Chapter 525: Uncovering the Hidden Threat

If Zhou Can hadn’t insisted on checking the pancreas, that tiny tumor would have slipped by completely unnoticed.

Why is pancreatic cancer so terrifying?

Because pancreatic cancer often has no distinct symptoms and lacks reliable direct diagnostic methods, making early detection nearly impossible. By the time most people are diagnosed, the cancer has already reached an advanced stage and surgery is no longer a cure.

The mortality rate is staggeringly high, with a five-year survival below 5%. That’s why it’s known as the ‘king of cancers.’

Other chief physicians noticed the pancreas might be hurt from the scans, but didn’t think much of it. The bleeding wasn’t severe, and it had already stopped. Considering how weak the patient was, they wanted to avoid unnecessary surgeries whenever possible.

Even the patient’s broken legs and right arm were left untouched for now.

That’s basic emergency protocol.

Deal with life-threatening injuries first—the rest can wait.

Limb fractures like this usually aren’t fatal and can be handled later.

Unless the femoral artery is ruptured or a deep vein thrombosis forms in the leg. Those call for immediate action.

The fact that the other chief surgeons thought the pancreatic injury didn’t warrant surgery shows they didn’t realize how serious it was. But Zhou Can was dead set on examining it—was it just a hunch, or did he notice something specific?

Director Gou Qiong couldn’t help but ponder over this in silence.

If Zhou Can really spotted a pancreatic tumor just from scans and routine tests, that’s next-level expertise.

Even Director Gou Qiong, for all his skill, couldn’t do that.

“Director Gou, is it alright to remove the laparoscope now?”

Zhou Can asked for permission.

With a stroke of surgical prowess that bordered on magical, Zhou Can had already impressed every medical staff present with his removal of the pancreatic tumor.

Even the Attending Nurse, who used to underestimate him, now saw him in a totally new light.

The moment she realized there was a tumor in the pancreas, the Attending Nurse felt genuinely shocked.

She couldn’t help but start looking at this young doctor from Tuyu with newfound respect.

“Surgery was flawless—let’s go ahead and pull out the scope.”

Once the endoscope was removed, there was still fluid in the abdominal cavity, so a drainage tube was needed. It would let out any new buildup and help the team watch for further bleeding.

If one of the repaired blood vessels ruptured again, the fluid would increase—and the color could turn to fresh, red blood.

Placing a drainage tube sounds simple but it’s trickier than it looks.

You have to make sure it doesn’t become a passageway for bacteria or viruses.

Otherwise, post-op care gets a lot more complicated.

With the laparoscopic surgery wrapped up, next came the toughest part—controlling the bleeding inside the skull.

The amount of blood inside the skull wasn’t extreme, but it wasn’t stopping on its own. Left unchecked, it could be fatal.

“Director Ming, can the patient handle a craniotomy right now?”

Whether he liked it or not, Director Wu Yongming had no choice but to tackle this tough job.

The patient’s intracranial bleeding surgery could not be postponed.

“Vitals are stable and breathing’s picked up a bit. I think he’ll be fine with a neuroendoscopic procedure.”

Director Ming Xin gave a thorough assessment of the patient’s condition.

Things were looking up.

Several vital signs had already improved.

Blood pressure and heart rate were steady—more so than before the operation, which was a really good sign.

This paved the way for the upcoming neuroendoscopic surgery.

“Alright, I’ll get started. Director Gou and Dr. Zhou have done so much already and scored the first win—no way I can let the team down now.” With that, Wu Yongming began cutting the patient’s scalp at the marked spot, making a cross-shaped incision…

Soon it was time to drill into the patient’s skull.

The human skull is like a tough turtle shell, shielding the brain and all the crucial nerves—including the brainstem and cerebellum—inside.

To get inside the brain, you have to saw through the skull.

Traditionally, surgeons would remove the whole skullcap—a major operation. But with today’s technology, doctors can just drill a small hole and insert an endoscope to work within the cranial cavity.

They weren’t far into drilling before the life monitors screamed out with shrill alarms.

The patient’s blood pressure plummeted and his heartbeat dropped sharply. That meant severe bradycardia.

Director Wu Yongming was so startled he stopped drilling at once.

“Did the drill damage brain tissue?”

Director Ming Xin asked urgently.

Some others couldn’t help but question Wu Yongming’s technique. Skull drilling is always risky, demanding top-notch skill.

“No, I hadn’t even broken through the bone yet!”

Wu Yongming looked sincerely wronged.

It wasn’t his first neuroendoscopic surgery—he’d always followed procedure. How did everything suddenly go sideways?

Sometimes, the scariest part of surgery is when trouble pops up out of nowhere.

And when you can’t pinpoint what’s wrong at all.

“The slow heart rate is likely caused by hypotension. We can try a 0.5mg intravenous injection of atropine and see if that helps.” Zhou Can sized up the patient’s stats and quickly made a diagnosis.

Maybe he didn’t have as much experience in emergency care as Director Xiang Fei, or anesthesiology like Director Ming Xin.

But Zhou Can had an edge almost no other doctor could match—his medical skills, across so many specialties, were level six and above. He was a true all-rounder at the highest level.

Plus, he had the special skill Life-saving Insight backing him up.

That made him even stronger than most chief physicians when it came to emergency rescues.

In Tuyu Hospital, whether it was the OR, the ER, or the ICU, just having Zhou Can nearby was like giving every patient a life-saving charm.

Over the past two years, Cardiothoracic Surgery had handled plenty of difficult high-risk cases. Ever since Zhou Can joined, there hadn’t been a single mishap.

It wasn’t that nothing ever went wrong in surgery—it’s just that when trouble came, Zhou Can always managed to find a way, teaming up with the staff and turning things around.

With every experience, his success rate in emergency rescue had climbed to over 99%.

Now, with only a quick glance, Zhou Can swiftly diagnosed the situation.

“Can’t we use adrenaline instead?”

Ru Yaji, standing behind Director Xiang Fei, couldn’t help but ask.

In emergencies, for cardiac arrest or heart failure, adrenaline is more common.

“Adrenaline constricts blood vessels and raises both blood pressure and heart strength. But it also contracts vessels in the heart, liver and muscles, and especially those in the skin and limbs. It’s often used to treat shock and in critical emergencies, but with patients whose blood vessels are already fragile, you need to be cautious.”

Zhou Can glanced at her and explained.

“The patient just had his splenic artery repaired and reconnected. His blood vessels are already fragile, and using adrenaline could make them rupture all over again.”

Director Xiang Fei took the chance to guide his protégé.

The biggest danger in medicine is becoming rigid and cookie-cutter—every patient is different, and so are the methods that work.

Ancient practitioners of Chinese medicine summed it up as: ‘A thousand patients, a thousand prescriptions. Every case is unique.’

Patients might look equally critical, but the right rescue approach could be totally different.

Take the same drug, for example—the dosage could vary wildly. Some need a rapid push; others, a slow drip. Some might only need 0.5ml, while others wouldn’t feel a thing from that dose.

Obese patients, for instance, often need a higher dose.

Plus, you have to check for allergies, absorption issues or any underlying conditions the drug might make worse.

Take patients with stents: when giving them blood thinners, caution is a must.

Usually, these patients must take anticoagulants for life to keep their vessels clear.

“Got it!”

Ru Yaji nodded, grateful for the advice, giving Zhou Can a thankful look.

She found herself even more impressed with his clinical rescue skills. The gap between them felt wider than ever.

She’d thought the real divide was how he handled surgery.

But now, seeing how he managed critically ill patients—both in diagnosing and prescribing—Zhou Can had her beat on every front.

Now she was completely won over.

Nearby, Pang Houzhong seemed just as shaken, his spirit crushed by the experience.

After a 0.5mg intravenous injection of atropine, the patient’s condition started to improve.

But the situation was still worrying.

“Director Ming, would transfusing about 150ml of blood now pose any risk for the patient?”

Zhou Can consulted her.

Only two people at the scene had top-level rescue skills: Director Ming Xin and Director Xiang Fei.

It made sense to consult the anesthesiologist in charge.

After all, during surgery, she was responsible for the patient’s life.

“Why 150ml instead of more, say, over 200ml?”

She threw the question back.

“Maybe I’m just overly careful, but after factoring in his heart rate and blood pressure, I figured 150ml would just barely stabilize the patient’s vitals and help us finish the brain surgery. If we give too much, I’m worried we might trigger other problems or make bleeding in the brain harder to control.”

Zhou Can gave his reasoning.

That drew another round of amazed—and maybe slightly jealous—looks from everyone.

Calculating blood transfusion volume isn’t a rare skill. Most doctors can do it by looking at hemoglobin levels and estimating blood loss.

But in a rescue, being able to determine the precise volume on the fly, with just heart rate and blood pressure as guides, is something even Director Xiang Fei couldn’t match.

That 50ml difference between 150 and 200 might seem small, but inside a patient it could totally upset the balance and cause a chain of bad outcomes.

Getting the transfusion just right was truly a sign of expertise.

“Someone get 150ml of plasma, and transfuse the patient now.”

Director Ming Xin gave the order.

During the blood transfusion, Wu Yongming hadn’t gone back to drilling into the skull.

Earlier, the whole scare had really spooked him.

“Dr. Zhou, you have some serious rescue skills! Who did you study under at Tuyu—Director Liu Xiangqing from ICU?”

With some downtime as the transfusion went on, Director Ming Xin used the chance to dig a little into Zhou Can’s background.

This guy really was something special.

“I’m surprised you know Director Liu. Yes, I did spend some time learning from him.” Zhou Can recalled his days as a trainee in the Critical Care Department, feeling deeply grateful for Director Liu’s mentorship.

Finding a chief physician truly invested in training you was a stroke of luck for anyone working in medicine.

If you worked hard and had a hint of talent, your career would take off.

But Zhou Can was luckier than most—he had several chiefs who appreciated him, pouring their all into his training. That’s how he’d become such a standout young doctor.

Even at the highest-level Provincial People’s Hospital, he was turning heads everywhere.

He showed everyone just what Tuyu’s best and brightest could do.

“No wonder you’re so talented—top students always have great teachers. Who taught you surgery? Watching your technique, I felt like I saw Tuyu’s two legendary blades—one as steady as ever, the other like Master Yi Yidao with his world record. Did you have all these amazing surgeons mentor you, or are you from some big-shot family?”

Director Ming Xin’s tone was clearly warmer now.

She was at least half-joking.

“What’s this—are you checking my family registry?” Zhou Can smiled, careful not to spill everything. “Anyway, the patient’s vitals are stable, so we should get back to surgery. That sudden drop in blood pressure and slow heart rate? It was just the trauma reaction from drilling into the skull, like a building ready to collapse. Sometimes, all it needs is a slight shake to come crashing down.”

Zhou Can smoothly shifted the subject.

He was sharp, pulling everyone’s attention back to the patient.

That way, no one would get too interested in his background or start digging around.

“Alright, let’s finish the operation. When we’re done, you owe us a chat. If Tuyu has a few more doctors like you, maybe our Provincial People’s Hospital should just bring you all on board.”

That was another lighthearted joke.

But it wasn’t entirely untrue.

If Tuyu really produced ten Zhou Cans, that’d be something to reckon with.

Once they matured, they could easily outpace every hospital in the province.

They’d be unbeatable in the entire region.

Zhou Can only smiled wryly, holding his tongue.

Sometimes staying quiet is the smartest move.

The surgery pressed on.

Wu Yongming carefully tried drilling into the skull again—this time, everything went smoothly.

Next, he incised the dura mater and showed impressive surgical finesse.

The chief physicians at the Provincial People’s Hospital were all truly outstanding.

“Dr. Zhou, how about you help me out with this next part?”

Unexpectedly, once the dura mater was opened, Wu Yongming decided on the spot to let Zhou Can assist him.

Naturally, his surgical assistant wasn’t too happy about this.

But there was no helping it.

The patient’s situation was critical; stopping the brain bleed was a hell-level challenge—and another emergency could flare up at any moment.

Having seen Zhou Can’s brilliance with the laparoscopic surgery, Wu Yongming made the call after weighing his options. Letting Zhou Can help had more pros than cons.

He was more reliable than the usual assistant, and brought a huge sense of reassurance.

And if something did go wrong, Zhou Can would jump in to save the patient without even being asked.

Plus, Zhou Can’s vascular anastomosis skills were top-tier—fast and precise. With the bleeding point so close to the brainstem, they might need him to patch up the blood vessels after all.