Chapter 569: Assistant Professor: The Severe Consequences of Myocardial Necrosis

Nearly fifty minutes later Zhou Can hurried to the director’s office in the Internal Medicine Building.

In terms of status Director Tan was second only to the Vice-Director.

According to some rumors if Tuyu Hospital successfully completes the reforms across all departments this time each major department head could be automatically promoted to Vice-Director.

For Zhou Can this was also a chance to climb the ranks quickly.

Right now his sole focus was to boost his academic credentials as soon as possible. This tied directly to his future title evaluations key position competitions and overall ranking as a renowned doctor.

The door to the director’s office was closed.

Knock knock knock!

He tapped politely and soon Director Tan’s warm and deep voice rang out.

“Come in!”

Pushing the door open Zhou Can saw Director Tan engrossed in a yellowish ancient book.

It was unmistakably a text on Traditional Chinese Medicine.

Doctors in the Internal Medicine Department often delved into medical theories and pathologies. Once they reached a certain level some even studied pulse theories.

At least three developed countries have created automated pulse diagnosis devices based on Traditional Chinese Medicine techniques. Sadly the results remain underwhelming.

That’s because pulse diagnosis in Traditional Chinese Medicine relies on a doctor’s knowledge of pulse patterns their meanings and diagnostic experience all blended into a comprehensive assessment.

It involves a crucial element of human intuition endlessly adaptable and requiring flexible judgment.

With current artificial intelligence it’s simply impossible to replicate.

Even in fifty years automated pulse diagnosis devices might still struggle to make significant breakthroughs.

Traditional Chinese Medicine is profound and vast. Those who don’t understand it often dismiss it as mysticism.

Only those who grasp its depth see it as true medicine.

Nowadays most young doctors in Huaxia view Traditional Chinese Medicine as somewhat mystical. A common trend is to recommend it to patients with tricky conditions or incurable terminal illnesses as a last resort.

From this perspective Traditional Chinese Medicine is undoubtedly undervalued.

Zhou Can at least had witnessed its power firsthand. Su Qianqian’s kidney disease had no solution in Western medicine beyond a transplant. Yet with Traditional Chinese Medicine prescriptions combined with dietary therapy and exercises she was completely cured.

She’s undergone three follow-up checks all showing normal urine tests and kidney function.

“Director Tan!”

“You’re here! Take a seat!”

Director Tan stood to brew him a cup of wellness tea laced with goji berries and astragalus.

Not many people received the honor of having Director Tan personally make tea for them.

Zhou Can was an exception.

“I’ve called you here for two matters. First yesterday’s heart attack patient has a special identity—he’s the director of Third Hospital.”

Mentioning Director Zhang Qilian’s identity brought a sly smirk to Director Tan’s face.

It was indeed quite intriguing.

Third Hospital prided itself on cardiac surgery services. There was a time when it basked in glory so arrogant it seemed to forget its place.

Now look at this—their own director suffered a heart attack their hospital couldn’t handle it and they sent him to Tuyu Hospital for emergency treatment.

The kicker? Tuyu actually pulled off the rescue.

“Third Hospital once dealt us a heavy blow. This is a golden opportunity to promote our cardiovascular and cardiothoracic surgery departments. The hospital is already planning interviews and a major PR push.”

As Director Tan spoke a hint of ruthlessness seeped through his calm tone.

Kindness has no place in business or leadership.

Anyone who rises to a key hospital leadership role is far from soft. When it’s time to strike their methods are ironclad.

A gentleman’s revenge can wait ten years.

It’s clear Tuyu Hospital intends to seize this chance to hit Third Hospital while it’s down.

A weak nation shouldn’t bow too low and the small shouldn’t fear the strong—these are grave mistakes.

When Third Hospital played dirty against Tuyu they should’ve known a day like this would come.

Tuyu Hospital can be magnanimous but that doesn’t mean endless tolerance.

“Since this involves you I’m giving you a heads-up to discuss it. The hospital’s PR campaign might require your cooperation.”

Director Zhang Qilian’s thrombus removal and vessel clearing were almost entirely handled by Zhou Can.

Using this for publicity naturally meant consulting Zhou Can out of respect.

As for ‘discussion’ take it with a grain of salt.

When leaders ‘discuss’ with subordinates it’s often just a formality. Decisions are usually already made and while objections can be raised they rarely change the outcome.

“I’ll fully support the hospital’s publicity efforts.”

Zhou Can declared his stance right away.

He knew his attitude would be reported back to the hospital leaders by Director Tan.

Using Third Hospital as a stepping stone didn’t weigh on Zhou Can’s conscience. Ruthlessness is sometimes necessary.

Hesitating with a saintly heart full of morals at a critical moment is just absurd.

Strike while the enemy is weak—that’s the way to survive.

The law of the jungle always prevails.

Lions and tigers don’t pity the weak. They focus on securing their food with the least effort.

“The second matter: your skill in interventional surgery is exceptional already at a very high level. The Internal Medicine Department’s interventional skills have always been lacking which doesn’t align with modern top-tier hospital standards. I’d like to hire you as a mentor for interventional surgery to specifically train our doctors here. I know you’re swamped but every doctor eventually takes on a teaching role. Only through teaching does medicine continue to thrive and endure.”

“Taking on a teaching position now will greatly benefit your future promotions in academia. If you agree I can secure an assistant professor position for you at the medical school. Even the top doctoral supervisors started from this very role.”

Director Tan must have thoroughly evaluated Director Zhang Qilian’s interventional surgery and its outcomes.

Realizing Zhou Can’s skill far exceeded expectations he was eager to bring him on as a mentor for interventional surgery.

This was a win-win arrangement.

“I’m more than willing to take on this role. Teaching is a rewarding experience in itself. I just worry my skills might not be up to par and I could fall short as a teacher.”

Zhou Can spoke humbly but his words were essentially an agreement.

It’s like visiting relatives and being offered a red envelope—people often politely decline verbally while their hands eagerly accept.

In academia faculty promotions typically progress from assistant professor to lecturer associate professor and finally professor.

Beyond professor there are tiers like first second and third-level professors.

First-level professors are the highest often pioneers in their field with absolute authority. Third-level professors are the lowest among professors but still incredibly accomplished.

Not just anyone can earn such a title.

Academic positions have thirteen levels much like hospital doctor ranks requiring step-by-step advancement.

Without sufficient skill or ability progress is slow.

Many academic faculty might never reach third-level professor lingering as lecturers until retirement.

Some unlucky ones with certain limitations might retire still as assistant professors.

In short competition in every professional field is brutally fierce.

The capable rise while the mediocre stagnate or get weeded out.

Stepping into a teaching role now was a huge opportunity for Zhou Can.

Many prodigies only start excelling after thirty. Beginning his teaching journey before that age would give him a massive edge in future promotions.

In career advancement starting ahead means staying ahead.

“Don’t worry about whether you teach well or not. Everyone starts with unsteady steps. The medical school will give you ample time and opportunities to grow without imposing harsh demands right away.”

Director Tan reassured him.

“Alright since you trust me so much there’s nothing more to say. I’ll roll up my sleeves and get to work. Just let me know the arrangements when the time comes.”

Zhou Can agreed readily.

No need to overthink it—missing an opportunity like this would be hard to come by again.

Three days later Zhou Can was performing emergency surgery when a distress call came from the Cardiothoracic Surgery Department requesting an urgent consultation.

Saving lives is like putting out a fire. Zhou Can entrusted the surgery to his two assistants.

They were now fully capable of handling level one and two surgeries as well as the routine parts of level three procedures.

For high-difficulty level two surgeries and critical aspects of level three ones Yang Zhi and Pu Dingdong still lacked the skill. Even so their progress was remarkable.

Yang Zhi with his solid surgical foundation clearly outshone Pu Dingdong in surgical ability.

But Pu Dingdong improved steadily at a consistent pace.

Who would ultimately surpass the other was still up in the air.

Zhou Can was quite pleased with his two medical assistants.

Expecting them to reach his level in just a year or two was unrealistic.

Compared to other doctors at their level their growth was already astounding.

He quickly made his way to the Cardiothoracic Surgery Department.

The atmosphere in the consultation room was heavy.

“This patient underwent emergency interventional thrombectomy in our cardiovascular department three days ago. Last night he began showing clear signs of discomfort—shortness of breath severe chest pain and a drastic drop in blood pressure. We now suspect that after the acute myocardial infarction extensive myocardial ischemia led to necrosis due to prolonged lack of blood flow. The patient’s condition is critical. After evaluating with several department heads we believe the surgical risk is extremely high. Since you’re most familiar with his case we’ve called you in for a joint consultation.”

Director Xueyan sat at the head of the consultation table.

The first seat on the left was left empty reserved specifically for Zhou Can.

Most doctors in the department tacitly regarded Zhou Can as the second-in-command of Cardiothoracic Surgery.

Since ancient times the left has been a position of honor.

The first seat on the left is typically reserved for the second most important figure.

Zhou Can reviewed the test results mainly chest ultrasound and CT scans.

These helped identify any abnormalities.

“When this patient was brought in for emergency treatment three days ago the optimal window for rescue had already passed. During the interventional procedure to clear the vessels I had a bad feeling. I suspected the area of myocardial necrosis might be extensive. Now it turns out I was right.”

Speaking of Director Zhang Qilian’s condition Zhou Can couldn’t help but feel troubled.

This was a tough case to crack.

“Based on my clinical experience his current state means certain death without surgery. Even with surgery the survival rate won’t exceed fifty percent. We discussed two options earlier. First attempt surgery and see how it goes. Second consider a heart transplant. Of course finding a donor for a transplant is a major hurdle. An artificial heart would be the preferred choice.”

Director Xueyan shared the discussion points.

Zhou Can listened but his concern lingered.

“Both surgical approaches have some feasibility. The critical issue is the patient’s widespread arterial deformities and severe atherosclerosis. During rounds I learned from family members that the patient has had vascular abnormalities since childhood. He’s been on medication to manage it ever since. He even studied abroad in Japan specifically to seek treatment for systemic arterial issues.”

The patient’s situation was extraordinarily complex.

Even for an average patient a heart transplant carries a high risk of death.

For someone with such severe arterial deformities the danger is even greater.

Hearing this everyone fell into a troubled silence.

For acute heart attack patients if extensive myocardial necrosis occurs it can lead to cardiac remodeling causing the heart to enlarge weakening myocardial contraction reducing cardiac output triggering heart failure lowering blood pressure and even causing cardiogenic shock.

If not addressed promptly the necrotic myocardium can bulge outward potentially forming ventricular aneurysms or rupturing papillary muscles or even the heart itself.

Additionally after myocardial necrosis the infarcted area thins while non-infarcted areas thicken leading to uncoordinated contractions. This can result in mural thrombi in the left ventricle which if dislodged could cause embolisms in the brain kidneys spleen lungs or limbs.

That’s why when Zhou Can checked on Director Zhang Qilian’s post-surgery condition that morning he warned the family that the real danger was far from over.

He could successfully remove the thrombus but he couldn’t guarantee the myocardium wouldn’t necrose.

By the time of the thrombectomy some myocardium had already died from ischemia. Without opening the pericardium it was impossible to confirm.

Western medicine often takes a more reactive approach.

It can be seen as a secondary form of defensive medicine.

For instance if a potential tumor is detected but it’s still small doctors might advise monitoring with follow-ups every three or six months. If it doesn’t grow it’s left alone.

In medical terms this is called coexisting with the disease.

The overarching philosophy of Western medicine largely follows this mindset—extending patient life as much as possible while finding ways to alleviate suffering.

Take cancer patients for example. They’re often first put on chemotherapy or radiotherapy to control the spread of cancer cells. The goal isn’t a cure but to prolong survival.

Then painkillers are prescribed to ease the agony of late-stage cancer.

Many believe trigeminal neuralgia or childbirth are the most painful experiences. Yet compared to cancer pain they pale in significance.

Cancer pain is truly unbearable.

Especially in the late stages the torment can make life feel worse than death.