Chapter 609: Sudden Crisis in the Operating Room

For a young woman to suddenly suffer heavy bleeding below without any clear reason, the first suspicion is always a miscarriage in progress.

Ectopic pregnancies are especially prone to ending this way.

That’s why, before surgery, hospitals always confirm whether a female patient could be pregnant. If so, they try to delay the operation. If surgery can’t be postponed, an obstetrician will be brought in to perform a joint procedure.

If the pregnancy is disturbed, or the surgery triggers a miscarriage, no one could bear that responsibility.

This patient’s lower abdomen might look flat, but there’s still a hint of pregnancy in other parts of her body.

It’s not just stretch marks on the belly and thighs that signal pregnancy.

Other signs include some areas of skin darkening, a dense fuzz growing on the lips, facial skin turning dull, even breaking out in pimples—all classic signs of pregnancy.

These signs might not be obvious in the early weeks.

But by late pregnancy, they’re impossible to miss.

“Both the patient and her family swore she wasn’t pregnant before surgery! It’s probably not possible, right?”

Even Tang Wangnian was clearly unsure.

He almost sounded like he was trying to dodge responsibility, maybe even covering for an incomplete pre-op check.

Zhou Can frowned slightly. Now wasn’t the time to point fingers.

Saving the patient’s life came first.

“Did you take blood for testing before surgery?”

“We did!”

A blood panel is practically a must before any operation.

What’s her blood type? Any infectious diseases? Are there any serious underlying conditions?

A lot can be found out from these tests.

“Tell the lab to run an hCG test on this patient’s blood right away.”

Blood hCG and progesterone levels are the gold standard for confirming pregnancy.

Clinically, hCG tests are by far the most used.

In theory, they’re even more accurate than checking progesterone.

hCG, or human chorionic gonadotropin, turns positive as soon as a woman becomes pregnant.

But the lab takes some time to process hCG tests, and this woman’s bleeding was so dangerous she might not survive long enough for results.

Major internal bleeding, especially uterine hemorrhage in women, is extremely risky and has a frighteningly high death rate.

“Have you spoken with the family yet?”

Zhou Can asked Tang Wangnian.

“N-no!”

Tang Wangnian’s face had turned pale, his eyes wide with panic and dread.

With this woman on the verge of dying, he was the primary surgeon and couldn’t escape blame. Who knew what kind of punishment might follow—even a suspension, a revoked surgery license, or worse.

Medical accidents happened every year at Tuyu Hospital, some unavoidable.

Others were the direct result of doctors or nurses not following protocol. In those cases, the hospital and higher authorities always came down hard.

“Director Zhou, since we haven’t figured out the source of the bleeding, bringing the family in now could just make the rescue harder and cause more confusion.”

Nurse Tang Ling had worked with Zhou Can for years.

They’d both joined the Emergency Department Operating Room at the same time—she as a nurse, he as a doctor.

Now, years later, she’d become a senior nurse, while Zhou Can shot up to deputy chief of the department, deputy group leader of the OR, and leader of the first team in Quality Control.

Each of those titles marks a level most doctors can only dream of reaching in a lifetime.

“If the patient starts bleeding heavily mid-operation and the family isn’t informed, that’s an even bigger headache. Right now, the only thing we need to confirm is whether the patient is pregnant.” Zhou Can’s tone was calm but still gentle toward Tang Ling.

After all, she was not just a colleague but an old friend. He couldn’t really get angry over something small like this.

“Dr. Tang, I’m not picking on you, but when you saw the bleeding, the first thing you should’ve done was run a pregnancy test. Skipping that check before surgery and then just thinking about dodging blame when trouble starts—if this patient dies on the table today, your entire medical career is over. Do you get that?”

Zhou Can couldn’t hold back his frustration any longer.

He let loose on Tang Wangnian.

It didn’t matter that Tang Wangnian was a senior attending in his forties, much older than Zhou Can. At work, Zhou Can was still his boss and had authority over him.

Rank always wins—it’s true everywhere.

“I—I just thought maybe she was on her period…” Tang Wangnian ducked his head under the scolding, mumbling a defense.

Deep down, he knew corners had been cut during this surgery.

Even after things started going wrong, he’d reacted slowly and didn’t do enough.

“Have you ever seen a woman whose period looked like a gushing fountain? And you’re a senior attending? You really lack that much experience? Get two pregnancy test strips right now. Attending Nurse, fetch a catheter. Waiting for the lab will take too long—find the cause immediately so we can act, or she won’t make it.”

Zhou Can’s experience in emergencies was unmatched, and he’d never stick to the rulebook when life was at stake.

Bureaucratic red tape never fazed him. If rules stood between him and saving a patient, he’d break them without hesitation. Hesitation gets people killed.

As long as he did his best and gave his all, the department and hospital could handle the fallout.

After all, Tuyu Hospital took good care of its doctors that way.

Especially with high-potential rising stars like Zhou Can—they made sure he had support.

This kind of environment let doctors focus on saving lives without worrying about the consequences, making them far more effective.

Besides, a doctor’s skills always improve fastest during these high-stress rescues.

There’s nothing like real pressure to draw out every ounce of potential.

Hearing Zhou Can’s rapid-fire plan, Tang Wangnian and the other staff couldn’t help but brighten.

Using a test strip really would be much faster than waiting on blood work.

The only trick was, you couldn’t count on the result being completely accurate.

In under five minutes, Tang Wangnian managed to get the test strips.

He was desperate to save himself too.

He phoned a relative who ran a pharmacy right next to the hospital and begged them to rush over with a box of pregnancy test kits.

Normally, he’d never let that kind of connection slip.

But around hospitals, businesses like pharmacies, inns, and maternity centers are almost always connected to people working inside.

It’s usually relatives or friends of the doctors and nurses.

Without some ties, just getting referrals would be a nightmare.

Take a maternity center. If your relative were an OB chief at Tuyu, they’d naturally send patients over whenever they had a good candidate.

Patients trust their doctor, so if they’re looking for a place, they’ll usually go with the suggestion.

Then the maternity center quietly gives the recommending chief a commission.

It’s a win-win.

That’s how you keep business booming, year after year.

Some doctors cut out the middleman and open a rehab center themselves or have their spouse run it.

So long as customers keep coming, profit is guaranteed.

The hospital mostly turns a blind eye.

As long as nobody gets hurt, nobody cares.

Some attendings only make a meager salary each month, but somehow they own multiple homes and drive luxury cars, send their kids to study abroad. You can’t live that well on wages alone.

When you’ve been in this line for years, you learn how to make it work.

Once the test strips arrived, Zhou Can had already placed the catheter and collected urine, dropping it on the test area.

Then all they could do was wait.

Resuscitation efforts continued the whole time.

But blood transfusions just couldn’t keep up with the loss. Things were getting seriously dangerous.

Not knowing if she was pregnant, Zhou Can didn’t dare use his full hemostasis skills. For uterine bleeding, the go-to method is packing with gauze.

But if she’s pregnant, that’s off the table.

The test result came back almost right away.

It was positive for pregnancy.

To be sure, they used two strips.

Both came out positive.

Now Zhou Can had basically figured out what caused the massive bleeding. While calling over obstetrics specialists for a joint consult and rescue, he also rushed to explain things to the family.

A critical condition notice was issued to the family as well.

In this incident, the hospital did hold some responsibility, but the family and patient had also hidden the pregnancy, which was a huge factor.

Even if this went to court, the hospital would likely win.

The OB department sent two doctors to assist. One was Zhou Can’s old friend and classmate, Yang Chan. The other, an associate chief, was Zhao Zhisheng. Many people still think all OB doctors are women, but that’s not true.

There are plenty of male ob-gyns out there.

Just like Zhao Zhisheng—a male OB specialist and a top-notch one at that.

Within minutes, they confirmed the patient had an ectopic pregnancy—a so-called tubal pregnancy.

It was likely that medication given during surgery caused uterine contractions, triggering a miscarriage and hemorrhage.

Ectopic pregnancies are dangerous to begin with.

For a patient to hide her pregnancy and let doctors operate without warning, it was gambling with her life.

Hemostasis and surgery were Zhou Can’s strengths.

But when it came to OB procedures, he was out of his depth.

Yang Chan hadn’t been around for a while and looked a bit thinner, but somehow even more beautiful, exuding this newfound confidence.

Clearly her skills had advanced a lot in recent years.

During the upcoming operation, she totally impressed Zhou Can with her technique.

Her current operating skills matched any seasoned attending’s—no wonder Director Zhang of OB had chosen and fully supported her early on.

Sure, Zhou Can had mastered multiple specialties to chief-level, leaving her in the dust, but he had systematic advantages.

She had no such help—just talent and sweat. Raising her surgical ability this far in just a few years was truly impressive.

……

The rescue ended with the patient’s uterus intact.

Most times when postpartum hemorrhage happens, the uterus has to be removed to save the patient.

When there’s uterine bleeding, doctors usually decide removal is best.

Stopping the bleeding is extremely hard.

It’s and extremely risky.

For this patient to keep her uterus—and her life—that was luck amid disaster.

Once the danger passed, Zhou Can let out a long breath. Only then did he notice his back was soaked in sweat.

Tang Wangnian took off his mask, his face etched with relief.

That was a close call—she almost didn’t make it.

The whole experience was like having your head on the chopping block.

This lesson would make him far more cautious in the future.

Recently, he’d heard through the grapevine he’d been nominated for an associate chief title in their department.

With that nomination, promotion was essentially guaranteed as long as all other criteria were met.

Many medical graduates think ability alone will get them promoted, but they forget the hospital itself is the biggest factor.

You work where you’re registered—and that means your career grows there.

Big hospitals have a set number of associate and chief spots based on size and reputation.

Get on the list, and it makes all the difference.

At Tuyu, those rare spots go to specific departments.

Thanks to Zhou Can, the Emergency Department had gotten a tiny slice of that pie in recent years.

Before, you’d be lucky to get even the leftovers.

Earning one of those associate chief slots left Tang Wangnian riding high.

But pride comes before a fall.

He’d let little mistakes and carelessness slip in, nearly causing a tragedy—a lesson he’d remember.

“Alright, looks like the patient will be fine. We can head out now.”

Director Zhao took off his mask and gloves, tossing them in the trash.

“Thank you, Director Zhao and Dr. Yang. Let me walk you out.”

Though Zhou Can had tried to avoid bumping into Yang Chan, this time he couldn’t. They’d needed her help, and it would be rude not to see them out.

He braced himself and escorted the two of them.

It was a matter of respect.

“Director Zhou, you never used to call me that!”

Yang Chan narrowed her bright eyes, a complex look flashing across her stunning features.

“Cough… Class Monitor, don’t tease me. Titles don’t matter—we’re old friends.”

With his coworkers watching, Zhou Can couldn’t help but blush.

The others exchanged knowing grins, finding his discomfort a little entertaining.

They were used to seeing Zhou Can crush any challenge in the department—the OR, the ER, each time without fail. Watching him get embarrassed now brought a special satisfaction.

“So you still remember me as your class monitor? I figured you’d forgotten all about us since becoming director! Every time I come here you’re nowhere to be found. Are you purposely avoiding me?”

Yang Chan sounded like she’d been holding back this grudge for a while and wasn’t letting him off easy today.