Chapter 629: Before the Scalpel: Lessons in Humility and Risk

Surgical procedures have always come with extremely strict operating standards.

In Internal Medicine, there’s no hierarchy—if a trainee is skilled enough, they can treat complex illnesses. But in the operating room, qualifications and access are tightly regulated.

A resident doctor can only perform level-one surgeries and, at most, assist in level-two cases.

From preoperative assessment to intraoperative sterility and safety management, to the strict post-op care—there’s an inviolable line for everyone in medicine: the safety of the patient.

Zhou Can is an exceptionally skilled surgeon, mastering nearly every field.

Whenever he operates, he’s always meticulous, which is why nothing has ever gone wrong.

But since he’s had smooth sailing throughout his career and with his bold personality, he’s started to push the boundaries, sometimes making surprisingly risky decisions during surgery.

So far, whether it’s in the Emergency Department, Cardiothoracic Surgery, or major cases in other departments, there’s never been a problem.

Even if something unexpected happens mid-surgery, Zhou Can has chief-level anesthesia skills, intensive care experience, and advanced pathology and pharmacology expertise—enough to pull a patient back from the brink at any critical moment.

At the end of the day, people aren’t so different.

With enough skill and too many easy wins, you start getting overconfident. When facing things you know well, it’s tempting to do things your own way.

Usually, when Zhou Can helps out in other departments, he follows the protocols the team sets in place.

He just handles the key moments.

If speed is needed, sometimes he’ll do most of the surgery himself, leaving only the final suturing and wound closure to the others.

In the Emergency and Cardiothoracic departments, he’s held in high esteem. The Chief Physicians trust him implicitly.

Because of that, his risky approach has never really worried anyone.

Wu Baihe noticing Zhou Can’s issue this time is definitely a good thing.

Recognizing your own shortcomings is the first sign of real courage.

It’s only by admitting your mistakes that you can keep improving and minimize errors.

“Director Wu is absolutely right. I have been a little too carefree before. I promise I’ll change that,” Zhou Can said, seeing his mentor get blamed and knowing Wu Baihe was looking out for him.

He accepted the criticism without complaint, eager to listen and improve.

“It’s good to see a positive attitude. No matter how talented you are, the rules are there for a reason. Surgical safety guidelines were written with the blood and lives of those who came before us. You might think they can be bent or even broken, but let me tell you—almost every so-called ‘genius’ surgeon who got into trouble, did so because they believed their skill could override the rules.

One slip, and all their talent is wasted forever.

Most people electrocuted are electricians. Most who drown are swimmers.”

Those words might sound harsh, but the bitter truth is the hardest to swallow.

And Wu Baihe made a lot of sense.

“You dove right for the brainstem—what if it wasn’t bleeding? Or even if it was, but the symptoms were mild and not the main cause of the patient’s coma? The brainstem is called the forbidden zone of life. Not even I, after decades in neurosurgery, would touch it lightly, let alone someone with just a few years’ experience.”

Wu Baihe’s scolding left Zhou Can feeling utterly embarrassed.

The consultation room had gone dead silent.

Director Lou and Dr. Xu didn’t say a word, but they clearly understood the gravity of the issue and wholeheartedly agreed with Wu Baihe.

Anesthesiologist Qu Zi just stared at Zhou Can, her eyes full of curiosity.

It was the first time she’d seen Zhou Can get chewed out so severely.

Up till now, all she’d heard was praise—from superiors, patients, even nurses—for Zhou Can.

“Anytime you tackle a major operation, always start somewhere safe. Deal with what’s certain first…” Wu Baihe began explaining the correct surgical order to Zhou Can.

“Minimally invasive surgery is the right call here, but it should stay that way. My suggestion: take care of the bleeding and damage in the thalamus first. Observe, then decide if the brainstem needs to be explored. Check the scan—the blood vessels in her brain are flecked with spots. There might be severe atherosclerosis that’s easy to miss, but there’s a lot of it.”

No wonder Wu Baihe is a top expert—he even spotted details Zhou Can had missed.

“Her blood lipids are way too high—that’s probably the main culprit behind such serious artery disease. Honestly, I hadn’t realized her vessels were this compromised. Director Qu, can you reassess her surgical risks?”

Zhou Can felt a chill in his heart.

Luckily, he’d called in Wu Baihe for the consult. If he’d gone with his own plan—making the brainstem his first target—the outcome could have been disastrous.

Not that something bad would definitely have happened, but with her arteries hardened like that, the surgery would have been twice as risky.

He couldn’t help breaking into a cold sweat.

Just when you think you’ve mastered it all, there’s always more to learn.

Step by step, small streams join to make a river—real progress takes patience and humility.

From now on, he knew he had to stay humble, keep learning, and never let arrogance creep in.

“Now that we’ve uncovered extensive atherosclerosis in her intracranial arteries, this will increase intraoperative bleeding and make hemostasis tougher. Fortunately, Director Zhou’s surgical skills can sharply reduce that risk. After reassessing, I still think the surgery can go ahead.”

Qu Zi herself was still growing in her career.

After changes in the Anesthesiology Department, she signed a one-on-one partnership with the Emergency Department.

She’d basically become their exclusive anesthesiologist.

Actually, the two people who called on her the most were Zhou Can and Dr. Xu.

Right now, only those two are truly qualified to lead level-three surgeries in the Emergency Department.

Dr. Tang Wangnian is vying for Associate Chief Physician, and with department support, it’s pretty much guaranteed. His credentials and research are where they need to be.

The only thing he’s missing is surgical achievements.

But that’s not critical for promotion—the department will cover for that and help him through.

So getting promoted this year to Associate Chief in Emergency Surgery shouldn’t be an issue.

Even after the promotion, he still won’t be able to lead level-three surgeries right away.

Even the simpler level-three surgeries are off-limits until he gains more experience.

He needs a lot more hands-on training to be truly ready.

“Director Wu, what do you think?”

She turned to Wu Baihe, respect written all over her face.

“Anesthesiologists keep patients alive, surgeons treat the illness—that’s how we’ve always done it, right? If you, as anesthesiologist, sign off, I’ve got no objections. But I’ll say this: don’t ever put too much faith in the lead surgeon’s ability. Consistent skill is good, but it’s just one small reference point for safety. It should never be your whole risk assessment.”

Wu Baihe might seem like a typical tough guy.

But when it comes to women doctors and nurses, he’s actually pretty gentle.

Even when he criticizes them, he keeps it mild—unlike what Zhou Can just got.

Male doctors usually try not to upset their female colleagues.

If the words are too harsh, the women might end up crying.

Even if they don’t cry right away, sometimes they break down in the bathroom or office later. Male doctors hate making colleagues cry—it’s always awkward.

“Understood!”

Qu Zi playfully stuck out her tongue.

She knew exactly what Wu Baihe meant: don’t let Zhou Can’s track record blind you when assessing surgical risk.

Those factors should matter less.

“So… since the plan’s set and the risks have all been cleared, shouldn’t we operate tonight while Director Wu is still here?”

Zhou Can suggested it right away.

“You really think ahead, don’t you? You’ve been planning this for a while, haven’t you?”

Wu Baihe couldn’t help but shake his head and chuckle.

He’s always looking out for Zhou Can, but somehow, the tables always turn.

“Well, you’re always busy. It’s not easy to get you here, and I wouldn’t want to waste your time. Plus, the patient’s family is strapped for cash, and her daughter is desperate to save her mom. If we can do the surgery tonight, it’ll be safer for the patient and will also save her family money.”

Zhou Can didn’t hide anything and spoke his mind.

Cheng Xiaolu’s father is disabled, and her earnings aren’t high—maybe six or seven grand a month.

The Pharmaceutical Division has been losing money for years—bonuses are a thing of the past.

Honestly, that’s pretty common—when a company’s bleeding money, they’re lucky just to pay salaries, let alone hand out bonuses.

Those firms giving out hundred-thousand-yuan bonuses or cars and houses are only doing that because the business is booming.

“I admire how you always put patients first and genuinely care for families in need. Let’s get things moving. I’ve got clinic duty tomorrow morning, so I need an early night.”

A rare smile appeared on Wu Baihe’s face.

He looked at Zhou Can with unexpected warmth.

Beneath it all, everyone’s got a warm heart.

Zhou Can always puts patients first and thinks about their financial strain—that’s why so many in the hospital genuinely like and respect him.

With Wu Baihe’s smile, the consultation room atmosphere instantly relaxed.

Next, the team quickly talked with the family, completed surgical prep, and sent the patient into the operating room.

When the patient was admitted yesterday, Zhou Can had told the resident to be ready for surgery at any time.

Now, that preparation paid off.

The patient was smoothly transferred to the endoscopic suite.

Everything was in place.

……

To improve the safety and success rate, Wu Baihe called over his specialized team.

It was essentially an unplanned extra shift.

Of course, for the medical team, this was a great opportunity to learn.

Following the strict protocols, after drilling into the patient’s skull, the endoscopic procedure officially began. Zhou Can handled the lead surgery, with Wu Baihe and a senior neurosurgery nurse assisting.

Everyone else fulfilled their roles.

The patient’s physical condition wasn’t great—that was the biggest risk.

Human life can be unbelievably tough. Earthquakes have trapped people underground, injured, with no food or water, yet they survive for more than a hundred hours until help arrives.

But sometimes, life is shockingly fragile.

Especially in surgery—a patient can walk into the OR looking fine, and then something goes wrong and they die on the table.

People often assume surgery in a major hospital is safe, but it’s never absolute.

Take the General or Gastrointestinal Surgery departments at Tuyu Hospital, for example. Those are considered among the safest surgical specialties, yet each year, over a hundred patients die from surgeries there.

That doesn’t even count those who survive for more than three days after surgery.

What does that mean?

It means some patients live for three days after, but then pass away a week, two weeks, or even later.

But their deaths are definitely linked to the operation.

No matter how safe you make it, every surgery carries huge risks—removing a lesion can also seriously damage the body in other ways.

Take the thymus, for example.

Most people don’t even know what a thymus is or that it matters.

In many open-chest procedures, surgeons routinely remove it.

Especially for cancer patients.

For infants, it weighs about 10 grams, topping out at 15. In healthy adults, it’s maybe 20 or 30, but not more than 40 grams.

With age, it shrinks back down to 15 grams or so.

It’s so tiny—smaller than a big tumor.

Yet, the thymus is the body’s largest immune organ.

Once it’s removed, your immune system is crippled. It’s not hard to predict what comes next.

Everyone knows how terrifying AIDS is.

But why is it so frightening?

Because it destroys the body’s immune defenses.

Someone with AIDS is terrified for their life and expects to die any day, but patients who lose their thymus or other immune organs don’t feel any fear at all.

Take the lymph nodes—those get removed all the time, right?

In many cancer surgeries, doctors clear out lymph nodes, or they remove swollen ones causing pain or cancer concerns.

But lymph nodes are vital to immunity too.

Lymphocytes are some of the most crucial immune cells in the body.

Right now, this patient’s life is flickering—any moment, it could go out. On top of that, she’s older, so opening her skull comes with massive risk.

Qu Zi and the anesthesia nurse were on full alert, not daring to relax even for a second.

Zhou Can carefully maneuvered the endoscopic forceps, gently shifting brain tissue aside toward the bleeding point. On the scan, the shadow here was obvious, so based on his experience, he quickly found the target.

“Director Wu, is it okay to drain the blood first?”

“Of course!”

Wu Baihe hated being asked for permission at every step—especially since he was right there to supervise and help. If there was an issue, Zhou Can wouldn’t even have to ask.