Chapter 518: The Shadow of a Blood Clot

From his clinical experience, the most common cause of venous thrombosis is incomplete air removal during venous cannulation. That’s a mistake many rookie doctors make.

Even seasoned doctors can overlook this detail when things get hectic in the rush to save a life.

Chief Xiang listened to Zhou Can’s analysis, his expression barely changing.

Doctors whose skills weren’t up to par thought Zhou Can was talking nonsense. Especially Chief Xiang’s two younger doctors, who all thought they were a cut above the rest.

Getting to study under a famous doctor—that’s where their sense of superiority comes from.

Besides, it’s no easy feat becoming Chief Xiang’s student. You have to beat out hundreds of competitors to make it into his circle.

Nearly every chief physician in any major hospital sets the bar sky-high when picking disciples.

Talent, perception, ability—you need them all, and some luck too.

“Chief Xiang, the patient’s blood pressure and oxygen are still dropping! Oxygen’s below 60!”

A nurse called out urgently.

There was a shift in Chief Xiang’s gaze, his brow furrowing deeply.

Clearly, he was still hesitating.

As chief physician, he had more to consider than just saving a life. The hospital’s reputation, and all the potential fallout if word got out.

“May I ask your surname?”

“I’m Zhou.”

“Mr. Zhou, thank you for your valuable advice. We’ll think it over carefully. Your visiting time is up, so please step outside for now. Thank you!”

In the end, Chief Xiang cared most about the hospital’s reputation and asked that Zhou Can be escorted out.

They were gearing up to handle things behind closed doors.

Zhou Can didn’t argue.

In this situation, he had no authority to dictate anything.

Even if he was right, Zhou Can couldn’t direct Chief Xiang and his team during the emergency.

Once Zhou Can had left, Chief Xiang ordered, “Get an ultrasound for the patient, immediately.”

“Professor Xiang, do you really believe what that young man said?” one of his male students asked, clearly surprised.

“Medicine is all about constantly verifying things. Any possible cause is worth checking out. Hurry, get the ultrasound machine over here. Let’s check.”

With so many doctors and students around, Chief Xiang wasn’t about to admit that Zhou Can was right.

Otherwise, wouldn’t it look like the renowned chief physician from Provincial People’s Hospital was being led around by some unknown young doctor?

Saving face is everything. That’s no exaggeration.

Especially for scholars and professors in high positions. Reputation is everything. Just look at those news stories about professors misusing their power to coerce female students.

Even if they’re doing literally criminal things, they keep talking about virtue and ethics, standing tall as teachers while coaxing or subtly threatening.

Threats like failing their thesis, not graduating, or getting excluded from important projects.

They have a thousand ways to pressure female students into compliance.

But what about those who refuse?

Sometimes, a handful of brave women would expose them online.

But most scandals never see the light of day.

They soon scanned the superficial and deep veins, focusing especially on the central veins.

After all, Zhou Can had pointed out that the problem might be a central venous thrombosis.

“Chief Xiang, Director Zhao, there really is a suspicious shadow here—the blood flow’s clearly obstructed.” The doctor doing the ultrasound was careful with his wording, steering clear of saying they’d found a blood clot outright.

Instead, he hinted at the diagnosis.

“Looks like the vessel really is blocked. Start thrombolytic drugs now, through the venous catheter.”

Chief Xiang’s face was looking a little awkward now.

That young man had identified the actual problem with just a glance at the patient and monitors. That was impressive—unusually impressive.

All these doctors had been working on the rescue for ages and never even considered this possibility.

It wasn’t just Chief Xiang—even Director Zhao and the older doctors felt their faces burning with embarrassment.

Good thing they wore masks, so it wasn’t too obvious.

Chief Xiang’s two junior doctors looked as if they’d just been slapped. They were shocked, a bit ashamed, and even now, a little unwilling to accept it.

Especially the young female doctor—she’d thought nothing of that young man and never imagined he’d be this good.

She couldn’t help but wonder—where did he come from?

There were only a few top-tier hospitals in the province—Tuyu, the Children’s Hospital, Provincial People’s, and some digital hospital. Those are the big four.

Other hospitals might be well-regarded, but most of those are specialized, like Fangxin Tumor Hospital or Jiang’s Orthopedics, and the now-famous Xinxiang Maternity and Child Hospital. Each shines in its field.

Every one of them excels in its specialty.

And that doctor, looking so young but so steady in front of Chief Xiang, had to be from one of the big hospitals.

She figured he must be from a major institution.

Still, as curious as she was, the priority right now was saving the patient. She forced her attention back to the task at hand.

“Who did the venous catheterization?”

After confirming with the ultrasound that the patient really might have a venous thrombosis, Chief Xiang’s face grew grim.

The person who’d done the vein puncture was sure to get an earful.

“Xiao Chen did it. He’s already off shift.”

Air that gets into a vein doesn’t form a clot right away—it takes time, and it takes even longer to do real damage.

A central vein thrombosis can be truly terrifying.

If it’s not detected and dealt with in time, the patient could die from it.

Even clots in the limbs are incredibly dangerous—especially those loose clots that can travel through the bloodstream like silent killers.

“Never let your guard down during catheter placement. Don’t let this happen again. Make sure Xiao Chen hears about this tomorrow.”

“Understood.”

It was Dr. He, at attending level, who replied.

With a venous catheter in place, delivering medication is easy. Thrombolytics can reach the clot directly.

“Doesn’t seem to be working. At the patient’s current state, I doubt they’ll hold out until the clot dissolves. The clot is huge, and if it breaks free, it could be even more dangerous.”

Director Zhao kept a close watch on the patient’s blood supply, especially at the blockage.

Imaging tests like ultrasound or CT are good for diagnosing venous thrombosis, but they’re no match for angiography—the gold standard of modern medicine.

Blood plasma D-dimer and other auxiliary tests can point you in the right direction, but they’re not enough for a definitive diagnosis.

They can only provide a direction for further testing.

If it’s a superficial venous thrombosis, you can sometimes diagnose it just by touch.

The area feels rock-hard when you press it, and swelling often follows.

It happens most often in the legs.

Older people are especially prone to varicose veins in the lower limbs.

That’s directly related to why venous clots often form there.

When you feel someone’s lower leg, if you notice lumps, it could be varicose veins.

“If the clot’s been there a while, it’s probably stuck tight to the vessel wall. If drugs can’t break it up, only an interventional thrombectomy will do.”

Chief Xiang knew—now, time was everything.

Even a tiny clot, if not removed or broken down quickly, can be deadly.

Thanks to advances in medical technology, there are now several ways to deal with deep vein thrombosis.

Of them, interventional thrombectomy is considered one of the most effective and direct methods.

But the procedure demands a highly skilled surgeon and a patient whose body can handle the stress.

In the past, removing a clot sometimes meant cutting open the vessel, clearing it out, then sewing it back together.

Modern interventional surgery is much less invasive.

It’s efficient, fast, and significantly safer.

If they hadn’t been so wary of Zhou Can, he might have suggested thrombectomy a lot sooner.

And if they’d given Zhou Can the chance, he might have done the procedure himself.

His interventional skills weren’t just good—they’d rank among the best in the province.

After all, his advanced medical techniques were all at level six, including Injection Technique and Placement Technique—the most common skills needed for this kind of procedure.

But there’s no use in what-ifs. The doctors at Provincial People’s would never let an unknown doctor handle such an operation.

…

Half an hour later, after tremendous effort, the doctors at Provincial People’s finally extracted the clot. The blocked vein was clear again.

Here’s the catch: they’d used a thrombolytic drug earlier.

It hadn’t worked on that stubborn clot, but once in the bloodstream, it could cause bleeding in areas that had already stopped bleeding.

They were facing more complicated problems ahead.

“Blood pressure and oxygen are both back up. The sudden turn earlier was probably due to that clot.”

After pulling the patient back from death’s door, the whole medical team felt relieved.

Chief Xiang, though, couldn’t feel proud—the real diagnosis had come from that young doctor surnamed Zhou.

They’d just followed his lead the whole way.

The real hero was that young man.

“Director Zhao, do you know the young doctor who came in to see the patient?”

Chief Xiang turned to Director Zhao, who was just under fifty.

The ICU isn’t like the clinic or regular wards—here, the work is demanding both technically and physically.

Older doctors simply can’t keep up.

So, the ICU doctors are mostly in their late twenties to early fifties.

Fresh graduates aren’t fit for critical care—they lack experience. Most ICU mainstays are in their thirties, with the backbone and elite being around forty.

Doctors around fifty are the real veterans here.

They’re the ones holding the baton.

“I don’t know him, but he does look familiar. I just can’t place where I’ve seen him.”

Director Zhao shook his head.

“I feel the same!”

A young doctor chimed in.

“He really does seem familiar. Could he be a doctor from our own hospital?”

One of the nurses joined in.

“I doubt it. If he was one of our young hotshots, I’d know. He didn’t even look at the test results or go over the medical notes—he just glanced at the monitors and the patient and pinpointed that the crisis was from a clot. That’s real talent.”

Chief Xiang frowned, increasingly baffled by the young doctor’s ability.

And the way he handled himself—steady, composed.

Frankly, the guy just had an air of authority.

“Oh! I know who he is now!”

The nurse who thought Zhou Can seemed familiar suddenly cried out.

“Ms. Hu, please mind your volume. We’re in the ICU.”

“Sorry! Got carried away.” She quickly apologized. “He called himself Zhou. Don’t you think he really looks like Dr. Zhou, the heart surgeon who did that live-streamed surgery online a while back?”

With that, memories clicked for everyone.

“That’s right! It’s him—Dr. Zhou Can. No wonder he looked familiar!”

Director Zhao confirmed it.

“So, he’s the accomplished young doctor from Tuyu Hospital. No wonder today felt like a master’s class.” Chief Xiang still found it hard to swallow his pride.

At his level, nothing’s harder than swallowing your ego.

Fame and fortune—always a curse.

But now, knowing Zhou Can’s true identity, Chief Xiang felt a bit better.

You learn something new every day.

Today, he’d experienced firsthand just how formidable Tuyu’s new generation of doctors really were.

“Ru Yaji, Pang Houzhong, you two should learn from him. You’re always so full of yourselves—now you see the gap between you and real talent?”

Tough love, but it shows how much Chief Xiang cares for his team.

He truly wanted to see them grow quickly and become the backbone of the department.

He wanted them to rise fast, to one day be pillars here.

“He’s really strong,” Ru Yaji admitted aloud, though she still couldn’t quite accept it deep down.

She wasn’t good at hiding her feelings—everything showed on her face.

“If I get the chance, I’d love a real exchange with him.” Pang Houzhong was equally unwilling to admit defeat—no one wants to be second-best.

“No wonder Tuyu Hospital’s been climbing so fast lately—their young doctors alone are outstanding, and who knows how impressive the senior staff are,” Director Zhao sighed.

It was a heartfelt admission.

“Director Zhao, Chief Xiang, there’s something I’m not sure I should mention…”

It was Dr. He, the attending, who spoke up, somewhat unsure of himself.

Among ordinary doctors, an attending could be a big deal. But among chiefs and associate chiefs, he instantly fell a notch.

“If there’s something, just say it! It’s only us in the on-call room.”

Chief Xiang gave the go-ahead.

“After Dr. Zhou Can mentioned the venous thrombosis and was about to leave, he seemed like he had something more to say. Maybe he had more advice but didn’t want to cause trouble or misunderstandings, so he held back?”

Everyone notices different things.

At the time, Dr. He just happened to catch some subtle expressions from Zhou Can.

“What do you mean exactly?”

Director Zhao’s gaze grew sharp.