Chapter 494: The Scalpel’s New Footing

Inside the operating room, anesthesiologist Qu Zi and her nurse were preparing a patient for general anesthesia.

Ever since her last talk with Zhou Can, she’d been showing up in the Emergency Department’s surgeries a lot more often. Whenever a patient needed general or spinal anesthesia, Zhou Can would always go to her to discuss the case.

Sometimes, when she felt the surgical risk was too high, she would refuse to take the chance.

Zhou Can could only do his best to persuade her.

Fortunately, she had a lot of trust in Zhou Can’s surgical skill. After working together so many times, they’d built up a good foundation of trust. So most of the time, Zhou Can succeeded in convincing her.

Once the patient was fully anesthetized, Zhou Can began the laparotomy.

The patient was so weak, like a lamp barely flickering in a stormy night. The moment the operation started, Qu Zi’s nerves went taut.

Luckily, Zhou Can’s technique wasn’t just fast—it was steady as a rock.

Between his Level 6 Incision Technique, Fast Scalpel, and Steady Scalpel, each cut flowed smooth as silk.

He opened up the abdominal cavity, heading straight for the source of bleeding: the ileocecal region.

There he found a massive mass, over 9 centimeters in diameter.

Its wall was thick and solid.

“Whoa, how did a mass this big even grow here?”

Dr. Xu was assisting his trainee at the table, visibly shocked at the sight of it.

“Doesn’t look like a tumor. My guess is it’s just full of blood.”

Zhou Can’s Level 6 Debridement Technique was no joke.

He studied the mass, pressed it a few times with his fingers, and quickly made up his mind.

“Should we drain the fluid from the mass first, Teacher?”

“No need! This mass won’t be easy to aspirate anyway—it’ll probably rupture if we touch it.”

When it came to surgical experience, Dr. Xu had Zhou Can beat by a mile.

If Dr. Xu said it was fine, it was basically never a mistake.

No one was more cautious on the table than Dr. Xu—name anyone else for second place and you’d be lying.

After all, he’d made a big mistake once—a slip that ruined his career and life. Once bitten, forever shy.

During surgery, Dr. Xu was strict with everyone, but even stricter with himself.

No matter how much he liked Zhou Can, if Zhou Can ever got sloppy in the OR, he’d get his head bitten off.

Zhou Can tried shifting the mass to separate it from the surrounding tissue.

Splat!

The moment he moved it, the mass instantly burst.

A rush of blood and fluid gushed out.

“Yang Zhi! Suction out the blood!”

“On it!”

Honestly, Yang Zhi was already set up before Zhou Can even spoke.

“If only your team had one more scrub nurse, you’d be basically perfect.”

Anesthesia nurse Qin Yue commented from the side.

She hadn’t used to talk much, but ever since Qu Zi mentioned wanting to join forces with Zhou Can’s team, she’d always greeted him with a smile. During surgeries, she was quick to point out any issues or flaws.

“I’d love to hire an extra OR nurse to take some pressure off Qiao Yu, but you know how it is. Most of my operations are still just basic Level 1 or 2 surgeries. It’s hard to keep more staff fed that way!”

Zhou Can’s answer was modest.

Given his surgical team’s insane daily workload, bringing on another scrub nurse was actually doable.

But that would mean splitting Qiao Yu and Ma Xiaolan’s pay.

Neither of them came from easy backgrounds. Both wanted to earn as much as possible.

They never complained about the heavy workload.

So for now, Zhou Can had no plans to hire anyone else.

While they talked, Yang Zhi had suctioned out all the fluid from the mass.

“This thing’s not just full of blood. There’s sloughy necrotic tissue here too. Looks like we’ll have to remove this whole section of bowel.”

Zhou Can checked the aspirated fluid and realized the patient’s ileum was in even worse shape than he’d thought.

If only they’d caught it sooner—they might have been able to cut out less intestine.

In fact, they might have even avoided surgery altogether if it’d been caught early enough.

On close inspection, he found not only necrosis in the local ileum, but also that the mesenteric lymph nodes were severely swollen and enlarged.

“Let’s cut it out!”

After examining it, Dr. Xu agreed to remove the affected bowel and lymph nodes.

With care, Zhou Can excised the diseased segment and the enlarged nodes. It was a hugely satisfying moment—not from perfectionism, but from the accomplishment of helping the patient by removing the source of disease.

【Fast Scalpel experience +1, Steady Scalpel experience +1.】

Right then, Zhou Can sensed something shift in his scalpel technique. He couldn’t quite explain it, but it felt like a real breakthrough.

Before, whenever he performed the Steady Scalpel, it felt like there was a mountain pinning down his hand.

Now, though, the Steady Scalpel suddenly revealed a brand new layer.

Holding the scalpel, the moment he touched any part of the patient’s body, he felt an almost magical sense of connection.

The tip or edge of the scalpel was razor sharp; as soon as it touched the skin or an organ, it cut right through.

Using the scalpel as a “third point of support”—that was something only the mad would dream up.

What surgeon would dare treat the scalpel like a support point for their whole body?

Even a tiny bit of force—just 0.1 kilograms—would be enough to do fatal damage to the patient.

To use the scalpel as a footing takes a level of control far beyond ordinary skill.

Zhou Can couldn’t wait and pulled up his surgical stats.

【Steady Scalpel: Current Experience—Proficient (1). Steady as a mountain, nimble as a swallow. Uses scalpel and both feet as support, a tripod of stability. Can be integrated into all scalpel-based surgeries.】

Diligence pays off in the end, turning an iron rod into a needle.

After tireless practice, his Steady Scalpel finally rose to the next realm—proficiency.

Now, when he took up the scalpel, it became a sturdy point together with his two feet, forming an unshakable tripod.

Physics dictates that triangles make the most stable structure.

Ancient wisdom was ahead of its time—even as far back as the Great Yu period, triple-legged cauldrons were forged to suppress floods and monsters.

The legendary Nine Cauldrons of the Nine Provinces—each one had three legs.

Zhou Can had never imagined the second realm of Steady Scalpel would work like this—scalpel and both feet forming a tripod. The technique transcended anything a mind could imagine.

You just had to keep practicing, refining your skill until you absorbed it naturally.

It was a profound understanding of force and control.

He wondered if Dr. Hu Kan’s Steady Scalpel had reached this tripod realm too.

Dr. Hu Kan had already passed on, so there was no way to ask anymore.

Steady Scalpel and Fast Scalpel were Zhou Can’s favorites. Each had its magic.

Now Steady Scalpel was finally at proficiency, and Fast Scalpel matched it. He wondered: Would raising one upset the balance, interfering with the unique technique he had forged from blending them?

Testing it out, Zhou Can found nothing was out of balance.

If anything, since the upgrade, his self-created surgical style became even steadier and more flexible.

After excising the diseased intestine and swollen lymph nodes, Zhou Can thoroughly debrided the site, sweeping away any suspicious tissue.

It’s not just cancer that spreads, after all.

Untreated ulcers can lead to rampant infection too.

Take stomach ulcers: they’re usually self-limiting, but for people with poor health or improper treatment, the lesions can grow rapidly.

For this patient, the removed ileum was totally rotten inside.

It wasn’t cancer, but it was just as dangerous.

If it weren’t for the blood loss and shock that sent him to the hospital, given a little more time, his bowel could have ruptured outright.

All it would take is a single perforation to end his life.

Once that happened, intestinal contents would leak into the cavity and peritonitis would be inevitable.

Operating on him really did save his life.

With his upgraded Steady Scalpel, Zhou Can put his new skill to good use on debridement, completely absorbed in the process.

He found the procedure quicker, easier, and much safer and more precise than before.

Even after hitting Level 6 with Debridement, he’d never dared call his work “perfect.”

The best he’d claim was “just right.” He was always aiming for excellence.

But this time, for the first time, he truly felt the result was perfect.

Sure, today’s debridement was just a typical case, but if he faced a mess of clustered lymph node tumors, he was confident he could handle it too.

And this was just one perk of upgrading Steady Scalpel. No matter whether he had to dissect tricky anatomy, remove tough lesions, or separate stubborn adhesions, Steady Scalpel would bring his surgery to the next level.

By the time Zhou Can finished suturing and closing the abdomen, his patient’s vital signs had stabilized. Dr. Xu looked at him in amazement and said, “Xiao Zhou, watching your debridement just now, I can tell you’ve stepped up your game. Your hands are as nimble as a tongue and steady as a mountain—you’ve really put in the work the last couple of years!”

“Heh, nothing gets past you, Teacher. My scalpel skills really did level up during this operation.”

With his skills advancing another step, Zhou Can was in great spirits.

Resecting a section of small intestine and mesenteric lymph nodes wasn’t such a big deal.

Plenty of deputy and chief surgeons could do that.

But tracking down the cause of this patient’s illness, operating so quickly, and saving his life? Now that was really impressive.

“So it’s Old Hu’s Steady Scalpel you’ve broken through on, huh? You’d better catch up with my Fast Scalpel too!”

Dr. Xu’s tone had a touch of jealousy.

He couldn’t help but feel competitive watching his beloved trainee master Steady Scalpel while Fast Scalpel stagnated.

“I haven’t neglected Fast Scalpel. I practice all the time! But breaking through needs not just sweat, but luck too. Maybe it’ll click soon—then I’ll really make you proud.”

Zhou Can’s Fast Scalpel had hit proficiency ages ago. The next level up needed ten times more experience—not easy to reach.

“By the way, did someone send the excised bowel segment for pathology?”

He turned to ask Dr. Pu.

Right now, errands like that only landed on Dr. Pu.

“It’s already gone to pathology—they’ll have the report out a bit later.”

Dr. Pu replied.

…

By late afternoon, just before quitting time, the pathology report arrived.

The intestinal wall was thickened, and after being cut open, appeared soft and fish-like, with necrosis. Under the microscope, there were proliferating reticuloendothelial cells in the lymph tissue forming macrophages, with some engulfed lymphocytes, red blood cells, karyorrhexis fragments, and areas of ulceration and necrosis.

Seeing this, Zhou Can couldn’t help but admire Director Shang from Gastroenterology. The patient did in fact have typhoid enteritis.

Once you saw those giant macrophages, it was practically a confirmed diagnosis.

He read on: the sampled lymph nodes were enlarged, and under the microscope, typhoid cells were evident.

All these changes matched the diagnosis.

Now the reason for the patient’s persistent fever was finally clear. The bleeding source had been found and stopped with surgery.

The necrotic bowel had been thoroughly removed.

Once the disease hit the typhoid stage, necrosis set in.

Zhou Can learned a lot from this case.

It was one of the rarer problematic diagnoses he’d encountered.

Typhoid has always been a tough nut to crack.

Traditional Chinese Medicine even developed entire schools just for handling it.

He organized his insights and planned to write them up after work—so next time, he’d have a much smoother path.

With a clear diagnosis—typhoid enteritis—treatment now was straightforward.

Bleeding under control, all that remained was anti-infection and anti-typhoid therapy.

On the third day, the patient’s temperature was already normal. His vitals stayed stable. No more dropping blood pressure or shock.

Still, the patient had a stomach ulcer and signs of past bleeding—a sign of poor lifestyle and eating habits.

He was only twenty, supposedly in the prime of health.

But his whole digestive system was a mess, getting so bad it ended in typhoid.

Zhou Can felt it was vital to have a serious chat with the family.

But the boy’s father, seeing his son recover, had already gone back to work. His love was deep but silent—he was the breadwinner, and this illness had cost them plenty, so he needed to earn money to support the household.

The mother, on the other hand, was endlessly patient—she spoiled her son like a little emperor.

Watching this, Zhou Can found himself lost for words.

Doctors can heal a patient’s body, but they can’t change the family environment—or break bad habits.

Still, out of responsibility, Zhou Can decided to talk to the patient himself.

Really, Zhou Can was only a few years older than him.

After making his rounds after work, Zhou Can sat by the patient’s hospital bed.

The boy’s mother greeted him warmly.

After all, Zhou Can had saved her son’s life. She was grateful to every doctor or nurse who’d helped at all.

Seeing her son improve each day, and pulled back from death’s door, she felt nothing but thanks.

“So, what year are you in at university now?”

Small talk wasn’t Zhou Can’s strong suit—people usually approached him, not the other way around.

He could only search for something to say and break the ice.

“First year!”

“First year’s great! You’ve finally escaped the hell of college entrance exams. College life is way more relaxed—you might even get lucky and meet a beautiful girlfriend.”

“You said it! Compared to high school, college is heaven.”

The patient couldn’t help but smile and agree.

“So, are you dating anyone?”

Zhou Can asked with a grin.

The boy instinctively glanced at his mom, staying quiet.

Male or female, everyone dodges those questions around their parents.