Chapter 652: A Scalpel’s Edge: The Weight of Skill and Trust

Deep down, Zhou Can had always respected Director Lou, even after Lou sided with Director Gao later on. He understood that Director Lou only did so for the sake of the Emergency Department’s future, putting himself on the line.

But seeing Director Lou’s furious face as he tried to seize credit left Zhou Can just a little confused.

He went off to assign the staff, leaving that aside.

With Director Gao’s assistance and his own excellent connections across clinical departments, Zhou Can quickly pulled together a super-elite surgical team.

It was a shame Qiao Yu had gone abroad for further training.

Otherwise, she would’ve made the perfect instrument nurse for this surgery—it could’ve gone even better.

She’d also have gained valuable surgical experience and knowledge.

All the pre-op exams and preparations for Mr. Song were running at full speed.

As for the surgical plan, Zhou Can had already rehearsed it a thousand times in his mind.

After all, given Mr. Song’s status, there could be no mistakes.

…

While changing in the operating room, Zhou Can found a brief moment alone with Director Lou.

“Director Lou, I apologize for not reporting this to you sooner. Please don’t take it personally.”

“Hmph! I see you’ve grown some wings—big decisions like this, you just made them on your own. Do the surgery well. If you mess up, I won’t let you off.”

Director Lou grunted, refusing to let Zhou Can explain further.

This was the first time since Zhou Can joined the Emergency Department that Director Lou had been so cold and harsh toward him.

Zhou Can let out a quiet sigh.

He’d kept this from both Director Lou and Dr. Xu so they wouldn’t have the chance to stop him.

Dr. Xu was off today and probably still didn’t know about any of this.

His thinking was simple: if anything went wrong, he’d bear it alone. Dr. Xu had suffered enough already—Zhou Can couldn’t drag him into another mess.

As for Director Lou’s scramble for credit, that was a puzzle Zhou Can didn’t want to overthink.

Out of respect, he set his doubts aside.

If all went well, Dr. Xu would have a happy surprise waiting the next day.

But if anything happened during surgery, Dr. Xu would be in for a nasty shock before then.

Inside the No.1 Laminar Flow OR—the best in Neurosurgery—Zhou Can and his star surgical team got to work. Director Liu himself led the Critical Care Department’s team, joining forces with Director Feng’s anesthesia crew to guard the patient’s life.

On the nursing side, the overall command was handled by the most experienced Attending Nurse in neurosurgery.

Jiang Wei served as Zhou Can’s instrument nurse and the team’s vice-commander.

Ma Xiaolan wasn’t so lucky—her due date was near, so she could only take maternity leave at home.

She missed her chance to earn some gold-plated credentials this time.

Of course, the risk was high. If the surgery failed, her ‘gold-plating’ might’ve felt more like punishment.

Either way, the pre-op consent forms were already signed by the Butler.

If anything happened—if Mr. Song died on the table, say—at most, a couple of leading surgeons would take the heat. The others might face minor fallout, but nothing serious.

“Director Feng, are we ready to begin?”

“Vital signs are stable. Full anesthesia is complete. Start the craniotomy.”

Since the anesthesia department’s overhaul, Director Feng rarely appeared in the Emergency Department’s ORs—he mostly showed up for major neurosurgical and cardiothoracic surgeries.

He was hands-down the top anesthetist in Tuyu.

His seniority and rich experience put him at the peak of his field.

Although he and Zhou Can didn’t have an official teacher-student title, they shared a deep mentorship bond. Zhou Can had learned countless anesthetic skills and life-saving methods from him.

By life-saving, he meant for saving patients.

Accidents happen during surgery all the time. In those critical seconds, knowing what to do can mean everything.

Zhou Can took the lead on surgery—no one else could’ve done it.

The Song family didn’t care for hollow titles; they cared about the chief surgeon’s real skill.

They’d thoroughly investigated Zhou Can and decided he was up to the task.

Just then, the OR doors slid open and someone stepped inside.

Even with a mask and cap on, Zhou Can spotted Dr. Xu immediately.

His heart skipped a beat—he hadn’t expected his mentor to find out after all.

Still, Dr. Xu’s arrival barely drew any attention.

There were simply too many medical staff in the operating room.

And every last one was an elite—no one nosed into anyone else’s business.

All that mattered now was focusing on the job and supporting Zhou Can for a successful surgery.

Nobody cared about anything else.

Dr. Xu just stood silently behind Zhou Can, offering support without a word.

But Zhou Can could feel the warmth in his mentor’s eyes.

Every move Zhou Can made in opening the skull was careful and precise.

Mr. Song was so fragile—his flame of life barely flickering. The slightest rough handling could spell disaster.

Even Director Feng, who’d seen it all, felt his nerves tighten as Zhou Can cut through scalp, separated tissue, drilled through bone, then used an electric saw to work around the bone flap…

Every step left him on edge.

And it wasn’t just him—everyone in the OR felt the same.

When Mr. Song’s heart rate suddenly dropped, it seemed like the whole room stopped breathing.

“Director Feng, should we administer a cardiac stimulant?”

“Let’s watch first. Zhou Can’s technique is already excellent—this shouldn’t cause any dangerous changes in vitals. It’s probably just a reaction to the bone flap cut; give it a moment and he’ll stabilize.”

Director Feng sat calmly at the back, watching over Mr. Song’s life.

His eyes were sharp as he shifted between the monitor readings and the surgical field.

Step by step, Zhou Can worked his way through the anatomy until the brainstem was in view.

Even after all these years, the old surgical scars from the tumor removal were still visible.

An ordinary person might not notice, but Zhou Can’s deep neurosurgical experience let him spot every trace of damage with a glance.

“Teacher, was the nerve here the one severed back then?”

He pointed at a spot near the trigeminal nerve branching out from the brainstem.

“Yes, right by the pons—there’s a clean cut. The tumor at the time was huge, infiltrating the brainstem. If we hadn’t gone all in, it would’ve grown back. We had only two options: risk everything and try, or close up and tell the family it was impossible.”

Dr. Xu didn’t continue.

He’d chosen to take the gamble.

A desperate attempt.

In the end, the rest of his career was ruined, his bright future gone in an instant.

Being a surgeon isn’t easy. Becoming a truly compassionate, skilled one is even harder.

If Dr. Xu had to choose again, maybe he’d pick the safer route.

Close the skull, announce there’s nothing more surgery can do.

Hospitals see this happen every so often. It’s embarrassing, sure, but better than a fatal mistake.

“So after you opened it, you just stitched it closed again?”

“I tried to repair it, but the results weren’t great.”

Dr. Xu admitted without hesitation.

“Given what I’m seeing, we have to reopen that old repair, debride the area, and perform a fresh anastomosis.”

After a careful check, Zhou Can spoke with certainty.

Nerve anastomosis is incredibly difficult.

Nerve cells are the only ones that can’t regenerate.

They can’t heal on their own the way other tissues do.

When repairing nerves, you’re working with thousands of nerve fibers—every one has to be lined up perfectly for the repair to be a success.

If just one fiber is mismatched or missed—that’s where ‘your wires are crossed’ comes from.

The consequences can only be imagined.

“Director Feng, Director Liu, I’m about to start on the brainstem. At that point, the patient’s vital signs might flatline. What’s the longest window you can give me?”

Zhou Can took a deep breath, but his eyes stayed steady.

“Under three minutes is safest—the shorter, the better.”

Director Feng said this without hesitation.

The brainstem is called the ‘forbidden zone of life.’ Forget cutting it, even the outer regions scare off most surgeons.

Right now, only a handful of top hospitals in China dare claim they can handle brainstem surgeries.

Tuyu barely qualifies as one of those.

But honestly, Wu Baihe would never risk his career or future with odds like these. When the risk is too high, he steps back.

Not unless the family signs a full waiver and Tuyu’s legal team is involved.

Out of ten brainstem surgeries, pulling off even two successes is already impressive.

Zhou Can’s incision skill wasn’t quite level seven yet, while his debridement, anastomosis, suturing, knot-tying, and pathology diagnosis were all at seven. He had enough skill to try, but lacked absolute confidence.

His steady and fast scalpel techniques were still stuck at level two, stopping his incision technique from reaching level seven.

Debridement and incision deeply affect each other.

Especially with delicate brainstem repairs like Mr. Song’s—the challenge is obvious.

“Three minutes is nowhere near enough. I have no confidence at all.”

Zhou Can shook his head.

Opening up, debriding, and quickly suturing—forget three minutes, even thirty would be world-class speed.

“How long do you actually need?”

Director Liu asked quietly.

“To be safe, I’ll need at least ten minutes.”

If Zhou Can could break through with his fast and steady scalpel skills, maybe that time could shrink.

A clean incision makes the debridement simpler.

And it makes the suturing easier and more effective too.

After hearing this, Director Liu turned to Director Feng.

“Lao Feng, should we try hypothermia? Otherwise, I don’t think there’s a better way to stretch the window to ten minutes.”

“That’s a good idea.”

Director Feng’s eyes lit up as he nodded.

At low temperatures, the body’s demands are very different from when it’s warm.

These days, technology for cryogenic life support is quite mature. Even in sci-fi, there are tales of people frozen in avalanches who are revived years later.

Normal operating room temperatures hover around 25 degrees.

Since patients are exposed, this is the friendliest temp for them.

In winter, OR temps stay above 20—about 22–23 is best. In summer, under 26 works well.

Human ingenuity is limitless.

Under regular circumstances, that’s the range. But for rare, special surgeries, they challenge the temperatures to ensure better odds.

Fifteen degrees is the common target for hypothermic surgery.

Blood flow and metabolism slow dramatically—it’s great for controlling bleeding and stretching out surgical time.

“By lowering the room temp, we can triple your window—up to nine minutes is safe. Does that work for you?”

“Deal! But I’ll need to step out and put on a warmer jacket.”

Hearing the surgical window could be stretched to nine minutes, Zhou Can knew that was the limit.

Lowering the OR temperature does buy time for the patient, but it’s rough for the surgeons.

In the cold, hands slow down and feel clumsy.

That can make surgery take much longer.

Normally, Zhou Can could suture three times per second—that was his fastest. In the cold, he might not manage one.

So, while the patient gets a longer window, total surgery time grows too.

The only way around it: surgeons bundle up in warm clothing.

…

Ten minutes later, all primary surgical staff had donned thermal underwear.

Zhou Can even pulled on a down jacket.

It should be noted—when you step out to change, you need a fresh sterile gown and accessories afterward: new cap, gloves, the works.

It’s a bit of a waste.

But to make sure the surgery goes well, who cares if you burn through a few sets of isolating gowns? Even higher costs are worth it.

The family would gladly pay the extra.

Any reasonable family understands what’s at stake.

The OR’s temperature began dropping; Directors Liu and Feng were on high alert.

Dropping temps hit the patient’s vitals hard.

Frogs and bears can hibernate, but humans don’t have that luxury.

For critically ill patients, it’s even harder to handle the cold.

Every winter, many elderly and bedridden patients struggle the most.

Low temperatures often mean life is fading.

“Let’s move quickly!”

Director Feng waited until the patient was stable before signaling Zhou Can.

“Got it!”

Zhou Can gripped the scalpel, his eyes steely and focused. The whole team fell in behind him. The Song family’s hopes—and Dr. Xu’s chance at redemption—rested on this surgery.

That invisible pressure weighed on his shoulders.

After several deep breaths, he cut down.

No hesitation. No fear.

Only duty and compassion remained.

As he cut, the clear tactile feedback ran from his fingers and palm all the way to his mind.

Under this crushing pressure, Zhou Can could see nothing but the patient.

It felt as though he could truly see that fragile, flickering life.

“Beep! Beep! Beep!”

Alarm after alarm sounded from the monitors.

The whole medical team leapt into action while death itself hovered above the OR.

Inside Zhou Can’s mind, an instinctive enlightenment about scalpel technique unfolded.

He had to make every single cut perfect.

“The ultimate in fast scalpel is speed—striking like lightning, ignoring difficulty, slicing through chaos in a single stroke. Steady scalpel is all about control—stable, persistent, never tipping off-balance. Precise scalpel seeks pinpoint accuracy—no deviation, just the right amount of force, each incision exactly where it needs to be, cutting only the intended tissue.”

The essence of all three—fast, steady, and precise—swirled through Zhou Can’s mind.

He’d learned the fine scalpel technique while shadowing Wu Baihe in neurosurgery.

Now, all three blended together, flowing through his hands into the scalpel.

He was working on the pons region of the brainstem.

It had once been opened by Dr. Xu—a mistaken cut.

Later repairs hadn’t gone well, and now it had to be redone.

Zhou Can knew—Mr. Song’s life hung entirely on his blade.

The incision didn’t go perfectly, not meeting the standard he dreamed of.

“This is bad!”

His mind went completely blank in an instant.

Right then, he could feel disaster crashing down. Maybe it had already arrived.

Mentor’s expectations, the Song family’s prestige, his own career, the faith of every team member—they all stung like lashes across his back.

The greater the danger, the greater the need for calm.

He remembered Dr. Hu Kan’s advice.

Zhou Can’s grip on the scalpel relaxed, no longer clutching it like a lifeline.

The scalpel turned from a desperate tool into something almost playful in his hand. He’d reached a new sort of inner clarity.

Once, the blade dictated his actions; now, it was his will guiding the blade.

He relaxed, letting the scalpel live in his fingers—not out of carelessness or resignation, but because he’d given the tool a new life and spirit. It danced between his fingertips, perfectly in sync with his thoughts.

Wherever he aimed, it struck.

In that moment, the rest of the world faded away—the surgery and nothing else existed.

Operating had truly become a part of his life.

Yes, his incision wasn’t perfect, but with the next step—debridement—he could make up for it.

Behind him, Dr. Xu, and across from him, Wu Baihe, stared in disbelief as Zhou Can’s scalpel flashed through the debridement.

Their eyes widened in astonishment.

What sort of monstrous technique was Zhou Can using?

It didn’t look like standard steady, fast, or precise scalpel—it was a seamless fusion of all three, each compensating for the others’ weaknesses.

At a glance, even Dr. Xu couldn’t tell what made the incision so special.

But Wu Baihe looked on with envy, even a touch of jealousy. That kind of nerve cut was the perfection he’d spent a lifetime chasing—and never achieved.

Yet here Zhou Can had reached it.