Chapter 420: Night Shift Surgeons: A Test of Skill and Resolve

Just before 7 p.m., Director Xueyan rushed in.

“I got held up during rounds, so I’m a bit late. Director Le, you’ll be my first assistant. Zhou Can, you’re my special assistant—step in as chief if needed. Everyone else’s assignments stay the same.”

Director Xueyan wasted no time laying out the surgical roles with her signature decisiveness.

She used to be gentle in her words and actions, but reality had molded her into a tough, no-nonsense leader.

You can’t really understand hardship until you’ve lived through it, and without setbacks, you stay naive forever.

Her rapid progress over just two months—from gentle department head to iron-willed commander—must have come with plenty of bitter experience.

Only this kind of trial by fire can really build true management skills.

Zhou Can had never seen a department head who joked or messed around on the job.

No matter how friendly they seem, when things get tough, they’re ready to lay down the law. Mercy isn’t really in the job description.

Zhou Can figured it wouldn’t be long before Director Xueyan became a truly outstanding head herself.

The first surgery began quickly.

You could see the tension on Director Xueyan’s face and her unwavering focus. Her movements were steadier than before.

Zhou Can stood by, supporting her. Director Le played the role of first assistant, while the older Deputy Director Lu was only qualified as second assistant.

In any surgical team, younger doctors are always given priority for training.

Deputy Director Lu is fifty-four, with just a few years before retirement. With age, it’s harder to learn and stamina drops. And by the time someone’s trained, they’re about to leave anyway—not a great return on investment.

That’s why doctors in their thirties and forties are usually the most valued part of any surgical team.

By that age, most have outgrown their youthful impatience and gained the steadiness of someone settling into middle age. Their medical knowledge and surgical skills have also reached a solid foundation, making them easier to train further.

Once they’re fully trained, they become the backbone of the team.

In medicine, you get out what you put in.

Even just watching from the side, Zhou Can saw this as a valuable learning opportunity. He’d done numerous lobectomies before, but every surgery was its own challenge.

Standing outside the action lets you notice problems you’d miss when actually operating.

It’s an old truth: those in the thick of things are often blind to their own mistakes, while outsiders see clearly.

The first half of the operation went smoothly.

But when it came time to tie off the arteries for the lower lobe and basal segment, Director Xueyan hesitated.

Zhou Can didn’t jump in right away. He just waited patiently for her decision.

He’d only step forward if she was truly stuck and needed help.

Every surgeon’s growth depends on what they figure out for themselves in practice.

Book knowledge or a teacher’s tips only become your own after you’ve truly absorbed them. Otherwise, you just forget them again.

“I’m not confident about ligating this artery!”

After three or four minutes of silence, Director Xueyan looked up at Zhou Can.

She knew he had mastered all sorts of surgical skills for lower left lobectomies by now.

“Didn’t you handle the lower pulmonary vein just fine a moment ago?”

She’d deftly instructed the first assistant to use the retractor and pull down the diaphragm, exposing the inferior pulmonary ligament, then used the electrotome to cut upwards along the lung edge. Even when she hit an unexpected vessel in the ligament, she managed bleeding with calm.

Even when a rogue blood vessel was severed inside the ligament, her hemostasis was quick and composed.

So why hesitate now, when it’s time for the left lower lobe artery?

“How about I guide you and you handle the operation?”

Zhou Can asked calmly.

Thankfully, everyone in the operating room had once trained under Dr. Hu Kan and knew Zhou Can’s skills. A stranger would have been absolutely stunned.

It’s hard to imagine someone this young—a mere resident—daring to direct the chief of cardiothoracic surgery through a complex level-four procedure.

Talk about bold.

“I…”

She still looked uncertain.

The failed cardiac surgery from the other day, where the patient died, still cast a long shadow over her mind.

Overcoming it would take time—and more importantly, success in the operating room.

“Don’t worry. Even if something unexpected happens, I’ll help you handle it. I know you can do this.”

Zhou Can offered some encouragement.

“Alright! I’ll give it a shot!”

Director Xueyan completely dropped her usual authority in front of Zhou Can.

“Not just a shot—give it your all.”

Zhou Can pressed her, voice serious.

“Got it!”

She nodded firmly.

“Snip the mediastinal pleura over the lower pulmonary vein and expose the vein’s upper edge.”

Zhou Can patiently walked her through each step.

She knew the method, but some of the details and flexible adjustments weren’t as instinctive for her as they were for Zhou Can.

“Use your index finger to bluntly dissect the space between the lower lobe bronchus and the lower pulmonary vein. Free the vein, and don’t rush—any tissue you tear could make recovery harder later on…”

Both had learned under Dr. Hu Kan, though Director Xueyan got even more direct guidance.

But when it came to hands-on skill, Zhou Can had the clear edge.

He especially shone at making quick decisions in a crisis, skillfully applying techniques, and predicting postoperative issues.

Thanks to Zhou Can’s help, Director Xueyan and the whole team finished the left lower lobectomy without a hitch—he didn’t even need to step in himself.

“Excellent job. As long as the patient rests well in the ward, there shouldn’t be any major problems.”

Zhou Can offered genuine praise.

“Dr. Zhou, you’re practically our lucky star. If you could help out more often, that’d be a blessing. Honestly, since Dr. Hu passed away, every complex level-four surgery has left me on edge. But with you around, everything just feels calmer.”

Director Le let out a huge sigh of relief when the first surgery succeeded.

He truly cared about the future of the department.

“Many hands make light work. Our department really does need Dr. Zhou’s help right now.”

Though rarely outspoken, Deputy Director Lu chimed in.

He and Director Le both hoped Zhou Can could lend a hand more often.

As for the doctors and nurses below them, their feelings went without saying.

After the accident a couple days ago, everyone had been walking on eggshells.

The department head’s mood was practically a weather vane for the whole department.

“See? Everyone wants you to help out!”

For the first time in days, Director Xueyan managed to smile.

This successful surgery—chiefed entirely by her—did wonders for her confidence.

“Haha, thank you all for the trust. Whenever I’m free, I’ll come running!”

Zhou Can readily agreed, grinning.

He’d already promised Dr. Hu to do everything possible for Cardiothoracic Surgery, to keep it thriving. This was only natural.

“That one took three hours—it’s ten o’clock now. Shall we move on to the second surgery?”

Director Xueyan surveyed the group.

“As second assistant, I’m good to go. If needed, these younger guys can take my place.” Deputy Director Lu replied first.

He belonged to the department’s older generation and felt a deep bond with it.

Knowing he’d never climb higher, all he wanted was a quiet retirement and a thriving department. Cardiothoracic Surgery felt like his home.

“The cases are set—even if we had to work through the night until dawn, I’m in,” Director Le added with a grin.

“Same here.”

Zhou Can also gave his support.

Their group made all the calls in the OR. Everyone else—scrub nurses, anesthesiologists—had little real say.

Just look at the high rate of sudden deaths among hospital anesthesiologists and you’ll know how rough their job is.

If they could say no, who’d choose to keep working themselves to exhaustion?

“What about you? Still hanging in there?”

“We’re good!”

“No problem!”

The three surgical nurses answered in chorus.

“Honestly, I’d just like to finish early. If Dr. Zhou could help with the more time-consuming steps, we’d be a lot faster.”

As a chief-level anesthesiologist, their suggestion actually carried some weight.

Zhou Can rubbed his nose. After so many major cases, nearly every anesthesiologist recognized him as a speedster in the OR.

“Fine by me. Zhou Can could handle the whole second surgery if need be,” Director Xueyan agreed, knowing a slow pace was a big weak spot.

“I’m not ready to chief a level-four surgery! If you want to hand over the challenging steps, that’s better,” Zhou Can quickly replied.

A good number of his surgical skills were still only at the associate level—he wasn’t ready to tackle an entire high-level procedure alone.

But he could handle the crucial parts as needed.

After all, his Rapid Scalpel Technique was already at the proficient level, and his Steady Scalpel Technique had reached basic mastery.

With these techniques woven into his surgical repertoire—including Incision and Tissue Separation—he could easily perform at a chief’s level for those specific steps.

Just before midnight, they finished the second surgery.

To speed things up, Zhou Can handled many steps himself—including closing the chest at the end.

It was so late that if they’d left the closing to two younger residents, they’d likely still be at it by one or two in the morning.

And that’s no exaggeration.

Resident doctors are still considered newbies in a surgical team.

Some junior residents get so excited about closing up an abdomen, they’ll talk about it for a month.

It’s just that they rarely get these hands-on opportunities.

“I’ve ordered everyone a late-night snack. Take your share home or to the dorm—thanks for your hard work today.” Director Xueyan addressed the team.

With both surgeries a success, this was the happiest she’d been in two months.

It felt like a heavy stone had finally been lifted from her heart.

Zhou Can’s standout performance tonight sparked new hope for her.

Looking back, she realized her pride made her hesitant to ask for his help before. She thought she could manage alone, and just ended up making things worse.

Everyone involved seemed genuinely happy.

No matter how tiring it got, what really killed morale was a lack of hope.

“Zhou Can, could you help check on a post-op patient in the ward?”

Fresh out of surgery, Director Xueyan pulled him aside for more help.

“What’s going on with this patient? I’ll come with you. You’re like my big sister—I can’t say no!” Zhou Can replied with a grin.

“Thank you for being so nice to me! The patient had surgery two days ago, done by Associate Director He’s team—a lobectomy, but the drainage volume is way over normal…”

She gave Zhou Can a quick rundown of the case.

A little leakage after a lobectomy is totally normal. If the daily drainage is under 500ml, that’s usually fine.

But if it drops below 200ml the second day, that’s not always good either.

Especially the day after surgery—a low drainage rate isn’t proof of a flawless procedure. On the contrary, it could signal a blockage or other complication.

Lobectomies have always carried high risk.

Some doctors think they’re super safe simply because the technique’s been refined so much.

But if something goes wrong in surgery or complications arise, the chance of death goes way up.

“Does Associate Director He know about this?”

Zhou Can asked.

He had a poor opinion of Associate Director He. The hospital runs on a primary responsibility system, so since He performed the surgery, he’s responsible for the complications. It was out of the question for Zhou Can and Director Xueyan, still busy with their own surgeries, to pick up the pieces for him while he lounged at home.

Zhou Can refused to play the saint.

“He’s already been notified. He’s still on duty. While I was in surgery, he even sent me a message asking for help. The patient isn’t doing well, but no one’s figured out why there’s so much drainage yet.”

Director Xueyan smiled slyly.

Getting Associate Director He to lower himself and ask her for help was definitely satisfying.

He’d always had a rebellious streak, acting like the old guard.

Just this afternoon, she’d invited him to help with the first lobectomy, only for him to make up an excuse.

Karma, indeed.

No one would have guessed that by seven that evening, his own patient’s surgery would go south.

Now it was his turn to be anxious.

“I was worried you’d hesitate to stand your ground when the time came. Calling him in is the right move.”

Zhou Can felt like a real brother around her, so he spoke without reservation.

It was all for her own good.

“It’s only been a month since I became department head. I used to be soft—thinking if I cared for others, they’d care for me. But after getting backstabbed on a few cases, my eyes opened to who Associate Director He really is.”

Director Xueyan wasn’t naive—she’d only misplaced her kindness.

“You can’t be soft leading a department, and business isn’t about charity either. If you want to run a team this size, sometimes you have to be tough.”

Zhou Can told her seriously.

“I get it! We’re almost at the inpatient wing. Let’s save this talk for later.”

She didn’t want anyone else to overhear.

When they reached the ward, they found a male patient in his forties, face pale and looking terribly unwell.

After a thorough exam, Zhou Can’s expression grew solemn.

His wealth of ICU experience made it clear: this patient was in real danger.