Chapter 363: A New Surgical Approach

With modern technology advancing at lightning speed, messages now spread across hospitals and social media platforms in an instant. The competition between hospitals has grown fiercer than ever.

Xinxiang Maternity and Child Hospital, once a major specialty hospital, nearly went bankrupt within just two years after a single maternal death incident.

Even if Tuyu Hospital seems deeply rooted and its cardiothoracic surgery department has always performed well, without a leading pillar, decline could happen in just a year or two.

Sometimes, it might even crash and burn within a few months.

“I’ll do my best. After all, striving for greater medical skill has always been my passion and my lifelong career. It’s just… for cardiothoracic surgery, you know as well as I do, it takes at least ten years to truly achieve something. I worry I might disappoint you and all the chief physicians who have such high hopes for me.”

Even though Zhou Can has his medical experience system and natural talent, and on top of that works hard,

The training period to become a cardiothoracic surgeon is especially long.

Many doctors slog away, practicing hard for twenty years or more, just to gain some recognition.

“Zhou, your progress has been miles ahead of most doctors. Especially the speed of your surgical improvement—it’s honestly the fastest I’ve seen in my whole career. As long as you keep studying, I believe that in four or five years, you’ll reach a great height. At the very least, you’ll be able to handle the key parts of technically challenging surgeries.”

Director Hu Kan values him deeply.

He holds even higher expectations for Zhou Can than he does for Director Xueyan, Director Le, and the others.

“Today’s ventricular folding surgery is a great chance to prove that our cardiothoracic department’s skills haven’t gone downhill. I want everyone to be at their absolute best and ensure this surgery’s a success.”

Director Hu Kan’s gaze swept over everyone in the room.

For this department, carrying out a high-profile hard surgery is urgent and essential right now.

“Does everyone feel confident?”

“Yes!”

But their response was halfhearted. Their confidence clearly lacking.

“Confident, are you? Then say it louder.” Director Hu Kan’s face darkened with anger.

“Yes!”

This time, their reply rang out much louder.

Still, raising your voice isn’t enough to truly improve surgical skill.

…

Inside the operating room, the first surgery of the day was foreign object removal from the lung.

The patient was twenty-eight, a solidly built young man. According to his family, his mother took cold medicine during pregnancy, which led to intelligence issues from birth. Now, nearly thirty, his IQ is lower than that of a three-year-old.

Basically, if he can get food down, the moment he’s hungry, whatever he sees goes straight into his mouth.

As for the foreign object currently stuck in his lungs, nobody has figured out exactly what it is.

All they know is that it’s irregular in shape, about 1.2cm in diameter.

Even his family has no clue how it ended up in his lungs.

The initial guess is that he must have choked on it, sending the object into his trachea, then down to the lung. It’s probably metal.

They already tried extracting it with a bronchoscope, but unfortunately, that didn’t work.

With no other option, his family brought him to Tuyu Hospital. The plan here was to do traditional open-chest surgery and take the object out.

Test results showed that the object lodged in his lung had already caused some degree of pneumonia.

The patient was coughing badly.

If not treated in time, things would definitely get worse.

No wonder his family was desperate.

“Zhou, any problems with you leading this surgery?”

“I can give it a try.”

Zhou Can had already done lobectomy surgeries before, so he was more than capable of handling a foreign object removal like this.

Even better, he’d finally grasped the essence of the Steady Scalpel Technique during yesterday’s practice.

Today was the perfect chance to use it.

He’d get to see how it held up in real surgery.

“You take the lead. I’ll assist from the side and guide you if needed.”

With Director Hu Kan holding absolute authority here, nobody objected when he said Zhou Can would be lead surgeon.

Zhou Can put on his sterile gloves and took his place at the operating table.

Receiving the scalpel from the scrub nurse, he skillfully cut along the pre-marked incision line.

【Rapid Surgical Technique experience +1, Steady Scalpel Technique experience +1, Incision Technique experience +1.】

With just one stroke, three different technique experiences increased. The rush felt incredible.

“Huh!”

Director Hu Kan, standing nearby, couldn’t help but widen his eyes in shock as he watched Zhou Can. Pure delight broke out on his face.

Because he noticed immediately—Zhou Can’s scalpel work was clearly different from before.

Having spent his entire career immersed in the Steady Scalpel Technique and holding the title of the most skilled in cardiothoracic surgery, Director Hu Kan’s sense for these things was razor sharp. Zhou Can had made a breakthrough with his technique, and he saw it at just a glance.

But Director Xueyan, Director Le, and the others didn’t catch on.

Their skills weren’t at that level yet, and their eye just wasn’t sharp enough.

“That technique is so steady! Grown men often walk with slumped shoulders, carrying the weight of responsibility. A good scalpel technique is much the same—the blade moves as if it bears an invisible mountain. It carries both responsibility and composure. That’s a bit of the essence of the Steady Scalpel. All of my students, whether it’s Jin Mingxi or the chief physicians, have solid fundamentals but lack this touch of insight.”

Director Hu Kan was genuinely happy for Zhou Can, though he couldn’t help but sigh inwardly.

Talent is something you can’t force.

And those truly gifted are few and far between.

If even one or two of the chief physicians in cardiothoracic surgery had Zhou Can’s level of talent, the department wouldn’t be stuck in a rut with no one to take the lead.

Talent is hard to define, but it’s very real.

Take Jin Mingxi and Zhou Can as an example. Jin Mingxi had trained since childhood, working on the fundamentals of the Steady Scalpel Technique for the past two years. His foundation was strong, but that was it.

Zhou Can, despite his short practice time, already grasped a bit of the true essence—the scalpel steady as a mountain. That’s his intuition and talent.

Something Jin Mingxi and the other chief physicians envy but can never achieve.

From then on, the surgery became Zhou Can’s solo performance. Each cut was swift yet steady, each slice more controlled than the last, and his efficiency soared.

“Dr. Zhou’s surgical skills look to have improved a lot!”

Director Xueyan seemed to pick up on something.

She mumbled under her breath.

“What’s changed exactly?”

A glimmer sparked in Director Hu Kan’s eyes. He looked at his now-promoted chief physician student with a bit more hope.

Director Xueyan had some of the richest medical knowledge in the department, able to apply new ideas and offer key diagnoses for tricky cases, sometimes nailing the diagnosis on her own.

Her only shortcoming was not being a top-tier surgeon.

But now, being able to notice a real difference in Zhou Can’s scalpel work might mean she’s on the verge of a breakthrough herself.

Learning by observing and referencing others is another solid path to progress.

“I can’t really put my finger on it, but he’s steadier than before. Less nimble, a bit slower, but it’s like a rash young guy who’s learned composure and restraint. He’s matured.”

She couldn’t see any invisible mountain on Zhou Can’s scalpel, of course.

All she could tell was that his technique felt a lot more grounded.

“You’re observant. Keep watching! Zhou really is exceptional in his insights.”

Director Hu Kan nodded slightly.

He encouraged Director Xueyan to keep observing and learning.

When Director Hu Kan performed surgery himself, his level was so high that even chief physicians and attendings could only watch as if through fog, never seeing the underlying mastery.

But right now, Zhou Can had just reached a new level in the Steady Scalpel Technique, making it the best time for others to learn by watching.

Once Zhou Can fully internalized the essence of the technique, it would become indistinguishable, and it’d be hard for even the chief physicians to pick up anything.

…

A little over an hour later, the foreign object was finally extracted from the patient’s lung.

It was already blackening on the surface and looked like a pendant from an earring or necklace. No one knew how the patient got his hands on it, ate it, and then choked until it went down the airway to the lung.

“This pendant seems to be made of platinum—not stainless steel or silver.” Director Le studied the object with forceps and gave his professional opinion.

“Return it to the family. Ah, having a son with an intellectual disability like this—what a tragedy for the family.”

Director Hu Kan sighed.

Doctors see all kinds of families struggling with hardship. For various reasons, their lives are full of misfortune and worthy of sympathy.

Under normal circumstances, their son would’ve been out working and supporting his parents by the age of twenty-eight.

But this patient, with his intelligence problems, couldn’t take care of himself, let alone get a job, leaving his parents to look after him around the clock. No doubt, the parents are exhausted, and their finances probably aren’t great either.

“Well done, Zhou! Looks like five days off didn’t set back your Steady Scalpel training at all.”

During the operation itself, Director Hu Kan didn’t interrupt Zhou Can.

Now that the first surgery was finished, he couldn’t help but offer some praise.

“I just gained a little insight while practicing. Trying it out in real surgery made a real difference. The risk of the operation dropped a lot.”

After seeing the Steady Scalpel Technique in action, Zhou Can was quite satisfied.

To be precise, he’d combined both the Steady and Rapid Surgical Techniques—rather than using just one.

“Stay humble and keep working in this direction. I believe you’ll keep improving.” Director Hu Kan nodded.

“Did any of you learn something by watching Zhou operate just now?”

Director Hu Kan gave the other doctors a look.

Everyone kept silent.

Director Xueyan, however, frowned in deep thought, her gaze lingering, obviously analyzing Zhou Can’s surgical technique over and over.

After a brief cleanup of the operating room and a short break, the next patient was brought in.

This one was a cancer patient who’d had a lung tumor removed a year ago. Recent scans revealed a new tumor growing in the mediastinum, already causing obvious symptoms.

Whether it was malignant or not still wasn’t certain.

Its unclear borders and evidence of blood flow all pointed toward a high chance of malignancy.

A mediastinal tumor resection surgery was needed.

This was a high-level, grade-3 surgery.

Once again, Zhou Can acted as lead surgeon. The chief physicians did this on purpose—letting him learn by doing.

There’s no shortcut to a surgeon’s progress.

The fastest way to get better is right here in the operating room—accumulating hands-on experience through real surgeries.

Mediastinal tumors fall into three types: superior, middle, and inferior mediastinum.

This tumor was in the superior mediastinum.

Most likely, it was a result of lung cancer metastasis. Generally, cancer spreads through lymphatics, blood, or by invading neighboring organs.

Bloodborne spread isn’t as terrifying as people might imagine—not every cancer cell entering the bloodstream sets off a chain reaction.

Even getting into the blood requires a cancer cell to break through several bodily defenses.

And even if it enters the blood, it might get filtered out by the kidneys or the sweat glands. The immune system could spot it and destroy it, too.

Even if it finally makes it to another organ, planting roots for a new tumor isn’t easy—the immune system is always fighting back.

But if it truly evades all defenses, then a secondary tumor can form and spread quickly.

One important fact: Any tumor that develops from cancer cells is, by definition, malignant. It can’t be benign, no matter how clear the borders are or whether there’s blood flow. Conventional diagnostic techniques don’t help here.

Only a biopsy or removing the tumor and running a pathology test can confirm what it really is.

Some patients, hoping for the best, see clear edges or no blood flow on imaging and assume all is well. That’s actually quite risky.

This is especially true when young resident doctors, lacking hands-on experience, advise further observation for the sake of surgical prudence.

As a result, patients miss the golden window for surgery.

This patient’s mediastinal tumor measured 4.6 cm. After surgical evaluation, Zhou Can decided a minimally invasive approach would work.

Generally, tumors under 5 cm can be considered for minimally invasive removal.

Of course, this depends on the surgeon’s skill.

At a leading provincial hospital like Tuyu, there’s no technical barrier here. But back in Zhou Can’s hometown at Xinhai City People’s Hospital, it would be a different story.

That’s one reason people go to big-name hospitals for surgery—sometimes even for simple cases.

People would rather wait in line for a major hospital than pick a smaller, closer one.

It’s not about being picky—they just value their lives. In small hospitals, there’s a chance you’ll be used like a test subject for inexperienced doctors. If it goes well, everyone’s happy.

If not, then death is at least an end.

But ending up half-dead—that’s a fate worse than death.

Zhou Can powered through the surgery, keeping up his signature fast and decisive style. In under forty minutes, he’d already removed the tumor. Whether he was excising it or keeping bleeding in check, his hands moved like the wind.

Compared to the slow, methodical pace of most in the cardiothoracic department, Zhou Can was a total outlier.

If Director Xueyan and the others watched Zhou Can operate more often, they might break out of old habits. They’d see that speed has value, not just steadiness.

After watching him complete two surgeries back to back, their thirst for greater speed had grown much stronger.

In that sense, Director Hu Kan’s absence wasn’t entirely a bad thing.

Before, Director Hu Kan was almost a god in their eyes—the gold standard everyone aspired to.

Everyone tried to model themselves after him.

Over time, nearly all the surgeons in the department developed a habit: never rushing, always focusing on stability.

For the department’s development, though, that attitude wasn’t ideal.

A single blossom doesn’t make spring. You need a garden in full bloom to bring spring alive.

Only with diverse styles and new talent thriving can a department stay vibrant.

Some surgeons might not suit Hu Kan’s slow, deliberate method—they might work better with a different approach.

Zhou Can has managed to combine speed and stability, opening a new window and broadening everyone’s perspectives.

They’ve seen a whole new world of possibilities.

From now on, they might start breaking old patterns and trying new things boldly.