Chapter 440: A Test of Hearts in the Emergency Department

The first eight hours after cardiac surgery are always the most dangerous. Generally, if twelve hours go by without major complications, that’s a sign the surgery was a success.

Their surgery finished just after eleven last night, so it’s been a little over eight hours since then.

So far, the child is doing well. With Director Xueyan’s wealth of experience, she can easily judge whether the operation went as planned.

“I really believe our Cardiothoracic Surgery Department will only get stronger. If our teacher were watching from above and saw how you’re guiding the department back on track, breathing new life into it, I know he’d be proud.”

[About slow chapter updates: You can now use the huanyuan app to change sources and check for the newest chapters of this book across multiple sites.]

Zhou Can felt genuinely happy for the Cardiothoracic Surgery Department’s progress.

“There’s no way I could have done this alone. Thank you for always having my back. We’ve stumbled our way through, but to stand strong against the combined pressure from the Provincial People’s Hospital, Xinxiang Hospital and the Third Hospital, keeping Tuyu’s Cardiothoracic Department afloat—honestly, sometimes even I can’t believe it happened.”

She was truly grateful to Zhou Can and her heart was full of emotion.

In just over a year she’d grown so much, more than she ever thought possible.

Her medical skills, surgical technique, management and ability to handle crises had all reached totally new heights.

But compared to her, Zhou Can’s progress was even more astonishing.

Thanks to his efforts, the Emergency Department had already made its first big breakthrough.

Now they had a state-of-the-art laminar flow operating room that could support at least two surgeries at once, fully equipped with a rest area, a massive storage room and everything else needed. On paper it looked like a single high-grade operating room, but in practice it was like having two.

They’d also gotten approval for a new endoscopic surgery suite—the project had officially started and construction was now underway.

If all went well, it would pass inspection in three months and finally be up and running.

The Emergency Department’s inpatient ward had gone through two rounds of expansions too.

Now, the wards were split between Surgical and Internal Medicine patients. The Surgical area had thirty standard beds, while Internal Medicine had ten. As for temporary extra beds, no need to even mention those.

They kept things flexible so they could adapt on the fly.

They’d also done two rounds of doctor and nurse recruitment in the Emergency Department.

Each time, they only added a few people, keeping the expansion small and manageable.

Chief Lou and Deputy Director Han probably worried that moving too fast could backfire.

And of course, staff costs mattered—a department’s financial health depends on this. Salaries came from the hospital, but there’s no way a million-yuan-revenue department would be allowed to support a bunch of freeloaders.

Zhou Can made his way to the Pediatrics Outpatient Clinic, heading as usual toward Room 17.

Now, every Wednesday, that room was his territory.

“Dr. Zhou, you’re just in time! Come help me consult on a complicated patient.”

Dr. Zhuang from Pediatrics seemed to be waiting for Zhou Can on purpose.

The moment Zhou Can showed up, Dr. Zhuang waved him over right away.

“Where’s the patient?”

Zhou Can looked around but didn’t see anyone in Dr. Zhuang’s office.

“Heh, there’s still ten minutes till work starts! I just wanted to show you some case files. This little patient had heart surgery at the Third Hospital but things aren’t looking good. The grandpa has connections and found me through his network—he wants to know if Tuyu can admit him.”

Doctors often run into these favors they simply can’t refuse.

You get relatives or friends of friends sidling up—it’s impossible to say no.

But just because someone pulls strings doesn’t mean it’s your specialty or strength. In that case, the doctor has to grit their teeth and ask colleagues in the right field to help.

Sometimes, relationships are just this tangled.

A lot of people think government workers or officials are the most burdened by requests and favors, but doctors have it just as bad. They’re in the crosshairs too.

After all, everyone’s human—anyone can get sick.

The minute things get a little bit serious, families want treatment in a big hospital. That’s when they’ll try every connection they’ve got.

And if they can’t find anyone? They’ll try to slip you a red envelope.

All in all, families and patients never truly relax until they know someone personally at the hospital.

“So, heart surgery at the Third Hospital and now there are complications—they want to transfer him here for treatment?”

The moment Zhou Can heard, he knew this was bad news.

Most hospitals don’t want to touch high-risk transfer patients like this.

Sure, if you pull off a miracle, you get a reputation boost and maybe some benefits. But if things go wrong? That same family might turn on you in a heartbeat.

Lawsuits and compensation—those are the best case scenarios.

And hospitals that can pull off heart surgery in the first place have serious skills. If they struggle, why should you think you’ll do better?

Dr. Zhuang was in his fifties—there’s no way he didn’t get this.

“I know how risky this all is—so I haven’t promised anything. But the grandpa is an old student of my own mentor. I really didn’t have a choice but to ask around.”

He’d already gotten all the patient files ready.

So Zhou Can just took them and started going through each document closely.

The patient was an infant, only six months old, born with a primary-type atrial septal defect. The Third Hospital had done a repair operation.

The heart murmur was found during a checkup, so the family took the child to see a doctor.

Examination revealed symptoms like rapid breathing, sweating and limited activity—all classic signs. But thankfully, no congestive heart failure was found.

There were also no signs of atrial arrhythmia as a complication.

In theory, there really shouldn’t have been any major surgical risk here.

At least in Zhou Can’s view, when Dr. Hu Kan was around, this kind of operation had an extremely low mortality rate—almost never any incidents.

The grandfather clearly had influence, choosing the Third Hospital on purpose. No need to even ask: the surgery must have been done by that famous Japanese heart surgeon.

But Zhou Can had always suspected that Japanese heart specialist wasn’t as incredible as everyone made him out to be.

It was probably all hype, mixed with the tendency to idolize foreign doctors—that’s how the legend began.

“So what’s the patient’s condition now?”

“Main problem is heart failure.”

Dr. Zhuang clearly had already gotten all the latest info from the family. His face was extra serious.

“Heart failure in a baby—that’s not just serious, it’s life-threatening! No wonder the Third Hospital is out of options.” Even without seeing the doctor, Zhou Can could imagine the Japanese specialist was probably completely stumped.

“Dr. Zhou, you were Chief Hu’s star student—she taught you everything she knew about cardiothoracic surgery. You’re the main reason the department could survive this storm. Be honest with me—do you think we can save this child? Third Hospital already told the family that because of these severe post-op complications, survival odds are less than twenty percent. They’re suggesting a transfer to a major hospital in the capital.”

While explaining, Dr. Zhuang couldn’t hide the anger on his face.

“The child is so little, already struggling with serious complications, and now they want to ship him off to a hospital in the capital? That’s sending him to his death! A trip like that is exhausting—he might not even survive the journey. All they’re doing is shifting the blame.”

Getting timely treatment in the capital isn’t easy, either.

Never mind the long distance—you can’t even be sure the big hospitals want to take on such a risk.

Even the major hospitals in Zhengzhou might not dare accept patients like this.

But those hospitals are famous for saving the critically ill—sometimes after every other hospital has given up, families are already making funeral arrangements, yet Zhengzhou doctors still bring people back.

There are plenty of stories of patients brought back from the brink like that.

“Dr. Zhuang, we’re all one team, so I’ll be straight with you.” Zhou Can’s expression turned grim.

“No need to hold back.”

Dr. Zhuang nodded earnestly.

“Whoever takes this case is asking for trouble. It’s already the fourth day post-op; based on my experience, even intensive care probably won’t keep the child alive for ten days. In most cases, the high mortality rate kicks in around day seven or eight. Since the grandfather is your mentor’s friend, if we’re not blamed for a bad outcome, I’d say we might have about a forty percent chance—if the transfer happens this morning and the drugs they’re using for resuscitation haven’t been overdone.”

Zhou Can paused, then added,

“If the symptoms had shown up and he’d been transferred here on the first day after surgery, the survival rate could have been over seventy percent.”

But the odds of an immediate transfer are almost zero.

The Third Hospital wouldn’t agree and the family couldn’t possibly have known things would get this bad.

Now it was a total mess—the hospital wanted to dump the patient, and the family felt hopeless after realizing the Third Hospital wasn’t as capable as they thought. They were desperate for another shot.

“If we transfer him here, can you be there to supervise the rescue?”

Something about Zhou Can—the way he looked, talked, even his confidence—just made Dr. Zhuang trust him.

Maybe it was Zhou Can’s record, or maybe just the steadiness he showed when discussing the odds.

“Absolutely. As soon as he’s transferred, once the admission’s processed, just call me over right away.”

Zhou Can agreed without hesitation.

“Make sure you get the surgical records, post-op instructions, drug sheets and all details on rescue measures that have been used. That makes continuing the rescue here way easier—and it’s also important for sorting out responsibilities later. Otherwise, I doubt the Cardiothoracic Department will accept this child.”

If he says no, that’s that—no one’s going to take the case.

Even Dr. Zhuang couldn’t push through if Zhou Can refused.

Unless Pediatrics wanted to admit the boy themselves.

But that’s not going to happen.

Unless Dr. Tang Fei and Dr. Zhuang were willing to risk their own careers for charity.

“Go on, get to work. Thank you for this!”

Dr. Zhuang was full of gratitude.

Someday, if Zhou Can ever needs help, Dr. Zhuang’s sure to repay him.

Just like how Shangguan Yan from Tuyu Affiliated Hospital now owes Zhou Can a favor—they stay in touch, and Shangguan even sends him holiday greetings.

Debts of gratitude—those are the hardest to pay back.

Zhou Can went on to Clinic Room 17 to start his shift, not thinking about it further.

By now, families had already lined up outside the clinic. When Zhou Can walked in, those who recognized him called out his name with genuine warmth.

The ones who didn’t know him looked him over and silently wondered, ‘Wow, Dr. Zhou is really young.’

“Dr. Zhou, my son broke his arm! Could you see him first? I’ve heard you can set a bone in seconds. I’ll pay whatever it costs—please, just help my child first.”

A woman in her forties stopped Zhou Can in his tracks.

She had an eight or nine-year-old boy with her, his left arm dangling uselessly. The boy’s face was twisted in pain.

One look and Zhou Can could tell—it was just a dislocated joint. With his current bone-setting skills, he didn’t even need an X-ray; he could fix it in seconds.

It’d only take a few moments.

“Dr. Zhou, please, I’m begging you!”

The woman actually knelt on the floor in front of him, crying.

“Please, there’s no need for that, get up, really.”

Zhou Can quickly reached down to help her up.

“If you won’t help, I’ll just stay kneeling right here. Please, I’m begging you…” She sobbed even harder, moving everyone who saw her determination to relieve her son’s pain—she was willing to beg a doctor in public.

She was crying not just out of desperation, but real heartbreak for her child.

That’s the power of a mother’s love.

“It’s just a few seconds of work—doctor, why not treat him now?”

“Yeah, the kid’s suffering—just help him out!”

Several other families, moved by sympathy, chimed in to support her plea.

“I’m sorry, it’s true that setting a bone only takes seconds, but there’s a catch. I only do it after seeing an X-ray. I really do sympathize with your child—I can feel his pain. But right now, I just can’t treat him without proper checks. If everyone ahead of you agrees, I can give your son priority for an exam—that I can do.”

Zhou Can’s heart was steely, completely unmoved.

He’d learned the hard way from families who cried, knelt, and played the pity card before—some of them had turned around and caused him no end of trouble.

The more pitiful they seemed when begging, the more of a nightmare they could be if something went wrong later.

A doctor can be kind, but sympathy absolutely can’t cloud your judgment.

“A dislocated arm isn’t life-threatening. My daughter’s had a raging fever with vomiting and diarrhea all night—we’ve been waiting since early morning, so I don’t agree with anyone cutting the line.”

A father who’d brought his daughter for care was quick to object to letting the kneeling woman skip ahead.

“Me neither! Every child’s life is precious; no one comes to a hospital for fun. Fairness comes first.”

Another family made their voice heard too.

That’s the reality for families in these situations.

Everyone guards their own interests fiercely—mess with their spot in line, and you can expect a fight.

“How can you two have no compassion? So what if your daughter has a fever—doesn’t compare to my son’s broken arm! If your own daughter’s arm was snapped, I guarantee I’d let you go first.”

The woman realized her attempt to jump the line had failed.

She immediately transformed into a shrew, lashing out at the first parent who objected.

“And you—dressed all fancy, yet so stubborn! Letting my son go first isn’t going to hurt you. The doctor said it’ll only take a few seconds.”

When this woman started an argument, even three stubborn men would be no match for her tongue.

She went toe-to-toe against two families and still had them at a loss.

Her fierce, shrewish energy made even Zhou Can shiver.

He breathed a quiet sigh of relief—thank goodness he hadn’t let sympathy cloud his judgment and agreed to her request earlier.

Being a good doctor means more than knowing your medicine—it means learning how to deal with families and, most importantly, how to protect yourself.