Chapter 522: Authority and Crisis in the Operating Room

The Medical Department holds tremendous power.

Especially with these high-risk surgeries, approval from the Medical Department is a must. If leadership doesn’t sign off and something goes wrong, the doctors take the fall.

At the very least, the doctor’s department will have to shoulder the blame and swallow the bitter consequences.

Only with leadership’s approval will the hospital itself take responsibility if something happens.

That’s just how the industry works.

If Chief Huang doesn’t approve, which doctor would dare take on this surgery? No one is reckless enough to gamble their career and livelihood.

“What kind of reason do you want to hear?”

Zhou Can looked up at Chief Huang.

He’d already dealt with hospital leaders more than once. Right now, Zhou Can stayed perfectly calm. Facing Chief Huang’s official air and imposing presence, he was as unshakable as a quiet hill.

Let the wind blow as it pleases—the mountain stands firm.

“All I want is a reason that convinces me! Just like you convinced them!”

Chief Huang was clearly trying to make things a little harder for Zhou Can.

His exact intentions weren’t obvious yet.

Power gives the leader the last word—whatever they say, goes.

If Zhou Can wanted to save Deputy Director Lu, he needed to persuade Chief Huang.

Even knowing he was being put on the spot, he couldn’t show the slightest resistance.

Convincing a surgeon only takes a treatment plan and a clear explanation of the patient’s condition. To win over an anesthesiologist, you just assure them the patient’s perioperative safety.

But for Chief Huang, only appeals to interests—or to the heart—would do.

“First, you and I are both medical professionals. I believe you, like us, truly want the patient to survive. Beyond that, saving a patient with severe injuries like this would bring a huge boost to Provincial People’s Hospital’s reputation. It would also be a valuable learning opportunity. And if that’s still not enough, I’ve noticed that your hospital’s work style is all about strict discipline.”

“Being able to guide your clinical team to such high standards shows you have the spirit of a master physician—calm, selfless, driven by compassion, determined to heal all. Forgive my boldness, but I aspire to that, too. We are kindred spirits in medicine, and where minds align, distance means nothing. I’ve come from another hospital to help. There’s every reason for you to join me in saving this patient.”

Zhou Can’s words made Chief Huang nod repeatedly.

“The young doctors from Tuyu Hospital really know how to move people! Since you’ve all made up your minds, let’s hurry and save the patient! I’ll handle approval, arrange the OR, and leave the rest to you all.”

A smile finally broke through on Chief Huang’s face—like sunlight after the clouds part.

Everyone else broke into smiles too.

At this moment, they all shared the same goal—saving a life.

Lu Fen quietly wiped tears of relief and excitement.

Only those who lived through it could know just how much Zhou Can had struggled to save her father.

Her gratitude for Zhou Can ran deep.

And her trust in him only grew stronger.

Anyone her father would trust with his life must be worth believing in.

Now, seeing Zhou Can working so hard to save her father with her own eyes, her trust in him deepened even more.

……

Inside the endoscopy operating room, the anesthesiologist Ming Xin personally led the team to guarantee the patient’s safety.

She had three young doctors under her, all performing excellently.

Anyone brought along for such a critical surgery was definitely being specially groomed. A chief doctor might train plenty of students in their career, but truly passing on their legacy—finding their real disciples—that number was always very limited.

Most never had more than five.

Training a successor takes years and immense effort.

A few tips during one surgery aren’t enough to shape someone into a master.

Zhou Can watched as the group fumbled a little, hooking up the monitoring equipment for Deputy Director Lu and adjusting the respirator and other settings. The sight made him quietly anxious.

But he made no move to help.

Just being allowed to participate as a guest was already a big favor.

Jumping in for the spotlight now would look like showing off.

Since the patient had transferred from the ICU, much of the pre-anesthesia prep was already done. Pre-op skin cleansing and the like weren’t needed, either.

Once ready, they went straight to inhalation general anesthesia.

The surgeon in charge of Lu’s laparoscopic surgery was Chief Gou Qiong of the thoracic surgery department, leading his whole team into the operation.

From the way they skillfully made a small incision in the abdomen, the technique was fast and professional.

No wonder they’re a top provincial hospital.

Their surgical skills were truly impressive. Gou Qiong and his assistants probably represented just the tip of the iceberg of the hospital’s real strength.

Typically, cardiac surgery is even more delicate and specialized.

Brain surgery or neurosurgery is another level entirely.

Thoracic surgery is about as challenging as several subspecialties under general surgery.

Chief Gou Qiong and an assistant in his forties began the laparoscopic surgery. First priority: repair the ruptured spleen.

Chief Wu Yongming from neurosurgery and Chief Xiang from the Critical Care Department kept close watch on the monitor.

Chief Xiang Fei didn’t waste the chance either—he brought his two favorite students along.

Chief Wu from neurosurgery did the same, bringing his entire surgical team.

Once you reach associate chief status in surgery, you’re allowed to build your own team.

At attending level, you still need to work under a chief or associate chief—you’re not leading a team yet.

There’s a huge pay gap too, between chiefs with a team and those without.

If you’re a team-leading chief in a place like Tuyu or the provincial hospital, and your department’s doing well, annual income can hit a staggering three or four million. In Magic City, the Imperial Capital, or a national-level hospital, five million or more isn’t unheard of.

That’s one big reason so many medical students grind and strive, earning master’s degrees, then PhDs, and even pursuing postdocs when they’re able.

All for one goal: to become a chief physician with their own team, sooner rather than later.

Of course, by the time most finally get there, they’re well over fifty.

But compared to most people, these big names are educated, wealthy, and hold both status and power. They’re life’s real winners.

Chief Gou made the first incision to the left of the navel, inserted the endoscope, and started checking the spleen for hidden problems.

His command of the scope was skillful and precise—top level.

“How hard did they fall for the spleen to be this wrecked?”

He couldn’t help shaking his head in amazement.

The assistant, also in his forties, handled the auxiliary instruments, making another access point just below the xiphoid process.

That entry was on the left, too.

Since the spleen sits on the body’s left side.

Endoscopic surgeons never make things harder than they must. Unless the case is extraordinary, the more direct the path, the better.

If you overcomplicate the surgical design, the scope crashes all around inside the patient before you even begin—the poor patient might not even make it through.

“Let’s drain the fluid first!”

In cases involving internal bleeding, you always start by finding the bleeding source. Drain off the pooled blood and it’s much easier to track the source down.

The usual procedure is to stop the bleeding next.

Once the left side’s fluid is out, it’s time to hunt for the source.

“Director Tang, lift up the spleen’s right side a bit. I think the bleeding’s just underneath.”

“Got it!”

The older assistant answered crisply, using precise and practiced technique to raise the right side of the spleen.

“The vessel’s split—the tear is serious.”

Chief Gou found the bleeding point quickly. Blood surged out in a spray, the bleed was severe.

The spleen is fragile. Whether it’s blunt trauma or a fall from height, it’s one of the easiest organs to rupture.

“Chief Gou, should we stop the bleeding first or something else?”

“There’s no choice, we have to stop the bleeding before repairing the vessel. The tears are bad, and it’s at a vascular crossroad. Man, the repair’s going to be tough!”

Chief Gou Qiong frowned deeply after examining it.

At their level, years of skill let them see at a glance how tough the operation would be.

Director Tang had already started on hemostasis.

For small bleeds, you might try electrocoagulation—basically burning the bleeding vessel shut.

Back when Zhou Can first practiced hemostasis, step one was always electrocoagulation.

On mice, he could hit the target every time.

He’d honed his skills that way, day after day, until he reached level six at hemostasis.

But now, the bleeding vessel was much bigger—burning it wouldn’t cut it.

Otherwise, the spleen’s blood supply would be ruined.

And you can imagine the consequences.

“Tying off the vessel here is really tricky!”

Director Tang tried several times to stop the bleeding, but it was no use.

Watching from the side, Zhou Can figured Director Tang’s hemostasis skills were only around level five at best. His endoscopic moves were decent, but nothing spectacular.

“Can’t get it under control?”

Chief Gou asked.

“It’s pretty tough.”

Admitting defeat on this in front of so many people was hard for Director Tang.

Folks have their pride.

“Let me give it a shot!”

One of Chief Wu Yongming’s doctors stepped up to help.

He took over, trying to tie off and stop the bleeding.

You could tell his skills were much sharper, especially the fine details. Neurosurgery’s reputation for precision even outstrips cardiac surgery.

No surprise that this neurosurgeon was so skilled.

“Wow, these vessels are so fragile—even the suture seems to cut right through.”

After just a moment, the new doctor realized it wasn’t Director Tang’s problem at all—the patient’s blood vessels were simply too delicate.

Too little force and the tie wouldn’t hold. Use too much, and you end up cutting right through.

That’s what just happened.

Blood spurted out, even worse than before.

You could see it was taking a toll on the patient’s blood pressure.

“Blood pressure’s falling fast and the heart rate is climbing. We need a solution, now.”

Ming Xin, the chief anesthesiologist, sounded anxious.

With the patient crashing, the pressure was falling heaviest on the anesthesiologist.

“I’ll get the plasma. Should we start a transfusion to boost their volume?”

The Attending Nurse, experienced and quick, jumped in to offer help.

“No transfusion—not yet. If we do, the pressure in the ruptured vessels will only rise and make repairs even harder.”

Zhou Can hurried to speak up.

Watching the surgery, things had already gone wrong from the very start. He couldn’t help but panic inside.

Hearing the nurse suggest a transfusion made him even more anxious.

Normally, tying off a vessel never tears it apart this easily.

There was only one possibility—Deputy Director Lu’s blood vessels were far more fragile than normal.

The pressure was now down to 82, dangerously low, but not instantly fatal.

In fact, this might be the chance to rush and repair the vessels now.

With the pressure low, it was actually a lot easier to stop the bleeding.

But the Attending Nurse just ignored Zhou Can.

A young doctor from an outside hospital daring to act like some surgical legend?

She just turned to Ming Xin for the decision.

When it comes to transfusions, the anesthesiologist always has the final say.

“Listen to Dr. Zhou—for now, don’t transfuse.”

Ming Xin confirmed Zhou Can’s judgment.

“Chief Gou, Chief Wu, you’ve got to stop the bleeding and repair the vessel immediately. You probably have less than thirty minutes—twenty would be safer. If the bleeding doesn’t stop fast, the patient’s blood pressure will keep dropping, and it’ll get much riskier.”

She shifted the pressure directly onto the lead surgeons.

That’s the mark of an experienced anesthesiologist—never carries the burden alone, but makes sure everyone shares it.

“The patient’s vessels are as fragile as a sandcastle—what on earth are we supposed to do? This is driving us nuts!”

The assistants were so anxious they stamped their feet.

Chief Wu Yongming wanted to scrub in himself, but seeing the difficulty of stopping the bleeding, he lost his nerve. If he tried and failed, he’d lose face.

Both assistants operating right now were capable.

Even compared to the chief, they weren’t far behind.

“May I give it a try?”

Zhou Can looked at the two assistants.

Director Tang and the other assistant stared in shock. They knew Zhou Can was skilled, but he was just so young.

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The challenge of stopping the bleeding was simply frightening.

Not only Zhou Can—even if Chiefs Wu or Gou stepped in, success was far from guaranteed.

“Dr. Zhou is highly skilled at endoscopic and interventional surgery. Why not let him take a shot?” Chief Xiang Fei spoke up for Zhou Can.

But ultimately, Chief Gou Qiong’s approval was needed.

“Let Dr. Zhou try it!”

Gou Qiong wasn’t sure about Zhou Can, but he trusted Chief Xiang Fei.

He nodded and agreed.

“Dr. Zhou, please—don’t push yourself too hard. If tying off the vessel doesn’t work, we’ll have to find another plan.”

Chief Gou had never witnessed Zhou Can’s surgical skills firsthand.

He still felt a bit uneasy.

“Understood. I’ll be careful.”

Zhou Can agreed and stepped up. He deftly maneuvered the robotic arm, checking the patient’s blood vessels.

From his technique, the chief doctors were immediately reassured.

This was true skill on display.

Not at all beneath the two experienced assistants.

So young but already incredibly talented with the endoscope—how did he get this good?

But soon, everyone started frowning.

After Zhou Can took over, he kept adjusting the endoscopic arm, carefully probing the vessels, but never went to tie them off.

The abdominal bleeding just wouldn’t stop—was he really capable or not?

Could this kid be all talk after all?