesthesiologist arrived to have the family sign off on the final consent.

The patient was quickly transferred into the Operating Room.

In front of the family, Zhou Can—though subordinate to Dr. Duan and Dr. Zhao—took charge as the primary surgeon as soon as he entered the OR.

Neither doctor raised any objections.

They had both witnessed Zhou Can’s surgical prowess before.

Once the anesthesiologist administered full anesthesia, Zhou Can had the instrument nurse help him secure sterile gloves and confidently stepped up to the operating table.

He carefully snipped the sutures on the patient’s chest wound and reopened the incision.

A faint, putrid odor wafted out.

Upon opening the wound, Dr. Zhao and Dr. Duan were momentarily struck by dismay.

The sight of necrotic pectoral muscle tissue was both shocking and grim.

Although Zhou Can’s debridement techniques were still at the level of an attending, they were more than sufficient to clean the wound.

He meticulously cleared out all the necrotic tissue.

His superb tissue separation technique left Dr. Duan feeling thoroughly outclassed.

For a senior attending, his tissue separation skills far surpassed those of Dr. Duan. After finishing the debridement, Zhou Can repaired a damaged blood vessel with precise anastomosis before re-suturing the wound.

He didn’t hesitate to showcase his impressive suturing skills.

Dr. Duan was almost in disbelief—this was a level of suturing that even a department head would envy. It was extraordinary.

“Fortunately, the wound hadn’t developed an abscess—just an inflammatory response. Otherwise, it would have been impossible to close.”

Taking on this heavy responsibility was both a challenge and an excellent opportunity for Zhou Can to hone his skills.

This surgery had to succeed—Dr. Xu’s reputation was at stake.

Six years ago, Dr. Xu had lost to Director Hu Kan.

Now, as Dr. Xu’s protégé, Zhou Can was determined to honor his mentor’s name.

After debridement and suturing, Zhou Can didn’t unilaterally decide the postoperative medication.

Even though he already had a plan in mind, he remained humble and discussed it with Dr. Duan, letting him save some face.

Giving others face is the surest way to earn respect and goodwill.

After a series of treatments, the patient’s fever subsided and signs of sepsis quickly diminished. Just one day in the ICU was enough to stabilize his vital signs before transferring him back to the general ward.

At last, the patient pulled through.

Dr. Duan and Dr. Zhao could finally lay down their heavy worries.

The next morning, Zhou Can went on his rounds as usual.

Dr. Duan and Dr. Zhao followed closely behind.

“Dr. Zhou, please take some time to check on the patient named Yang Tie!”

Dr. Duan found it hard to refuse.

After all, as an attending, asking a trainee to check on a patient was a blow to his pride.

So he delegated the task to the lower-ranked Dr. Zhao.

“Alright!”

Zhou Can agreed readily.

With the patient still admitted, he wasn’t about to shirk his responsibilities.

Dr. Duan’s skills and experience were not far behind his own—though a recent scare had shaken his confidence.

Time and again, Zhou Can displayed an uncanny sense for impending crises, and coupled with his successful debridement, the patient’s turnaround left Dr. Duan convinced that Zhou Can was incredibly reliable.

As long as Zhou Can was in charge, Dr. Duan felt secure and assured.

Quickly, Zhou Can made his way to Bed 6.

The man named Yang Tie, originally in the ICU, had been moved—Bed 19 was now occupied by another patient.

Since the patient in Bed 6 had been discharged that day, the empty bed was reassigned to Yang Tie.

Nearly every hospital bed cycles through patients like clockwork.

The fastest turnover was in the observation area of the Emergency Department.

There, many patients were transferred or discharged within a day or the next.

Patients in Cardiothoracic Surgery usually undergo major operations and have longer stays, which makes bed availability even tighter.

On the bed, the patient slept soundly.

After days of suffering and following his second surgery, his body began to recover rapidly and naturally craved the sleep he’d lost.

The patient’s parents must have been exhausted these past few days.

Upon seeing their son’s improvement, they finally felt safe going home to rest.

The patient’s beautiful wife lingered by his bed, absorbed in her phone.

This time, she was watching short videos instead of desperately searching online about his treatment or the doctors’ competence.

“Good morning, Dr. Zhao, Dr. Duan!”

The woman felt a bit awkward when she saw Zhou Can.

She deliberately avoided greeting him, choosing to ignore his presence.

“How is the patient doing?”

Not one to quarrel over a woman, Zhou Can moved to the bed to inspect the healing wound.

There was no redness or swelling—the incision looked normal.

He reviewed the patient’s records—temperature, blood pressure, urine output—all were normal.

Everything appeared fine.

It seemed that in a few days the patient would be discharged.

“His temperature is stabilizing, the infection appears well-controlled. We can start reducing his antibiotics and taper the immune-supporting drugs,”

Zhou Can explained to Dr. Duan.

Whether it’s antibiotics or other medications, they can’t be used indefinitely.

In critical moments, dosages are maxed out to save lives; once the condition is under control, the amounts must be gradually reduced to help the patient adjust post-discharge.

This approach also avoids the adverse effects of overusing antibiotics.

Of course, some smaller hospitals, in pursuit of quick results and better reviews, are reluctant to cut back on medications.

This can leave a patient seemingly well at discharge, only to relapse at home or suffer a series of dysfunctions.

Many patients end up cursing doctors for ’holding tricks’ that prolong recovery.

They often have to return repeatedly for medication, or even undergo multiple hospitalizations.

These are likely the consequences of overly aggressive treatments.

It’s like abruptly weaning a baby—if you cut off breastfeeding all at once, the baby will cry incessantly. Gradually introducing solid foods helps them adapt when it’s time to wean.

“Today, I’m reducing the medication dosages on the orders!” Dr. Duan agreed with Zhou Can’s suggestion without hesitation.

“Uh… he’s just a trainee—at an intern level. Can we really trust his advice? My husband’s condition barely improved before reducing the meds—could this be dangerous? Don’t worry, our finances are fine; the medication cost isn’t an issue,” the beautiful woman quickly interjected.

Her concern was not without reason.

Especially for someone like her who loved to research on her own.

If the information was accurate it was fine; but if it turned out to be pseudo-science or a personal misinterpretation, it could lead to false conclusions.

“Although Zhou Can is just a trainee, his skill is remarkably high. His major efforts during the second surgery played a huge part in my husband’s rapid recovery. From a professional standpoint, his advice to reduce the medication is sound…”

After Dr. Duan’s thorough explanation, the beautiful woman was both shocked and abashed.

She never imagined that her husband’s speedy recovery was largely due to this trainee doctor’s efforts.

Moreover, despite her earlier harsh words and doubts about Zhou Can’s competence, he never held a grudge; instead, he consistently put the patient’s interests first.

At that moment, she felt deeply ashamed and embarrassed.

“I see now. It’s all my fault for misunderstanding and doubting you, Dr. Zhou—I’m sorry.”

She apologized to Zhou Can, her eyes now filled with gratitude rather than hostility.

“No worries!”

Zhou Can waved graciously.

“Next time, if you have any doubts, please don’t just google. Ask us medical professionals directly. What you read online might be correct, but it doesn’t necessarily apply to your situation. Even a simple cold can be treated in a hundred different ways—the right medications, dosage, duration, and supportive care are best determined by a doctor.”

He admitted he hadn’t intended to lecture, but her sincere apology prompted the advice.

The woman laughed awkwardly, “I often see news exposing hospital scandals and get worried about being swindled or treated by inexperienced doctors. I promise I won’t do it again.”

After this ordeal, she realized that online medical information can often be more misleading than helpful, fueling unnecessary distrust in doctors’ recommendations.

“Once discharged, please ensure he doesn’t immediately start on all sorts of supplements—ease into it. I’m really impressed by how carefully you’ve looked after your husband; it’s quite admirable,”

Zhou Can praised her before leaving, hoping to ease any future embarrassment.

He noted, “Today, our team handled two major surgeries, both led by Director Xue.”

He added that in treating the patient named Yang Tie, both Director Xue and Director Hu Kan were quietly monitoring the situation.

Now that his capability had been proven, Zhou Can’s prospects for more surgical opportunities looked very promising.