Chapter 207: Another One Gone, Rising to the Challenge

At the very least, this whole situation made Du Leng feel that things were finally looking up.

Zhou Can’s expression didn’t shift at all. Losing Song Ze wasn’t enough to put a dent in Deputy Director Liu’s surgical team.

After all, Song Ze usually just played the role of Second Assistant in major surgeries, handling things like retractors or running errands.

As for operating solo, well, Song Ze was an Attending Physician with little seniority. He could only handle some simple Level 1 or 2 general surgeries on his own.

Now that Song Ze was gone, Zhou Can could simply take over all of his surgeries.

He watched Director Yang Qing’s group of doctors leave but didn’t exchange a word with Song Ze.

When Song Ze walked past him, he even deliberately turned his head as if Zhou Can didn’t exist.

“Is Director Yang Qing’s team really that irresistible?”

Zhou Can honestly had no idea what Song Ze was thinking.

He couldn’t shake the feeling that Song Ze didn’t have an ounce of dignity in Yang Qing’s group.

Zhou Can turned his attention back to business and, along with an intern, brought a patient with biliary stones into the operating room.

Not long after, He Hansheng and Deputy Director Liu arrived one after another.

Zhou Can’s gaze flickered—he noticed the team had shrunk by another member.

“Director Liu, there’s something you should know. Resident Cheng Gang has left to join another group.”

He Hansheng forced himself to break the news.

“Another one gone?”

Mr. Liu was stunned for a moment. His tone was full of disappointment and his eyes clouded with sadness.

One by one, his doctors were leaving at such a pivotal moment, joining other groups. For someone nearly sixty, each departure felt like another blow to the heart.

As things stood, only First Assistant He Hansheng and Third Assistant Wan Sanlao were left in the surgical team.

Zhou Can was still just a trainee, rotating through the department—he’d be leaving soon too.

So he wasn’t really a permanent member of the team.

The other trainees and interns weren’t much help. They could only assist with tasks that were low-risk and not too technical. And before long, they’d be moving on as well.

For an intern to become a resident under Deputy Director Liu, the road was long. Full of twists and turns.

At Tuyu, over ninety percent of interns would eventually get weeded out.

Those who made it through? Less than one in ten.

Anyone who’s completed an internship knows—in a top provincial hospital, it starts out as a source of pride and wild hope for the future. But by the end, dreams of staying on become a fantasy—it’s tough just to earn the right to apply for a trainee position.

Big hospitals are brutally competitive.

It’s like thousands of troops funneling across a single bridge. Only a handful make it across; every success story is a standout.

Just today, three doctors—each one trained by Mr. Liu for at least two years—had walked out.

And when they left, not a word of goodbye. Just gone.

When personal interest comes first, people can be so cold.

“Those who want to leave can’t be stopped. Let’s get started.”

Mr. Liu let out a long sigh, looking deflated.

“Dr. Zhou, you’re pretty strong in endoscopic surgery. Let’s tackle this operation together and let Director Liu take a break.”

He Hansheng looked to Zhou Can for agreement.

At that point, Mr. Liu was shaken to the core. His hands were trembling. Whether it was anger or just not feeling well, who could say?

After all, he was getting older.

He was in no condition to operate personally.

“I’m totally fine with that. Director Liu can just guide me through the crucial steps—I’m confident I can handle this surgery.”

Zhou Can had already looked over the patient’s test results.

There were quite a few stones in the bile duct, so an endoscopic check plus cholecystectomy and common bile duct stone removal were needed.

He’d already done endoscopic gallbladder removals before.

Even without supervision from a senior doctor, he felt up to the task.

“Zhou, just follow the same steps as laparoscopic cholecystectomy for the beginning.”

Mr. Liu had complete faith in Zhou Can’s endoscopic skill.

“Got it!”

Zhou Can went straight through the steps for laparoscopic gallbladder removal.

“For laparoscopic surgery like this, you can either check via the cystic duct or make an incision in the common bile duct, depending on if the cystic duct is widened. If it’s short and thick—over 5mm in diameter—you’d consider the first method. For this patient, the stones were small and few, so a common bile duct incision and T-tube drainage made sense.”

Mr. Liu stood by and calmly guided Zhou Can.

“Understood!”

Zhou Can answered while carefully tracing the cystic duct up to the common bile duct.

He handled the cystic artery, freed the cystic duct, and worked along the junction toward the hepatoduodenal ligament’s anterior layer.

Only when the bluish-green bile duct was clearly revealed did he move on.

These maneuvers called for top-tier endoscopic technique.

Even if Mr. Liu did it himself, he might not have performed as well as Zhou Can that day.

The rest of the staff watched in silence.

Some focused on the endoscope screen; others kept their eyes fixed on Zhou Can’s hands.

With steady hands, Zhou Can incised the anterior wall of the common bile duct.

A vessel appeared in the exposed wall.

Calm as ever, he used curved dissecting forceps to lift the duct wall and cauterize it.

Next, he placed a little piece of radiopaque gauze in the Foramen of Winslow, then snipped open the common bile duct with a curved micro-scissor, about a centimeter in length.

His practiced skills in placement and holding forceps all came into play.

Success meant a showering of experience points for him.

Because these were his first attempts, and the difficulty was high.

For him, both surgical experience and endoscopic technique improved by leaps and bounds.

The system awarded him 100 experience points—usually a sign he’d pulled off something tough or made real progress during surgery or diagnosis.

“Not bad—keep going just like that!”

Deputy Director Liu watched Zhou Can’s surgical progress with pride.

Next up was fiberoptic choledochoscopy to fetch out the stones.

Zhou Can advanced the scope up into the hepatic ducts to search for stones, using a retrieval basket when he found them. Then he checked downwards in the bile duct, using the same technique.

Along the way, he noticed the patient had quite a few stones.

“Director Liu, can I just use a laparoscopic articulating forceps to get these stones out directly?”

Zhou Can checked with Mr. Liu before proceeding.

“You can!”

Mr. Liu gave the green light.

This approach was quick and effective.

After most were removed, Zhou Can swept the duct again with the choledochoscope to make sure every last stone was gone.

A few final steps remained: placing the T-tube and closing up the duct.

Suturing this area was critical. If bile leaked around the T-tube, it meant sloppy stitching.

Luckily, Zhou Can’s suturing and ligature technique were already at Associate Chief Physician levels.

The operation went off without a hitch.

Now it was time to remove the gallbladder.

After that, he irrigated the field and placed an abdominal drainage tube.

During surgery, this drain was routed through a right anterior axillary trocar site into the abdomen, positioned next to the T-tube and the hepatorenal recess—a lot harder to do than it sounded.

After a lot of effort, Zhou Can delivered results and finished the entire procedure.

“Director Liu, may I ask—earlier, while removing the gallbladder, I noticed signs suggesting malignancy. In cases like this, should we send it for pathology?”

Zhou Can asked Mr. Liu for advice.

“Usually, there’s no need. It cuts down on costs for the patient and spares them the stress if the result came back bad. The gallbladder is out—it can’t become cancerous again, so why go that extra mile? During post-op rounds, just let the patient or their family know they’re lucky we caught these changes. That way, they’ll feel even better about the surgery’s outcome.”

Mr. Liu taught Zhou Can how to handle tricky patient conversations gracefully.

Communication between doctors and patients is critical.

It comes into play throughout the entire perioperative period.

Good communication can massively boost a patient’s trust in their doctor. If it falls short, it can sow the seeds of future disputes.

“Of course, if there’s obvious tumor or risk of metastasis in the gallbladder, you have to send it—and check nearby lymph nodes and vessels for signs of disease.”

If something serious is going on, lymph nodes are the frontline defenders.

Signs like swollen nodes or lumps are telltale warning signs.

Once surgery wraps up, the rest is up to the recovery room and ICU staff.

He Hansheng glanced up at the clock on the wall and hesitated for a few seconds before speaking in a troubled tone. “Director Liu, our group had nine surgeries scheduled today and we’ve done the two toughest ones. That leaves seven minor Level 1 and 2 surgeries. Normally, splitting the load with Song Ze, we could finish by eight or nine at night. But now there’s only me…it’s rough.”

Not everyone could match Zhou Can’s speed in the OR.

In reality, most surgeons work slower.

They’d rather take it slow than risk a mistake.

With Song Ze out, all the second-level operations fell squarely on He Hansheng. Wan Sanlao, a resident, could handle some of the first-level ones, but not many.

No wonder He Hansheng was stressing out.

He’d probably be working overtime till midnight and still might not finish.

Doctors aren’t made of steel.

Every operation demands full focus and physical stamina. If you’re worn out, there’s no way you can do right by the patient.

“You’ve got limits, both in skill and energy. There’s no way you can cover all those surgeries. Go ahead and push some off until tomorrow. Hang in for now, and in a few days, we can hand off more incoming surgical patients to other groups when we do clinics.”

After thinking it over, Mr. Liu gave his answer, sounding a little bitter.

Referring patients to another team always feels like admitting failure.

If Mr. Liu weren’t completely out of options, he’d never make that call.

He Hansheng was an Attending Physician and a real workhorse. Every minute of his day was already booked.

The next couple days would have him running himself ragged.

Getting help from other teams was one of the few decent ways to handle the overflow.

But it did sting his pride. His team would lose face.

Three doctors had defected already, which was a disgrace.

Now, begging other groups to take their surplus surgeries would only fuel the gossip.

Day one, and they’d already lost the competition.

That was the hard truth.

“Director Liu, Dr. He, I have a bold request—if you agree, maybe we can keep up with our surgery quota and not scale back at all.”

At the crucial moment, Zhou Can stepped forward.

If he could help this small group win the competition, when new subspecialties were created, they could recruit the best doctors.

The key was to get through this rough patch and fight for victory.

They didn’t need to be number one in every field.

With general surgery splitting into multiple sub-departments, there’d be at least eight or nine new divisions. Win in any area, and you could be chosen as team leader.

“Let’s hear it!”

All eyes were on Zhou Can—Mr. Liu, He Hansheng, even Resident Wan Sanlao and the trainees and interns were hoping for a shot at redemption.

No one wanted to be written off just yet.

Everyone wanted a shot at a brighter future.

“While you two are operating, I can do surgeries by myself in the same OR. Say, you focus on the big Level 3 surgeries and I tackle the Level 1 and 2 cases. You know my skills—I just don’t have independent surgical privileges yet.”

Zhou Can spelled things out. He was sure Mr. Liu and He Hansheng would get it.

“That’s… actually a workable idea. As long as Dr. Zhou’s surgeries are up to par and there are no slip-ups, it could be done.”

He Hansheng’s eyes lit up. It was risky, maybe even a bit unorthodox, but sometimes that’s what you need to solve real problems.

And it could lead to huge gains.

For Zhou Can, money wasn’t the issue—it was about racking up surgical experience and valuable case points.

A steady stream of Level 1 and 2 surgeries would let him quickly rack up both.

His three months in the Emergency Department gave him a rock-solid foundation.

He was still reaping the rewards.

“Zhou Can pulled off miracles in Emergency last year. You’re even stronger now—I believe you’ll do fine.”

Mr. Liu remembered Zhou Can’s legendary stint in Emergency.

Back then, the department’s surgery load skyrocketed to one or two thousand cases a month, sending Director Xie of general surgery into a panic.

Things escalated all the way up to the Vice-Director.

“So you’re both on board? Let’s do a trial run right away. I’m already familiar with all the cases for today—only two Level 2 surgeries really require a senior doctor. I’m confident I can manage the rest on my own.”

He was thoroughly prepared.

Knowing the cases inside-out gave him all the confidence he needed.

His voice brimmed with self-assurance.

“I was supposed to head to Tuyu Medical College later for some research, but I can delay that to observe your independent work here.”

Deputy Director Liu still wanted to supervise.

Normally, no chief surgeon would let an intern perform an operation solo. Trainees only got hands-on with things like closing the skin, holding retractors, or providing suction.

Even clamping an important vessel with a hemostatic forceps was usually off-limits for a trainee—too risky to the vessel wall.

Trainees standing at the operating table would freeze up at the sight of blood. Ask them to clamp a vessel? The results could be disastrous.

“Thank you for your trust, Director Liu! I’ll give it my best!”

Even as he solved the whole team’s headache, Zhou Can humbly thanked Mr. Liu.

It was that gentlemanly attitude that made him a favorite with his seniors.

With the plan in place, they moved to a larger OR so Zhou Can could operate solo with Mr. Liu present.

There’s a world of difference between assisting and operating independently.

First, you have to break that psychological dependence.

Then you need a rock-solid grasp of every step, and you must be able to handle whatever happens next.

Many large ORs have two or more theaters, so multiple surgeries can run at once.

This setup was designed with the risks of surgery in mind, since chief surgeons are rare.

With two tables, the lead could handle the big cases outside while senior and associate doctors completed secondary ops next door.

If anything went wrong, help was always nearby.

Many top hospital surgeons had come up this way.

So when Zhou Can started flying solo in Emergency, it wasn’t unprecedented.

He had a precedent to learn from.

Though truth be told, the Emergency ORs were a lot more basic than those in general surgery.

The first patient was wheeled up to Zhou Can’s table.

It was a simple Level 1 case: subcutaneous tumor removal.

Low risk, straightforward.