Chapter 31: A Surgeon’s Crucible

Opportunity is knocking. You must be bold and have thick skin to grab it.

“Dr. Xu, may I perform the laparotomy?”

“No!”

Before he could even think twice, Dr. Xu refused outright.

Dr. Lu cracked a smile as he glanced at Zhou Can, his expression tinged with a mocking hint of ‘don’t get ahead of yourself.’

“Don’t worry, Zhou Can. When the time is right, Dr. Xu will give you a chance to prove yourself,” Ye Tingting reassured him with a wink.

“Alright!”

Zhou Can returned her smile with gratitude.

This was a level-two surgery. Although an abdominal incision isn’t as dangerous as opening the chest, the risks are still high. Dr. Xu’s refusal was exactly as expected.

Opportunities must be seized with courage.

Success or failure was beyond his control.

At least he could take comfort in trying without regrets.

“You stand over there and watch closely!”

After denying him the chance to operate, Dr. Xu still offered a prime viewpoint for observation and learning.

Zhou Can felt a surge of joy—Dr. Xu clearly intended to mentor him.

“When choosing the scalpel position, always avoid major blood vessels and nerves. The appendiceal position is similar in both men and women, but the appendix itself can vary greatly in its anatomy. You’ll need to refer to the patient’s imaging to determine the incision site. Normally, the appendix is in the lower right abdomen, at the point one-third along the line between the navel and the iliac crest, known as Ma’s Point.”

Dr. Xu explained while demonstrating.

“See? Her Ma’s Point is right here. Make your incision along that mark.”

Such hands-on experience was invaluable.

It was the result of countless surgeries performed by his predecessors.

It ensured the highest likelihood of surgical precision.

Zhou Can memorized every word, stowing away his impulsiveness. It was time to focus and absorb every detail.

After his explanation, Dr. Xu began the incision.

The scalpel seemed to come alive in his hands.

One swift downward stroke, then a smooth pull back.

His gaze was sharp, his moves precise, steady, and fast.

Layer by layer—skin, subcutaneous fat, the anterior sheath of the rectus abdominis, the rectus muscle, and then the posterior sheath—the human tissues parted as if by magic.

Zhou Can watched with wide-eyed awe.

The technique was every bit as impressive as Director Liu’s methods.

He never imagined that the worst-rated Emergency Department could hide such remarkable expertise, especially when Dr. Xu was merely an attending.

Not even a deputy director.

With such surgical prowess, having him work as an attending in the Emergency Department was truly a waste of talent.

As the layers of tissue were cut open, blood began gushing out rapidly.

Dr. Lu, in his role as First Assistant, immediately grabbed the electrocautery knife to staunch the bleeding.

Yet, Dr. Lu’s skills left much to be desired.

His speed was acceptable, but he often misdirected or failed to fully secure the bleeding.

He was notoriously careless in his work.

No wonder he had been sidelined by the dominant departments.

If he didn’t correct his shoddy methods soon, he’d be limited to assisting in level-one or level-two surgeries, unable to lead them.

Even his hemostasis skills were far behind Zhou Can’s.

Though Zhou Can despised his clumsiness, as a trainee he wasn’t in a position to criticize a superior resident.

Dr. Xu frowned continuously but chose not to comment further.

He probably had no choice.

The Emergency Department was chronically understaffed. Even if Dr. Lu was subpar and careless, he was the only option.

This was the harsh reality of the Emergency Department.

However, with both Zhou Can and Jin Mingxi on board, this situation would soon change.

“Remember, once you reach this point, you’re only left with the peritoneal fat layer and the peritoneum. Work slowly and carefully—don’t rush with one big slice. What’s most important in surgery isn’t flashy techniques, but safety. No matter how skilled you are, one small mistake could be catastrophic.”

Dr. Xu’s final words carried a distinctive, heartfelt tone.

There was a deep emotion behind them.

It made Zhou Can wonder about the stories behind Dr. Xu.

With a learned precision, Dr. Xu held the scalpel as if crafting a masterpiece, his expression solemn and focused as he made careful, deliberate strokes.

The peritoneal fat layer was flawlessly incised.

Soon after, it was the peritoneum’s turn.

The moment it was cut, pus began to seep out.

Dr. Lu, standing in the First Assistant’s role, froze like a statue.

Such a situation required immediate suctioning of the exuding pus.

This time, Zhou Can didn’t wait for permission.

There was no time to ask.

He quickly grabbed the suction device and cleared away the pus completely.

“I didn’t expect such severe suppuration. This condition must have been dragging on for a long time,” Dr. Xu remarked admiringly at Zhou Can’s quick reaction.

Dr. Xu shot Zhou Can an approving look.

Had Zhou Can been any slower, the wound could have easily become contaminated.

“Dr. Lu, move over there and assist Jin Mingxi with the retractor. Xiao Zhou, stay here to help,” Dr. Xu ordered.

Noting Zhou Can’s adept assistance and quick thinking—clearly outshining Dr. Lu—Dr. Xu promoted him to the First Assistant role without sparing Dr. Lu’s already bruised pride.

The retraction for the appendectomy wasn’t overly taxing and the surgery was comparatively short.

However, this rearrangement meant Zhou Can was now First Assistant, while the more experienced Dr. Lu was demoted to Second Assistant.

Even behind his mask, Dr. Lu’s displeased expression was unmistakable.

Zhou Can, being the subordinate, accepted the orders without question.

Taking his position as First Assistant, he gripped the electrocautery knife in one hand and the suction device in the other.

He was fully alert and ready.

The peritoneum was gradually incised, eventually matching the size of the surgical wound.

At that moment, the inner details became visible.

A putrid stench hit him hard.

The abscess was even more severe than he had imagined.

Necrotic tissue was clumped together like minced meat.

“Widen the incision slightly,”

Zhou Can quickly achieved hemostasis at the bleeding points with the electrocautery knife, then meticulously suctioned the pus from the abscess.

It had to be completely cleared to prevent peritoneal contamination.

Anything less would spell serious trouble.

No comparison, nothing beats a clean field.

Unlike Dr. Lu’s clumsy assistance, Zhou Can was meticulous, ten times more diligent, and his hemostasis skills clearly outclassed Dr. Lu’s.

“Xiao Zhou, locate the cecum,”

“Yes!”

Zhou Can understood; Dr. Xu was now focusing on honing his skills.

It was practically a hands-on lesson.

Tracing along the colon’s band, he carefully parted the adjacent fatty appendages. It wasn’t long before he spotted the cecum, its color a shade paler than the small intestine, more grayish than white.

Finding the cecum meant he had also located the appendix.

After all, they are connected.

Using gauze on his fingertip, Zhou Can lifted the cecum; following the colon’s band, he successfully identified the appendix.

“The adhesions seem particularly severe,”

Zhou Can looked towards Dr. Xu.

“Just be careful; separating them isn’t difficult,”

Dr. Xu responded calmly.

He delicately separated the adhesions, his actions meticulous, precise, unhurried, and exuding a masterful aura.

During the process, he explained various techniques and key points to Zhou Can.

It took nearly half an hour to completely free the adherent tissues.

“Now, we can resect the necrotic cecum. Remember, whether it’s the cecum or the appendix, try to perform the resection outside the peritoneal cavity to avoid contamination. If conditions don’t permit, then you must operate inside the cavity—but ensure you pad the surroundings with gauze to safeguard all tissue layers.”

With the diseased area isolated, the resection from the peritoneal cavity was ready.

Dr. Xu personally sutured the colon’s cut end.

He left no detail unspoken—explaining techniques, precautions, and various suturing methods to both Zhou Can and Jin Mingxi. As for Dr. Lu, he had likely been instructed long ago.

“Return the intestine, clear any clotted blood or fluids, and once you’re sure everything is in order, always count all surgical instruments and consumables.”

Too often, irresponsible doctors have left instruments or gauze inside patients.

This carelessness has led to catastrophic medical mishaps.

Such good habits must be ingrained from the start.

“Xiao Zhou, close the abdomen!”

Dr. Xu had rightly refused to let him operate and resect the cecum.

Zhou Can’s experience and surgical skill were still lacking.

After this session, the odds would be much better next time if he were to handle a cecum or appendectomy himself.

Every doctor’s growth comes gradually over time.

The experience system might accelerate progress, but it can’t do everything overnight.

Dr. Xu gradually conceded more authority, nurturing Zhou Can little by little.

It might seem harsh, but it was an act of care.

If a child learning to walk were allowed to run freely, it would only end in a painful fall.

After suturing the abdominal cavity, Zhou Can earned an extra twenty experience points.

In total, he placed ten stitches.

His suturing technique had become noticeably more refined.

Suturing on a patient was a far cry from practicing on pigskin or a white mouse.

For one, the tactile feedback was entirely different.

Human skin is much more delicate—it demands a gentle touch during suturing.

Moreover, practicing on pigskin carries no psychological pressure. When suturing on a patient, the stakes are higher and tension naturally builds.

In fact, this was his fourth time suturing on a patient.

Compared to his first attempt, his skills had improved significantly.

Though still not as composed as Dr. Xu, he no longer felt the paralyzing nervousness of his initial attempt. Earlier, while closing the abdomen, he felt a surprising calm.

This mental shift wasn’t something the experience system could provide.

It could only be honed through actual surgical practice.

“Your suturing was decent. From now on, you’ll handle tasks like epidermal suturing and closing the abdomen. Dr. Lu and Dr. Jin have long since outgrown these mundane tasks, haven’t they?”

It was painfully obvious—Dr. Xu was deliberately grooming Zhou Can.

“It’s great to see Zhou Can gain more hands-on experience,” Jin Mingxi remarked.

“I’m not impressed by suturing and closing. When will Dr. Xu let me lead a level-two surgery?” Dr. Lu joked.

“When will you correct your careless ways and come back with that request?” Dr. Xu retorted bluntly.

Dr. Lu forced a smile and kept quiet.

The elderly patient’s surgery had been a resounding success. Soon after awakening from anesthesia, she was wheeled out of the operating room by a nurse.

…

One after another, patients flooded into the Emergency Operating Room—there was no shortage.

For Zhou Can, it was a paradise for sharpening his surgical skills.

Unfortunately, many procedures couldn’t be performed here.

Either Dr. Xu had to lead them or patients were advised to transfer to specialty departments.

It wasn’t until the handover doctor arrived at midnight that Zhou Can finally clocked out.

Leaving the hospital, Zhou Can felt his body nearly falling apart.

Being a doctor is truly exhausting.

Yet today’s gains were beyond imagination.

Not only had he secured his position as a trainee at the hospital, but he had also quickly integrated into the close-knit Emergency Department team, earning recognition from Director Lou and Dr. Xu.

Provided he stays out of trouble, a bright future awaits him.

Dr. Xu has clearly begun grooming him for greater responsibilities.

Even Jin Mingxi wasn’t afforded such preferential treatment.

Beyond that, he had amassed considerable experience in suturing, hemostasis, ligature, and injections. However, incision experience was minimal—only two points earned.

For riskier anatomical dissections, Dr. Xu always took charge personally, unwilling to let Zhou Can handle them.

At most, he’d detail every step and precaution during the incision.

After all, developing a capable medical professional takes time.

It isn’t a matter of days.

Zhou Can adjusted his study regimen based on the current situation.

After work, he planned to buy more white mice and rabbits for anatomical practice at his dorm. Although practicing on small animals yields five times less experience than on humans, it’s risk-free.

And if you practice diligently every day—even if you gain only twenty or thirty incision points per day—a few months’ work will elevate your skills to the level of an attending.

He hadn’t had a moment to check his phone all day; now he pulled it out to see.

Unread messages were piling up.

The chat for Class 512 had exploded with activity.

Nearly all classmates and teachers were congratulating him and Yang Chan on securing a trainee qualification.

Yang Chan had already replied in the chat, expressing thanks to the teachers for their guidance and to everyone for their blessings.

Zhou Can hesitated to reply in the group, as some classmates began to voice their discontent.

They started teasing, saying that now that he’d made it big, he’d ignore his teachers and peers.

Worse yet, someone claimed he was now the top trainee at Tuyu Hospital, treating his teachers with disdain and forgetting his roots.

Zhou Can scrolled casually through the class chat messages, exasperated.

It was clear that his classmates were getting a bit too boastful.

Some even joked that now that he had ‘made it,’ he wouldn’t give a damn about anyone.