Chapter 4: Operation Critical Moment

Red lights and flashing lightning propelled the patient straight into the operating room.

“Good morning, Director Liu! Good morning, esteemed doctors!”

Zhou Can observed at least seventeen or eighteen people already inside, all donned in surgical protective gear with masks and head covers. Frankly, without a careful look, it would be easy to mix them up.

They greeted each other—experience had taught him that much.

Only Director Liu was greeted individually; the rest of the doctors were collectively acknowledged as senior physicians.

Normally, Director Liu would spend his mornings at the outpatient clinic.

Today, with the surgery scheduled earlier, it was clear he had an unexpected commitment.

“I have a symposium at the Provincial Medical Association this afternoon. Once this surgery is done, I’m out. Let’s get started promptly!”

Director Liu was quite seasoned, though his academic achievements lagged. Stuck at the Associate Chief Physician level, he longed to drop the ‘associate’ before retirement.

His recent flurry of academic conferences underscored his urgency.

The team collectively wheeled the patient onto the operating table.

A Attending Nurse instructed the patient to remove his shirt and performed another skin disinfection. Then the anesthesiologist arrived for a pre-anesthesia checkup, ensuring everything was in order before attaching various life-monitoring leads and a respirator mask.

In a major surgery like this, the anesthesiologist was just as crucial as the chief surgeon.

He was responsible for continuously monitoring the patient’s vital signs and providing timely advice.

This was a neck lymph node tuberculosis excision, classified as a general tertiary procedure.

For a surgery of this magnitude, it typically required a deputy chief-level surgeon to lead.

Even the experienced attending physicians could only serve as first or second assistants.

The risks of the procedure were self-evident.

Zhou Can, merely an intern, only had his fleeting moment of glory escorting the patient into the ward. Now that the patient was on the operating table, he didn’t even get a chance to hold a retractor.

He could only stand at the back to watch and learn.

While observing a high-profile surgery once or twice was exciting, repeatedly watching without actively participating yielded limited learning.

Interns often joked about ‘rushing through the motions’ to describe their role.

They couldn’t possibly remember which tool was used for which step or procedure details.

Only in sudden emergencies, when rescue medications were used, did things truly stand out.

“Mr. Gao, can you hear me?”

The anesthesiologist, applying inhalation anesthesia, had the patient under; his eyes were now gently closed as if in deep sleep.

Calling out to the patient was merely to test his responsiveness.

The patient remained as unresponsive as if he were fast asleep.

The anesthesiologist checked the patient’s limbs again and then glanced at the monitors displaying his vital signs.

“Anesthesia successful. Patient’s vitals are stable. You may begin the surgery.”

This remark was clearly directed at the chief surgeon.

Director Liu instructed the instrument nurse to help him put on gloves, and the first, second, and third assistants all took their positions.

The scene resembled a battle formation on the verge of an attack.

Only, these warriors were determined to defeat disease.

“Begin the incision!”

The chief surgeon addressed the first assistant.

For such a critical operation, the chief surgeon typically handled only the most crucial part.

It was also the most complex phase.

The first assistant steadily placed the scalpel at the designated mark and began to carefully incise the skin of the patient’s neck.

Here, with a dense network of blood vessels and numerous lymph nodes, Zhou Can felt a chill run through him.

If it were his turn, he wouldn’t have dared to make a cut.

As the incision and tissue separation progressed, the second and third assistants diligently used hooks to widen the opening, allowing the chief surgeon a better view and creating optimal conditions.

They revealed a lymph node the size of an egg, surrounded by several others of varying sizes. The carotid artery pulsed steadily nearby.

Removing the diseased tissue in an area teeming with blood vessels and nerves posed a tremendous challenge.

The chief surgeon focused intently on peeling away the largest lymph node.

His expression was concentrated, his movements steady, meticulous, and deft.

The first assistant’s coordination was impeccable.

At the slightest sign of bleeding, an electrocautery tool was promptly used to staunch it—swift and precise like a well-practiced whack at a mole.

Zhou Can watched in awe.

Midway through the surgery, the patient suddenly convulsed, and his vital signs plummeted.

Almost immediately, the monitors emitted a series of alarming beeps.

“This is bad! The patient’s blood pressure has dropped below 60, with abnormal respiration and a heart rate of 160… Director Liu, did you accidentally injure the carotid artery?”

The anesthesiologist asked nervously.

“No!”

Having witnessed many perilous scenarios, Director Liu remained unruffled and composed.

“Damage to major nerves is unlikely. This area lacks respiratory nerves,” the first assistant added.

Following that, the interns looked on in helpless confusion. The resident doctors were at a loss, and the intern team was gripped by panic.

In just a few moments, the anesthesiologist delivered more disheartening news: the patient’s condition had deteriorated drastically, and he was now in shock.

Shock and death were dangerously close.

Sweat beaded on Director Liu’s forehead in an instant.

“Wipe that sweat off!”

A scrub nurse hurried forward to help wipe the sweat from Director Liu’s brow.

Panic quickly began to spread throughout the operating room.

If the patient were to inexplicably die on the table, Director Liu’s long-standing reputation would be tarnished, and everyone involved would face disgrace.

Zhou Can took a deep breath, exhaling slowly to steady his nerves.

He forced himself to remain calm.

At that moment, he felt an invisible weight of responsibility on his shoulders.

Safeguarding the patient’s life was the solemn duty of every doctor.

Despite knowing his own limitations, he was determined to contribute.

This patient happened to be under his care and in the operating room, so he was fully familiar with the illness, diagnostic results, and all related details.

He began to review the patient’s records, medical history, and test results repeatedly.

Then, he casually noticed red rashes appearing on the patient’s skin.

A realization dawned on him.

“Yes, it must be this!”

Suddenly, Zhou Can blurted out an unexpected remark that left everyone astonished.

“Zhou, be quiet. Can’t you see Director Liu and the attending physicians are deep in thought?” The Chief Resident snapped at him.

“Director Liu, I believe I’ve discovered the reason for the patient’s shock.”

Ignoring the Chief Resident’s warning, Zhou Can looked at Director Liu with excitement.

This time, everyone was stunned.

They all turned to gaze at the intern in the back.

Even the seasoned Director Liu and experienced attendings couldn’t pinpoint the cause—how could an ordinary intern like him identify the reason for the patient’s shock?

They were incredulous.

“Explain yourself!”

After his initial surprise, Director Liu decided to hear the intern out, though his hopes were not high.

Having taught for many years, he’d seen his fair share of overly confident youngsters who thought a bit of reading made them exceptional, only to be proven wrong.

Their analyses of various conditions were often unrealistic and based solely on subjective assumptions—a recipe for inevitable embarrassment.