Chapter 498: An Unexpected Case, A Doctor’s Calm

Sometimes, having too much experience isn’t always a good thing.

When doctors get overly confident from their experience, it’s easy to make snap judgments and end up proven wrong.

Director Xueyan was actually lucky this time. After all, she only gave a treatment plan too early in the diagnostic process.

If the patient hadn’t secretly live-streamed the appointment, she could have just told the patient the old plan was no longer suitable and to switch approaches.

That’s in line with standard medical procedures. No one could have found fault with it.

But now, feeling stuck in a hard spot, what really worries her is harm to the department’s reputation.

With over ten thousand viewers watching the patient’s live stream, the publicity was on par with a typical local TV interview.

“This patient has coronary heart disease and myocardial infarction, plus her body is already frail. Cardiovascular intervention to clear the vessels is still the top choice. As for how—maybe we should try a different approach.”

Zhou Can’s specialty was always thinking outside the box.

“What do you mean?”

She looked a bit lost.

“Normally, cardiovascular interventions are done through the femoral artery. But if the blockage is severe or the vessel’s calcified, the guidewire might not get through. In that case, we can go from the other end of the vessel. Approaching it in reverse gets the same result.”

Zhou Can shared his thoughts smoothly and confidently.

Looking at the patient’s scans, it was clear the blocked artery had multiple calcified plaques—a classic sign of severe cardiovascular disease.

Calcified, blocked vessel walls made it much harder for a guidewire to pass through.

“Reverse approach?”

Director Xueyan was stunned by Zhou Can’s suggestion.

“Our mentor never taught us this kind of treatment, did they?”

She prided herself on learning with great care. There couldn’t have been a major gap.

But every time they hit a tricky case, Zhou Can always provided a solution or diagnostic insight she hadn’t learned.

This specific interventional plan surprised her.

“When I was training in the Cardiovascular Medicine Department, I saw an article where Academician Ge performed a similar procedure. If he succeeded, I think it’s at least worth trying. Even if we fail, interventional surgery barely injures the patient and shouldn’t lead to any fatal consequences.”

Zhou Can was genuinely excited to try a complex cardiovascular intervention.

Taking on a challenge is a chance to break through your own limits.

“Great! At last, we’ve got a solid plan. Let’s go over all the details and backup options.”

For the first time that day, a look of real relief spread across Director Xueyan’s face.

As department head, her stress was miles above everyone else’s.

……

After more than half an hour of discussion, they finalized the surgical plan and agreed Zhou Can would be the lead surgeon.

When it came to interventional or endoscopic surgeries, Zhou Can’s talent was unmatchable.

He was stronger than ever these days.

His Placement Technique and Injection Technique were both at Level 5, already at deputy chief physician level. Handling regular interventional procedures was almost too easy.

But this was a highly challenging cardiovascular intervention. If only his skills bumped up to Level 6, he’d feel a lot more confident.

But patients can’t just wait for a doctor to level up.

The only way was to just go for it.

At least the risks of this kind of intervention were low—the worst that might happen was failure and embarrassment.

He and Director Xueyan agreed to start the operation around 7 p.m.

Doing it in the evening mostly just fit Zhou Can’s work schedule.

Back in the Emergency Department, Zhou Can dove straight into a whirlwind of surgeries, but that’s another story.

It was already a bit past two in the afternoon.

Yang Zhi and Pu Dingdong had begun handling some minor surgeries on their own.

Usually, Zhou Can saw patients in the morning, and by around one, the surgical team would gather in the operating room.

“Dr. Zhou, take over?”

Yang Zhi was handling an incision and drainage for a patient with a subcutaneous abscess. Pu Dingdong assisted.

Qiao Yu and Ma Xiaolan passed instruments and circulated.

When Zhou Can walked in, they all lit up with smiles.

He was, without question, the heart of this surgical team.

“It’s fine, keep going!”

Zhou Can stood by and observed Yang Zhi’s technique.

“You’re way faster and better than me. Plus, there are so many patients outside waiting just for you. I really can’t take up your time. Let me finish later when it’s not so busy.”

Yang Zhi couldn’t match Zhou Can’s speed in the OR.

He knew not to hog the stage.

When Zhou Can first came in, he’d spotted patients lined up out the door. The pre-op room was already packed, and the hallway was no better.

“Alright, then stay close and assist me.”

Zhou Can took over, promptly suctioned out any remaining pus, then began debriding the abscess.

The purpose of debriding an abscess cavity is to remove all infected and dead tissue so the patient can heal faster.

With Level 6 Debridement, Level 6 Incision, and Level 6 Tissue Separation, clearing this sort of abscess was a walk in the park for Zhou Can.

A scalpel in his hands was like a magician’s wand.

Wherever he cut, it only took a moment to decide whether to keep or remove the infected and dead tissue.

Swish, swish, swish!

Every cut was precise—making quick work of diseased tissue, perfectly dodging blood vessels and nerves along the way.

[Rapid Surgical Technique EXP +1 +1…]

He entered a wild, almost frenzied state.

With Level 6 Debridement, Incision, and Separation as his foundation, he didn’t even need to rely on the Steady Scalpel Technique to rein in the risks of the fast technique. Patient safety was a given.

This wasn’t his first time using it. Ever since leveling up his Tissue Separation, he’d been consciously practicing it on minor operations.

He kept exploring, learning by doing.

The Steady and Rapid Scalpel Techniques could be used separately or even blended together.

So far, Zhou Can was probably the only one who could fuse the Steady and Rapid Scalpel Techniques.

Even Dr. Xu hadn’t reached that point.

Three different scalpel techniques, each for a different scenario.

He could always tailor his approach to the patient’s exact needs.

Surgery done—six minutes and fifty-eight seconds, not even seven minutes.

“Doctor, did you make sure my abscess is cleaned out? I just don’t want it coming back! I had it drained at the county hospital, and it returned right away.”

This patient was under local anesthesia, fully aware the whole time.

When Zhou Can took over, he didn’t mind at first.

But Zhou Can’s speed was almost unsettlingly fast.

When Yang Zhi worked on him, it took nearly half an hour just to cut open and drain the pus.

Now this younger-looking doctor had finished the whole surgery in just a few minutes. No wonder the patient felt uneasy.

“You can totally relax. Dr. Zhou is the head of our surgical team. Having him personally operate is ten times better than having me do it. As long as you take care of the wound, you’ll see what a fast, top-notch abscess treatment is like.”

Yang Zhi jumped in to support Zhou Can.

Maybe he was buttering Zhou Can up, but honestly, he was just stating the facts.

A lot of patients really did come specifically for Zhou Can’s reputation.

“If your surgery goes well, don’t forget to recommend Dr. Zhou to your family and friends!”

Ma Xiaolan chimed in with a smile.

“Haha, absolutely! If everything goes well, I’ll tell everyone how skilled you all are. I came all the way to Tuyu and the provincial capital because I trust you guys!”

The patient, a man of about fifty, broke into a happy grin at the team’s confidence.

……

It was after 7 by the time Zhou Can finished seeing all surgery patients.

He gained a heap of surgical experience—and a whole lot of exhaustion to go with it. As for patient gratitude, that only came once they’d recovered.

If a patient developed an infection or complication, instead of thanks, he’d be facing complaints and curses.

Normally, patients and families rarely lost their tempers face-to-face.

Most just complained to the Medical Department in private.

“Dr. Zhou, could you squeeze in one more? The triage desk just received a six-year-old girl with cyanosis and an oxygen saturation of only 61%. She looks pretty bad.”

Most of the Emergency Department nurses knew Zhou Can well.

He was genuinely approachable.

Whenever they ran into an emergency, they’d always ask for his help.

And Zhou Can could almost never say no.

“With such low oxygen, did you check her airway?”

Oxygen intake depends mainly on the lungs and upper airway.

If a child’s oxygen levels are this dangerously low, the first thing to check is a blocked airway.

Like that recent baby Zhou Can saved who had a peanut stuck in his throat.

“Dr. Xie’s on night shift. He’s not that experienced—already checked everything but couldn’t pinpoint a cause. I’m really worried something might go wrong, so I asked you to take a look.”

“Okay, let’s check on her first.”

Following the nurse to the triage desk, Zhou Can saw a pair of young parents with a six-year-old girl.

Her face and lips were deep purple, even patches of skin had turned the same color.

It was a pretty scary sight.

The mother was clearly limping and stood awkwardly.

Zhou Can realized at once that she likely had a leg disability.

The father was tall and looked anxious, but stood normally.

As Zhou Can stepped closer, Dr. Xie greeted him like a lifeline.

“Dr. Zhou, her oxygen’s only about sixty. We can’t see any sign of a foreign body in her airway. Could you please take a look?”

For slower-developing doctors, even with five or six years of practice, emergencies can rattle them silly.

Sometimes, a patient’s life hangs by a thread.

“How did your child end up like this?”

Zhou Can started examining her right away.

He noticed the girl’s chest caved in every time she breathed.

She was obviously struggling to inhale.

She was a pretty little girl, quietly lying on the bed, her bright eyes watching Zhou Can with innocent trust.

To her, all these white-coated doctors and nurses were angels sent to save her.

“Mm mm… Ah ah…”

The father gestured with both hands, trying to make sounds that came out muffled and unclear.

Suddenly, Zhou Can realized—the man was mute.

He turned to look at the mother.

“Yi yi…”

She was also mute.

Both parents were hearing- and speech-impaired.

He wondered if the daughter had inherited these impairments.

“Sweetie, are you feeling unwell right now?”

Zhou Can gently asked the girl.

“It hurts! Feels like something’s pressing down on me here!”

Her words came out clear and precise.

So her hearing and speech were just fine.

“Mm mm…”

Her father took out a notebook and pen and wrote:

“My wife and I are both mute. I have hearing loss too. Our daughter’s always had a purplish face since birth, but today she suddenly collapsed. Please, save her!”

Zhou Can now noticed the father wore a hearing aid.

Earlier, all his focus had been on the child, so he’d missed that detail.

Modern hearing aids are designed to minimize visible difference, so unless you look closely, they’re hard to spot.

With a hearing-impaired father, a mother with a leg disability and speech impairment, this family was truly vulnerable.

“Don’t worry. We’ll do everything we can for your child.”

He reassured the parents and moved quickly to a physical exam.

For patients with such low oxygen, percussion and lung auscultation are essential.

With the stethoscope, Zhou Can heard both lungs breathing normally, no weird sounds.

Then he listened carefully to the heart.

There it was: a strange murmur with every beat.

His face changed slightly. Misfortune really did strike the unlucky. He’d figured the problem might be an airway or lung issue, but the root was likely the heart.

From the father’s message, the girl’s face had always been purplish—so the illness had been there for years.

Most likely, it was congenital heart disease.

With his experience from cardiothoracic and pediatrics, Zhou Can had seen plenty of such cases.

Even without special tests, he was ninety-nine percent certain: congenital heart disease.

“Don’t worry, sweetheart. Uncle just needs to check your chest and ribs, so your shirt will have to come off.”

He made sure to gain the girl’s and her family’s permission before each step.

To medical staff, once a patient enters the hospital, gender isn’t a big deal. For any major operation, the patient is either undressed or put in a hospital gown.

If you end up in the ICU, you’re definitely undressed from head to toe.

Sometimes, depending on the situation, you might get a hospital-issue shirt.

So, the idea of male doctors having bad intentions while examining female patients is basically off the table. At most, seeing a young, pretty patient might be a treat for the eyes.

A lot of male doctors doing ECGs or similar checks just let female patients unbutton themselves and explain what’s needed. They’ll often turn away to prep the equipment and avoid embarrassment.

Once the sensors are in place, they’ll help cover the patient up right away so nothing sensitive is exposed.

It’s all about helping patients feel less embarrassed during checkups.