Chapter 511: Hidden Strengths in the Emergency Department

Back then, he figured sticking with Zhou Can would open more doors for him. So he pulled a few strings and made the jump from Cardiothoracic Surgery to the Emergency Department.

That move turned out to be the right call.

At the very least, his surgical skills have skyrocketed and his future looks brighter than ever.

Still, every time he ran into the leadership from Cardiothoracic Surgery, he couldn’t help but feel a little awkward. Head down, looking like he couldn’t face anyone.

“Dr. Pu, settling in well in Emergency?”

Director Xueyan asked with genuine concern.

“Getting used to it! Getting used to it!”

Pu Dingdong’s face went bright red. He couldn’t even meet Director Xueyan’s gaze.

“Thank you for asking, Director Xue.”

After a pause, he managed to squeeze out the words.

“Stick close to Dr. Zhou and give it your all. Tuyu Hospital is a massive stage. If you’ve got skill, you’ll definitely shine one day.” Director Xueyan nodded and offered some encouragement.

“Let’s go. We need to get to the hybrid operating room.”

This surgery was really special—vascular bypass and interventional surgery with a stent all in one.

It demanded top-tier facilities and equipment in the OR.

Even with all of Tuyu Hospital’s resources, there were only two suites capable of handling such advanced cases.

They were mostly used by Cardiothoracic Surgery and Neurosurgery.

When other departments needed them, they had to submit an application and get on the schedule.

As they reached the hybrid OR, they spotted a commanding older gentleman outside the door, with a formally dressed young man behind him carrying a leather briefcase, waiting respectfully.

“That’s the patient’s family—they flew in on a charter just for this.”

Director Xueyan gave Zhou Can a quick introduction.

The older man radiated the poise of a seasoned businessman. That powerful aura made it obvious to Zhou Can: this man wasn’t an official, but definitely a mover in the business world.

But Chen Zhongzhi had all the air of both a privileged rich kid and the child of an official.

Probably some of the Chen family were in government.

In big families, when someone with integrity and reputation leads the way, they can unite everyone and pool the family’s resources for greater progress.

“Director Xue, when will my son’s surgery be over?”

The older man glanced at his watch and asked.

“Hard to say for sure at this point. We’re looking at three hours at minimum, but the specifics will depend on how things go in there.”

Director Xueyan treated the man with clear respect.

Doctors might have higher social status compared to the average person, but in the face of major business figures or top officials, their standing drops in an instant.

“I’m leaving my son in your hands.”

The older man swept his gaze across the whole team and gave a deep bow.

“Mr. Cai, there’s no need to be so formal. It’s our duty. If you’d like to wait, there are benches over there—please make yourself comfortable.”

Director Xueyan pointed toward a nearby bench.

Family members waiting here were all anxiously hoping for loved ones to come out safely from surgery.

Some looked calm, while others couldn’t hide the worry on their faces.

Hearing Director Xueyan refer to the elderly man as Mr. Cai, Zhou Can felt a surge of confusion.

The patient’s name was Chen Zhongzhi, but his father’s surname was Cai… Did that mean the patient took his mother’s name?

This family definitely had some complications.

Generally, if kids take their mother’s surname, it means the father married into her family.

Inside the OR, Zhou Can got changed and entered the main operating suite. The patient was already lying on the table.

Anesthesia was being handled by Director Feng, assisted by a nurse and two students.

Zhou Can, who was also Director Feng’s student, stepped over to say hello.

“Not bad, kid! Already innovating on major surgeries, huh?”

Director Feng rarely handed out compliments and almost never smiled.

But he made exceptions for Zhou Can, Shangguan Xueluo, Qu Zi—the ones serious about their studies and who had real strength. He always liked those types.

Back in the day, Dr. Guan was basically being groomed by Director Feng to be his successor.

But Dr. Guan hadn’t developed as quickly as Director Feng had hoped. Zhou Can could tell that Dr. Guan’s position in Anesthesiology wasn’t what it used to be.

That’s how it is in every department—the capable ones move up.

If you’re not moving forward, you’re falling behind.

Dr. Guan still worked hard, but ever since he made one big mistake, he’d become much more cautious. He was ultra-conservative when handling higher-risk surgeries.

These days, whenever Cardiothoracic Surgery had a level-three or bigger case with any real risk, barely any lead surgeons wanted to team up with Dr. Guan.

He got shot down way too often on surgical plans.

If an anesthesiologist is too reckless, things can go wrong. But if they’re too cautious, surgeons and patients miss out on opportunities for better outcomes.

It’s all about balance.

If Dr. Guan can’t break free from his over-cautious mindset, he’ll never grow fast enough.

In the end, he’ll get edged out by the pace of progress.

On a personal level, Zhou Can and Dr. Guan were pretty much old friends.

Zhou Can had tried—bluntly and subtly—three or four times to say that for surgeries where the risks were reasonable, it was okay to loosen up a bit. Dr. Guan always agreed in words but never changed his ways.

Eventually Zhou Can just let it go.

Adults are stubborn like that.

Never try to wake someone who’s just pretending to be asleep; it’ll only ruin your friendship.

Zhou Can had learned long ago that there’s no point pushing if advice isn’t working, so he dropped the subject.

Anesthesiology’s really been taking off lately.

People like Qu Zi and Shangguan Xueluo have been improving at breakneck speed.

From top to bottom, the department was full of talent and showing wonderful momentum.

Anesthesiology wouldn’t be doing this well without Director Xie from Surgery. He’d offered them all kinds of support.

You really had to admire Director Xie’s foresight.

He must’ve realized early on that Surgery and Anesthesiology are mutually dependent. Only by strengthening Anesthesiology could the surgical departments gain a solid ally.

Because every department needed anesthesia support, they all worked to keep good relationships.

With that, Anesthesiology was thriving, despite the perennial struggle of recruiting new people.

But change was on the horizon—a departmental reform was coming, and for doctors like Dr. Guan, it would be a real test. For now, anesthesiologists shared cases evenly, but that might not last.

If there were special needs or a name request, the department would try to accommodate it whenever possible.

Now Dr. Guan was rarely being asked by other departments to assist with anesthesia. For now, he could still get work, but it might not last after the reform.

If he stopped getting cases, he’d be in a tough spot.

That’d mean switching over to Critical Care, or seeing if another department’s ICU needed an extra attending.

From the day you chose to become an anesthesiologist, your journey was bound to be filled with thorns and risks.

Whether sticking with anesthesiology or moving to Critical Care, you’d always be rolling the dice for every patient.

“Do we need to stop the heart?”

Director Feng turned to Zhou Can for confirmation.

He already knew Zhou Can had designed the whole surgical plan. For all the critical points, he wanted confirmation in person.

“As long as there are no big surprises, we won’t need to stop the heart. But we do need to be ready for extracorporeal circulation during the bypass. If there’s trouble—like severe fibrillation or cardiac arrest—it’ll buy us time for emergency resuscitation.”

Zhou Can answered.

“In that case, we’re set. The patient’s already under—BP’s a little iffy, but everything else is stable. Let’s get started.”

Director Feng never wasted time.

He wasn’t one for dallying or small talk.

…

The operation kicked off quickly.

There were two steps: first the vascular bypass to guarantee blood flow through the aortic branch, and then placing the stent.

It sounded simple, but it demanded technical skill and flawless teamwork.

For any big surgery, the assistant, nurses, and anesthesiologist all had to work in perfect sync—there was no way one person could do it all.

Zhou Can brought in Qiao Yu and the others to observe on purpose. He wanted them to see how a true team pulled together around the lead surgeon.

Inside Cardiothoracic Surgery’s OR, Zhou Can carried an invisible authority.

Once the surgery started, even Director Xueyan and the others revolved around him. Like a high-precision engine coming to life.

Everyone knew their role. During the operation, cooperation was seamless.

Each person owned their part of the process, acting like masters of their station.

If someone tried to shirk responsibility, skip the hard jobs, dodge high-risk tasks, or just ignored warning signs with a ‘not my problem’ attitude—

—it could cause complications, even failure.

After Dr. Hu Kan passed away, Zhou Can had earned his hidden leadership role through sheer hard work, step by step.

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That status wasn’t set in stone, though.

If Director Xueyan was leading the surgery, everyone—Zhou Can included—would shift around her as the core.

Whoever led the surgery was the team’s center.

Still, whenever there was a crisis during a major procedure and Zhou Can was present, he was always the one leading the rescue. Tackling impossible challenges, pulling off miraculous saves, he became the anchor that everyone trusted.

It was a type of authority that no other surgeon in Cardiothoracic had.

Only Dr. Hu Kan had ever had that kind of presence.

As Zhou Can opened the patient up, seeing the dissection in the chest and abdomen left him rattled.

This patient was unbelievably lucky to still be alive.

“Director Le, can you block blood flow for this branch?”

“No problem.”

Zhou Can swiftly incised the branch vessel and performed the anastomosis.

His hands moved fast and sure.

Joining an artificial vessel with the patient’s own demanded real skill.

Get it wrong and you’d have a world of trouble.

The aortic pressure was sky-high, making the anastomosis crucial—if you messed up, the blood flow could tear everything apart.

If it wasn’t secured, the flow would blow it wide open.

All his suturing, ligature, and anastomosis skills were leveling up with each move.

His mastery of ligature was closing in on level six.

One, two… all five branch vessels were connected to the artificial graft.

Next was expelling every air bubble, then finishing the aortic bypass.

Sometimes, testing the anastomosed bowel or blood vessels with a water injection helped catch problems in advance.

Especially for surgeons less confident in key areas, the test could save the day.

Leakage after a bowel or vessel anastomosis was a total disaster.

Some patients had hardened or brittle vessels, or severely adherent intestines—fragile as tofu. Those cases called for extra care.

When the anastomosis was done, it was easy to tear.

You had to take every step early to protect the join.

An hour and a half later, Zhou Can finally finished the aortic bypass. As he watched the new blood pathway, hope filled him.

Now, it was down to the blood flow test.

His ligature technique was nearly level six. One more tough case would likely get him there.

This innovative surgery had brought him extraordinary growth.

Most importantly, it gave him new confidence and a deeper insight into life itself.

“Everything comes down to this. Let’s check the blood flow!”

He released the ligature and blood gushed into the artificial vessel like a storm surge, instantly forming a secondary channel.

After more than five minutes of testing, everything held steady, not a single problem appeared.

Cheers broke out around the operating room.

A successful bypass meant the most critical part of the surgery was done.

Next up: the vascular stent.

Zhou Can didn’t rush to close the abdomen—not with the risk of aortic rupture hanging over them.

If disaster loomed, he was ready to jump in and control the bleeding.

Placing the vascular stent proved trickier than expected.

But with level six in both placement and injection techniques, he pulled it off without a hitch.

The longest stent in cardiovascular history was finally in place.

With that, the operation was a resounding success.

The lurking threat of aortic dissection had been wiped out.

But the final, most important step was still ahead.

Once the stent was in, the entrances for branch vessels were also sealed off. Now, the blood supply depended on the bypass Zhou Can had performed.

Everyone held their breath, eyes fixed on the patient.

The new secondary blood route had already been tested and was clear, but once the branch vessel’s entrance was sealed, could the bypass provide enough flow? That was the unknown.

Physiologically, humans walk upright, so the lower the vessel, the harder it is for blood to get there.

A common example is that when you’re cold, your feet always get chilly first.

That’s because feet are the lowest point for blood flow.

Whether sitting or standing, it’s always the case.

Only when lying flat can blood in the feet recirculate easily.

Ten minutes ticked by, and nothing seemed amiss in the patient’s body.

“Director Feng, how’s the patient doing?”

Director Xueyan was even more anxious than Zhou Can.

No one could really grasp the weight on her shoulders—this breakthrough surgery was huge for the department.

“The patient’s vitals are stable. Looks like we’ve cleared the first hurdle. Zhou’s surgical plan works.” Even Director Feng was tense.

If anything had gone sideways, he would’ve jumped in instantly.

“Can we close the incision yet?”

“Let’s give it another twenty minutes. I’ll test the limb nerves and monitor urine output, make sure the operation was really successful.”

Director Feng kept a close watch, not easing up for a moment.

Time dragged by, second after second.

While they waited, everyone started discussing the clever points and key techniques of this operation.