Chapter 5: Critical Moments in the OR

Look at the rash on the patient—it only appeared a while after the surgery began. I made sure his skin was clear during pre-op cleansing in the ward.

The doctors’ faces darkened.

Especially the Chief Surgeon and the First Assistant.

They bear primary responsibility.

“What nonsense are you spouting? Are you saying we caused these rashes?” the Chief Resident barked.

This isn’t a joke.

The patient suddenly went into shock on the operating table, and Zhou Can’s comment only served to shift the blame onto the Chief Surgeon and his team.

That kid is completely naive—he has no idea what should or shouldn’t be said.

“Director, I believe the patient is showing signs of an allergic reaction.”

Ignoring the Chief Resident, Zhou Can pressed on.

“Allergic reaction?”

Director Liu’s eyes instantly lit up.

Exactly! Why hadn’t anyone thought of that? The sudden shock had thrown everyone into chaos.

“Was a skin test done for the anesthetic?”

Director Liu turned to the Anesthesiologist for clarification.

“Yes, everything was normal. We even confirmed with the family and the patient beforehand—there was no history of anesthetic allergy,” replied the Anesthesiologist, unwilling to take the blame.

“I suspect the patient might actually be allergic to rubber,” Zhou Can continued.

Zhou Can calmly laid out his reasoning.

“And why do you suggest that?”

Director Liu realized this intern was no ordinary case; he now took Zhou Can’s opinion very seriously.

“When drawing the patient’s blood, I used a rubber tube to tie his arm, and his reaction was abnormal. I didn’t think much of it then, but now, with the shock and symptoms, I boldly suspect a rubber allergy.”

Zhou Can calmly explained his theory.

[Pathology Diagnosis Experience +1.]

That sudden experience boost—an entire point—felt like a gift from above.

It delighted him immensely.

With that bonus, he was even more convinced his diagnosis was correct.

He had learned that the experience gained from a surgery was worth ten times as much as any textbook—no wonder every doctor said that the operating room was the fastest way to grow.

He finally understood why even a minor opportunity to close a wound or cavity sent resident doctors scrambling like hungry wolves.

All for rapid growth.

“Immediately initiate anti-shock treatment. Replace all rubber items. Attending Nurse, call the family at once to check for any history of rubber allergy.”

Director Liu acted decisively, setting everything in motion.

When rescuing a patient, there’s no room for hesitation; wasting precious time could be disastrous.

After intensive efforts, the patient’s vital signs gradually stabilized.

“It’s all right, it’s all right!”

The Anesthesiologist was as joyful as a child.

During surgery, the patient’s life rides on the Anesthesiologist’s skills.

Every doctor hopes to see the patient safely out of the OR.

Everyone exhaled in relief, smiles spreading across their faces.

Then, more good news arrived.

“Director Liu, I just spoke with the family—the patient is indeed allergic to rubber,” announced the Attending Nurse as she returned from the call.

“Excellent! With the cause of the shock confirmed, I can proceed with the surgery with confidence.”

Director Liu, no spring chicken these days, had been seriously shaken moments ago.

He had nearly risked his reputation.

Once the crisis was averted, he immediately acknowledged the true hero.

His gaze turned kindly toward Zhou Can, who stood in the distance.

“You must be Xiao Zhou, right?”

“I’m Intern Zhou Can.”

Zhou Can was at a loss for words; after nearly a year of internship, his mentor couldn’t even remember his name.

But that was nothing new.

Mentors are high-ranking and rarely work directly with interns—usually, residents manage them.

The one who dealt with Zhou Can the most was none other than Chief Resident Dr. Fang.

“You performed exceptionally well—calm in a crisis, with solid medical fundamentals. At the critical moment, you applied your learning to connect key details about the patient. That is truly commendable.”

Director Liu showered praise with words like ‘exemplary’, ‘steadfast under pressure’, and ‘truly remarkable’.

It was clear just how much he valued Zhou Can’s earlier performance.

“Come here. From now on, during my surgeries, you’ll stand in this spot. A young doctor must be nurtured properly.”

Director Liu was referring to the position at the resident’s central station.

This spot is known as the ‘Fourth Assistant Position.’

Securing that position in Director Liu’s surgery wasn’t easy.

Even the resident doctors took turns standing there.

Now, with Director Liu personally designating the spot to Zhou Can, all the residents and interns were green with envy.

“Thank you for your guidance, Director Liu!”

Feeling unexpectedly favored, Zhou Can was both astonished and honored.

Though he had been in countless surgeries for a year, this was his first time occupying such an important role.

Chief Resident Fang, pushed out of the Fourth Assistant position, felt a pang of disappointment.

Seizing the moment with Director Liu in a good mood, he forced a smile and said, “Director Liu, I’ve studied under you for years, but I’m only 28. As your young protégé, please don’t neglect me just because of my experience.”

After all, the crying child gets the milk.

Chief Resident Fang worried Zhou Can might monopolize the Fourth Assistant spot, leaving others without a chance.

“Haha, you slick talker. Relax, opportunities will come to everyone,” Director Liu replied with a playful scold.

“With those words, I can rest easy. I want to be your student for life,” Chief Resident Fang said, masterfully playing on emotion.

In just a few words, he had melted Director Liu’s heart, drawing broad smiles from him.

Making a good impression on leadership would surely open more doors for future opportunities.

“Alright, let’s continue the surgery! Xiao Zhou, help with retraction. Watch closely as I dissect the lesion tissue—especially around the major blood vessels and vital nerves. Technique and experience are crucial here.”

Director Liu resumed the operation.

He even brought Zhou Can into the procedure. Although Zhou Can’s role was limited to retraction, this was a third-grade general surgery.

Even an attending surgeon would normally just handle retraction.

For an intern to be given that task was an honor in itself.

Chief Resident Fang’s silver tongue couldn’t diminish Zhou Can’s standing in Director Liu’s eyes. In today’s surgery, he was destined to be Zhou Can’s backup.

At that moment, Director Liu began in earnest.

With meticulous care, he separated the massive lymph node mass from the surrounding tissues, cut by cut.

In his hands, the scalpel came alive.

Every incision—its force, angle, and depth—was executed with sheer precision.

The First Assistant’s coordination was equally spot-on.

New bleeding points constantly appeared during the dissection.

The First Assistant immediately used the electrocautery knife to seal them.

Bleeding stopped in an instant.

Their teamwork was seamless.

The Second Assistant’s job was to support the chief surgeon—holding the specimen or retracting tissues that might obstruct the view.

Zhou Can noticed that actively participating in surgery was completely different from merely observing from afar.

Although Director Liu was the one making the incisions, Zhou Can felt an intense, up-close tension.

Every time Director Liu raised and lowered his scalpel, his heart raced.

When the blade struck, his heart leaped into his throat, filled with worry that the cut might nick a major artery or nerve.

Only when Director Liu lifted his scalpel and the patient remained unharmed did Zhou Can finally exhale in relief.

……

The surgery proceeded smoothly, with all the targeted lymph nodes and masses successfully removed.

Zhou Can felt he had learned a tremendous amount.

His understanding of tumor and lymph node excision deepened considerably.

He learned how to minimize risk when separating a mass from an artery, and how to methodically clear a complex operative field.

The First Assistant’s flexible hemostatic techniques also offered him great insight.

Which vessels needed ligation, and which required hemostatic clamps?

How should one handle bleeding points right next to nerves?

These were lessons that hardly any book taught.

They had to be learned in the field.

The operating table was like a battlefield—every situation demanded a different solution.

That meant doctors had to continually accumulate experience and adapt on the fly.

“Alright! Everything’s been cleaned out—send these specimens for pathological examination. Based on my experience, malignancy is unlikely,” Director Liu said as he examined the excised tissue and nodules.

“He Hansheng, Song Ze—ensure the surgical wound is completely staunched,” he ordered.

This command was clearly directed at the First and Second Assistants.

During the surgery, these two effectively acted as the Chief Surgeon’s right and left hands.

Their skills were formidable as they handled many critical tasks.

“Thank you for your hard work. Take a breather—if we missed a spot, we can always double-check,” said the First Assistant modestly.

The Second Assistant was the doer type.

He rarely spoke, preferring to work in silence.

He assisted when needed and charged forward without hesitation.

Meanwhile, Zhou Can and the Third Assistant continued to manage retraction, watching as the First and Second Assistants carried out vascular anastomosis and fluid drainage.

These tasks demanded high technical skill.

Even an average attending might struggle with them.

Poor wound hemostasis could lead to complications like hematoma or seroma after suturing, severely affecting recovery.

“Director Liu, the wound’s hemostasis is complete. Please check it once more.”

Director Liu was meticulous—he inspected every part carefully.

He even parted tissues to check the hidden spots.

Such rigorous attention to detail was an excellent example for young doctors.

“Excellent work—you can now proceed to suture the skin.”

After a thorough check, Director Liu nodded in satisfaction.

For procedures like skin suturing, the First, Second, and Third Assistants were usually sidelined.

At that moment, Zhou Can—who had been managing retraction—felt his opportunity finally come.

His suturing and ligation skills had reached an impressive level; while he wouldn’t dare undertake vascular or organ suturing, closing the skin was well within his capability.

He wasn’t the only one eyeing this chance—the residents and interns behind him were all eager for their opportunity.

Opportunities were fleeting.

If someone else grabbed the chance first, it would be hard to speak up later.

Steeling his courage, Zhou Can said, “Director, could you let me handle the skin suturing?”