Chapter 535: An Accident Caused by Anesthesia, One Person’s Strength Ultimately

Within the hospital walls, medical staff undeniably hold the upper hand with both strategic positioning and unified support.

When it comes to persuading patients to leave, they’ve got plenty of tricks up their sleeves.

Plus, everyone’s already on the same page, bound by shared interests. No one even needs to spell it out—when a situation like this arises, they instinctively know how to handle it.

“Trust the doctors; you can’t go wrong. Tuyu Hospital has such a stellar reputation, their ethics must be top-notch. Let’s hurry and transfer Xie Chao to Provincial People’s Hospital.”

“I agree, we should get him to Provincial People’s Hospital. It’s a public major hospital, after all—more reliable in every way.”

“The ambulance we hired hasn’t left yet. Let’s make the call now.”

The family members chimed in one after another, quickly settling the matter.

Soon, the patient was whisked away by the accompanying doctor and nurse on the ambulance.

Renting an ambulance to transport a patient usually means hiring a private one, often called an external hospital ambulance. The hospital’s own vehicles rarely take on such jobs.

In these cases, the ambulance driver arranges for an accompanying doctor and a nurse.

Their fees are typically included in the transportation cost, but the family is expected to slip an extra red envelope to the doctor and nurse.

If the family doesn’t get the hint and the red envelope isn’t forthcoming, the accompanying staff might slack off or drag their feet.

Watching the patient being taken away, Zhou Can and Director Lou both let out quiet sighs of relief.

Every day, they encounter a few patients who need to be persuaded to leave.

Outright refusing treatment? Major hospitals rarely do that. Instead, they use softer tactics to nudge patients away.

“Zhou, just how low were the odds of saving that patient earlier?”

Director Lou asked in a detached tone.

“Barring a miracle, there’s no hope. Certain death.”

Zhou Can’s reply was firm and unyielding.

“You’re that sure?”

Director Lou’s skills weren’t lacking, but when it came to diagnostic prowess, he’d already been surpassed by Zhou Can.

“That’s a conservative estimate. I’m certain that even if the patient’s urine is still just a deep yellow now, it’ll turn soy-sauce dark within two days at most. He’s already in acute renal failure. With the upper lobe of his right lung removed, it’s also triggered respiratory failure. He might not look critical yet, but there’s no saving him.”

In the past, Zhou Can wouldn’t have dared to make such a definitive diagnosis.

Even among colleagues, he’d have hesitated to sound so certain.

Now, with his pathology diagnosis skills elevated to a director’s level, coupled with the intense study he’d done on kidney diseases to treat Su Qianqian’s condition—including mastering urology—he could diagnose cases like this with near-perfect confidence.

“Removing the upper lobe of the right lung, and somehow wrecking the patient’s kidneys in the process? Third Hospital just keeps making headlines for all the wrong reasons!” Director Lou had heard plenty about Third Hospital.

Mostly negative news.

Especially lately, with Third Hospital’s funding chain in crisis, they lacked the spare cash to manage bad press.

As a result, all sorts of scandals were being exposed online by victims.

It was the classic downfall—when you’re at rock bottom, everyone pushes the wall down on you.

“I doubt it’s directly tied to the lung lobe removal. I suspect anesthesia is to blame. I used to think Third Hospital was impressive for hiring cardiac surgery experts from Japan, but now I see a hospital’s strength isn’t carried by just one or two doctors. Third Hospital lacks depth; it’s riddled with weaknesses. This medical accident likely stems from anesthesia gone wrong. We’ll see how the family handles it.”

Zhou Can’s eyes flickered with thought.

He’d clearly overestimated Third Hospital before.

Whether the family would cause a scene after the patient’s death was still up in the air.

Some families are more docile, believing the doctors did their best if a patient dies post-surgery. They often don’t pursue trouble with the hospital.

But for a family to take on a hospital isn’t easy.

To an individual, a hospital is a towering giant.

Families and patients are always the weaker party.

“Anesthesia issues? Break it down for me.”

Despite Director Lou’s wealth of experience and solid skills, he often felt powerless against complex, tricky cases. That came down to talent, specialization, and diagnostic thinking.

Whether he admitted it or not, Zhou Can—despite his youth—had been mentored by masters across multiple departments. Combined with his exceptional talent and relentless learning, his ability to diagnose a wide range of difficult cases already outstripped Director Lou’s.

“I believe the patient underwent thoracic surgery, likely in a lateral position. That can cause the side pressed against the operating table to suffer pressure injuries from the body’s weight. This patient showed clear soft tissue damage on the left shoulder, arm, hip, and thigh—swollen and darkened. It’s highly probable that during surgery, under general anesthesia, the padding was too hard, severely compressing the left side. This led to ischemic necrosis and muscle breakdown.”

“Capillaries ruptured, clogged, and changed in permeability. Once the surgery ended and the patient was moved to a supine position, the pressure on the side was relieved. That’s when local bleeding occurred, with a large amount of plasma fluid rapidly seeping into the tissue gaps, causing muscle swelling. Without timely intervention, the pressure in the muscle compartments skyrocketed, worsening local blood flow obstruction and ischemia. Ultimately, the compressed areas on the left side became swollen, hard, and cold.”

Zhou Can meticulously analyzed the patient’s entire injury process.

Pressure injuries during surgery are often overlooked by doctors.

Yet they demand serious vigilance.

“When I examined the patient earlier, pressing on the swollen areas on his left side felt rock-hard, like stone, and the limbs were ice-cold. That indicates the muscle tissue has already necrotized, long past the window for effective treatment.”

During the check, it might’ve looked like casual prodding, but Zhou Can’s rich experience allowed him to gauge the patient’s condition instantly.

“Impressive, your analysis is spot-on. So, you think the renal failure is linked to these pressure injuries, right?”

Director Lou nodded in deep agreement after listening.

Nearby, young doctors quietly jotted down notes, recording Zhou Can’s analysis for future study and as a cautionary lesson.

“With the left-side muscles necrotized, swollen, and hardened, it causes significant local fluid loss or bleeding, ultimately reducing total blood volume. The patient’s critically low blood pressure is proof of that. Reduced blood volume means less perfusion to the kidneys, leading to ischemia. At the same time, the necrotic muscles release a flood of toxic substances into the bloodstream, further poisoning the kidneys. Then, myoglobin deposits block the renal tubules directly, triggering acute renal failure.”

Zhou Can dissected the entire process of renal failure step by step, earning high praise from Director Lou.

Other doctors and nurses looked at Zhou Can with admiration or respect in their eyes.

“Such a shame. The patient is still so young, and a life was wasted like this. If the issues post-surgery had been addressed promptly with targeted treatment, there might’ve been a chance to save him. Now, with irreversible acute renal and respiratory failure, it’s beyond recovery. He’s too far gone.”

Zhou Can didn’t outright say Third Hospital botched the patient’s life.

Yet his analysis made it painfully clear that negligence and errors during treatment at Third Hospital were to blame.

This was a textbook case of a severe medical accident.

In the evening, after finishing surgeries in the Emergency Department, completing rounds, and enjoying a delicious meal brought by Su Qianqian, Zhou Can hurried to the Cardiothoracic Surgery Department.

A mountain of tasks awaited him there.

The retired official had agreed to surgery, though Zhou Can wasn’t sure how the family had been convinced.

Hospitals operate this way—families and patients must adapt to the hospital’s treatment protocols, not the other way around.

This official’s treatment costs were almost fully reimbursable, and his family wasn’t short on money. His daughter-in-law insisted on the safest and ‘best’ surgical option: placing a vascular stent.

But doctors couldn’t cater to her wishes.

How many stents would that even require?

And the results wouldn’t be ideal anyway.

Using a single artificial vessel for a bypass would solve everything.

It’s far cheaper, less hassle, and once done, there’s little worry about issues with that vessel down the line. The only drawbacks with an artificial vessel are aging and potential leakage if the anastomosis isn’t perfect.

Let’s talk about aging first.

The lifespan of an artificial vessel is at least ten years, with better ones lasting over twenty.

In reality, even thirty years of use might not pose a problem.

Since it’s sealed inside the body, aside from corrosion by blood and bodily fluids, there’s no contact with external air, significantly extending its durability.

The retired official was already sixty-five. Even if he lived to a hundred, that’s only thirty-five more years.

The artificial vessel should hold up until then without issue.

And if a problem does arise, he can always return to the hospital for a replacement.

For patients with systemic conditions like arteriosclerosis, living to a hundred is a long shot.

Often, reaching eighty is already considered a long life.

Because the patient’s abdominal arteries, cardiovascular system, cerebral arteries, and more will keep deteriorating. One day, a brain hemorrhage or heart attack could end it all in an instant.

Inside the Cardiothoracic Surgery operating room, Zhou Can personally performed the surgery for this retired official.

The patient’s family waited anxiously outside.

Zhou Can wasn’t privy to how Director Xueyan had negotiated with them. All he knew was that the official had specifically requested Zhou Can to operate.

The more prestigious the patient, the more they sought out renowned doctors.

After a thorough intraoperative assessment, Zhou Can selected an artificial vessel—38 centimeters long and about 8 millimeters in diameter—for a bypass from the right common femoral artery to the popliteal artery.

Considering the fourth toe on the right foot had already necrotized and turned black, there was no saving it.

With the patient and family’s consent beforehand, an amputation of the toe was performed.

This was already minimizing the damage as much as possible.

Other hospitals had demanded a full right leg amputation to save his life.

Under Zhou Can’s care, losing just a single toe was the best possible outcome.

Post-surgery, tests on the right foot’s blood flow showed both the popliteal and dorsal pedal arteries had recovered. With the naked eye, you could see the skin on the right foot gradually regain a faint rosy hue.

Compared to its previous pale, icy state, it now had a hint of life.

This confirmed the right foot’s blood circulation was restored.

With proper blood flow and nourishment, the right foot shouldn’t face further necrosis.

“Post-op, ensure he receives thorough anti-infection treatment. Monitor the right foot closely. If there’s any sign of ischemia or continued necrosis, address it immediately.”

Zhou Can instructed the circulating nurse.

“Understood.”

The circulating nurse held deep respect for Zhou Can.

In the Cardiothoracic Surgery operating room, Zhou Can was practically king. The nurses and doctors here all recognized his skill and trusted him implicitly.

After wrapping up this surgery, two more major operations awaited Zhou Can.

One was a patient who’d had surgery at a provincial tertiary hospital out of state, but the results were subpar, requiring a redo—a second-entry case. The other was a mitral and tricuspid valve insufficiency repair.

Both were significant surgeries. Zhou Can sighed inwardly, resigned to battling through until dawn.

More and more, he felt the limits of one person’s strength. Even if he pushed himself to the brink, operating from morning till night, how many could he save?

This realization made him prioritize training successors.

Whenever the chance arose, he’d selflessly share surgical insights, guide newcomers, and even advise other attending physicians. As for deputy directors or directors, he wouldn’t dare ‘guide’ them—those interactions were framed as ‘exchanges.’

Past one in the morning, he finally called it a night.

Three surgeries in total, all completed successfully. The final one, the mitral and tricuspid valve repair, was led by Director Xueyan with Zhou Can assisting.

Or rather, it could be seen as both operating simultaneously.

This was a fresh approach.

With two surgeons working on different parts at once, as long as they coordinated well, it drastically cut down surgery time.

For open-chest major surgeries, the shorter the procedure, the better.

Had they not teamed up for this case, they might not have finished until three in the morning.

Around ten the next morning, while Zhou Can was busy in the Emergency Department operating room, Director Zhu called Dr. Xu.

Zhou Can’s phone, of course, went unanswered during surgery.

“Zhou, after you finish this surgery, use your phone to call Director Zhu back. He said he’s got something to discuss with you.”

Dr. Xu came in to relay the message.

“Got it.”

Zhou Can had a hunch about what it might be.

Likely, the medical exchange with Provincial People’s Hospital had been greenlit.

Inside the operating room, the other doctors and nurses overheard that Director Zhu had personally called for Zhou Can. A wave of envy rippled through them, along with a newfound respect.

This kind of status boost was subtle but undeniable.

It’s like when a colleague is known to have a vice-director uncle—everyone instinctively gives them a bit more leeway.

After completing the surgery at hand and delegating the suturing to two subordinate doctors, Zhou Can headed to the changing room to grab his phone and return Director Zhu’s call.

Director Zhu had tried reaching him twice with no answer.

He quickly dialed back.

It rang twice before connecting.

“Director Zhu, I’m really sorry for not answering sooner. I was in surgery and left my phone in the changing room.”

Zhou Can rushed to explain right off the bat.

Missing a call from the hospital’s top leader could easily rub them the wrong way.

“I understand! You don’t bring your phone into the operating room to focus fully on the patient. That kind of work ethic deserves praise. Zhou, regarding the medical exchange with Provincial People’s Hospital, the hospital board has approved it. Reach out to their side and see if they can send a leader to discuss the details.”

Director Zhu showed no trace of irritation.

Instead, he offered Zhou Can a word of commendation.

“Alright, I’ll head down after my surgeries at noon. I’m planning to visit Director Lu at the hospital anyway, so I’ll ask them then.”

Zhou Can deliberately mentioned Director Lu.

Whether those individuals could return to Tuyu Hospital still depended on Director Zhu’s approval.

Since Director Xueyan hadn’t brought it up, there mustn’t be any progress yet.

The hospital leaders were holding off on giving the nod, and no one could force their hand.