Chapter 94: The Demanding Art of Healing

Sometimes growing as a nurse can be even tougher than becoming a doctor.

From an outsider’s point of view, isn’t nursing just about caring for patients—giving injections, running IVs? It sounds simple.

But every profession has its own mountain to climb.

Only insiders truly grasp the intricacies, while outsiders merely watch the show.

First off, there are many types of nurses, each with markedly different responsibilities.

For instance, there are ward nurses, operating room nurses, outpatient nurses, and so on.

What most people picture as nursing involves fetching, dispensing, and administering medicine, giving injections and IVs, and drawing blood. Yet, advanced nurses even provide expert postoperative nutritional and rehabilitation advice.

In many developed countries, high-level nurses enjoy a status nearly equivalent to that of doctors.

Imagine a patient fresh off major surgery—surviving the operation but extremely weak, with doctors fearing severe postoperative complications and predicting a recovery period of at least six months.

Then a wealthy family spends one million dollars to hire an elite nurse.

This care fee can be ten times the cost of the surgery itself.

The expert nurse first reviews all of the patient’s conditions—health status, past surgeries, underlying diseases, serious medical history, personal preferences—before formulating a comprehensive postoperative recovery plan.

This plan covers four key areas: nutrition, daily activities, professional rehabilitation training, and psychological counseling.

Two months later, not only did the patient survive, but they recovered to a point even better than before falling ill.

During a follow-up, the attending doctor was so amazed he exclaimed three times, ‘Oh my gosh!’

Such is the capability of elite nurses abroad.

Doctors treat the illness, but nurses lead the recovery.

In the operating room, nurses tailor their advanced training specifically around surgical procedures.

Beginners usually start as circulating or intern nurses, advance to scrub nurses, and finally reach the top as instrument nurses.

Many chief surgeons have a fixed surgical team.

Instrument nurses are permanent members of these teams.

In a complex operation, there might even be more than one instrument nurse.

Zhou Can chose to mentor Qiao Yu not only because they worked in sync but also because her integrity, ambition, and commendable character made her worth the investment.

These qualities made her a long-term talent for Zhou Can.

……

After Jin Mingxi made the incision, Zhou Can could already see the cecum.

Once the cecum is located, you can trace the colon band to find the appendix.

Everything was proceeding smoothly.

“Teacher, I’ve found the appendix—it’s severely swollen, but there’s no sign of pus.”

If pus were present, drainage would be needed, delaying the next surgery by about three months.

Today, Dr. Xu has already given the go-ahead for this appendectomy.

It’s a routine case without any complicated anomalies, which is why it was entrusted to Zhou Can.

“Alright, good. Next, carefully separate the appendix from the surrounding omental and bowel structures. Sequentially isolate the appendiceal artery and the root—tie them off individually, then dissect the mesoappendix before removing the appendix.”

For laparoscopic surgery, a ligation stapler is typically used to secure the artery and the remnant.

Still, many doctors prefer tying them off with sutures.

While the new method is more convenient, traditional techniques remain safer and more reliable.

These time-tested methods have been handed down through years of clinical practice after proving their safety.

Zhou Can had observed Dr. Xu performing appendectomies.

And not just one.

Now, handling it himself, he realized that watching and doing are entirely different.

Finding the appendix went relatively well.

But the subsequent steps proved far more challenging.

His technical skills were solid and he knew every step, yet when it came to performing them, he became overly anxious and distracted.

While separating the appendix from the surrounding omental and bowel structures, his palms were drenched in sweat.

There were even two moments when his hands trembled.

He had to stop immediately, take a deep breath, and steady himself before continuing.

……

This surgery took far longer than a typical appendectomy.

Yet, no one hurried him.

In nurturing new doctors, most seasoned practitioners at the hospital are exceptionally patient, understanding the struggles of beginners.

As long as the newcomers avoid gross mistakes or medical mishaps—even if they work a bit slower or less precisely—senior doctors usually remain supportive.

At most, they’ll point out areas for improvement.

After nearly forty arduous minutes, Zhou Can finally completed separating the appendix from the surrounding omental and bowel structures.

【Separation Experience +1】

【First successful separation of intestinal tissue—rewarded Separation Experience +100】

Another tremendous bonus.

After all his hard work, the rewards were equally abundant.

Separating intestinal tissue in a patient is worlds apart from doing it on a White Mouse.

Messing up a White Mouse’s intestine is relatively inconsequential.

One only needs to learn from the mistake for next time.

But separating a patient’s intestinal tissue carries enormous psychological pressure—like two mountains crashing down. There’s no margin for error; one wrong move could be catastrophic.

Every cut felt like walking on thin ice—demanding utmost caution.

Once he successfully separated the appendix from the omentum and bowel, the next steps became slightly easier.

Yet, the relief was minimal; the pressure still loomed large.

The tension remained intense.

Both tying off the appendiceal remnant and the artery required exceptional precision.

After everything was secured, he cut the mesoappendix.

Then, he successfully removed the appendix.

Zhou Can let out a long, relieved sigh.

Throughout the procedure, Liu Xia had wiped his sweat countless times.

Next, he cleared the abdominal cavity, checked the sponges, and verified that all instruments were accounted for—a mandatory step in the surgical safety protocol.

“Teacher, do you think we can close the abdomen now?”

After checking twice to ensure everything was in order, Zhou Can called Dr. Xu over for his review.

“Looks good. Let’s close up!”

Dr. Xu nodded.

He was quite satisfied with the entire operation.

Dr. Lu had returned about ten minutes earlier. After transferring the patient to the Hepatobiliary Surgery Department and completing the handover, he probably slipped away with minimal hassle—even if a minor scuffle with the family occurred.

Surely, he must have taken the chance to relax a bit.

But when he returned to the OR, he was irked to see Zhou Can confidently performing the appendectomy as the chief surgeon.

Up to now, Dr. Xu hadn’t let him perform an abdominal operation even once.

Watching Zhou Can skillfully close the abdomen, his suturing skills far outshone Dr. Lu’s.

His expression fluctuated between envy and uncertainty.

If Zhou Can’s previous excellence had only added pressure before…

Now, Dr. Lu truly felt the threat of being replaced.

It was the crisis of obsolescence.

He had heard stories of doctors at Tuyu Hospital who, after failing to compete, were phased out.

Once interns are eliminated, the more capable ones might move to Tuyu Affiliate Hospital.

But even there, it’s a constant struggle to just get by.

And he had heard that Tuyu Affiliate Hospital employs a dual promotion system to maintain high standards.

Pure newcomers can advance through a standard process.

However, promotions for eliminated doctors from the main hospital are extremely rare.

Climbing from intern to attending in the main hospital is even tougher.

Ideally, one would rise to attending status at the main hospital.

Even if eliminated and relocated to Tuyu Affiliate Hospital, one can still work in the outpatient clinic, mentor newbies, and perform several surgeries daily—ensuring a comfortable life and decent standing.

Dr. Lu’s gaze instinctively shifted from Zhou Can to Jin Mingxi.

Now, Zhou Can had surpassed him. If he didn’t step up his game, Jin Mingxi might soon outdo him too.

Dr. Lu then looked over to Qiao Yu, who was assisting Zhou Can.

He couldn’t help but think she looked even more beautiful.

What’s unattainable will always seem the best.

“I need to start working harder!”

Dr. Lu clenched his fist, his eyes gradually hardening with resolve.

But… he had made such resolutions countless times before.

Every time, he lasted less than three days before slipping back into complacency.

“Suturing’s done, Teacher. Can you take a look?”

Zhou Can was inviting Dr. Xu to review his work and point out any flaws.

He had performed suturing and closing so many times he hardly needed oversight.

Senior doctors rarely needed to worry about his work.

“You can let the patient wake from anesthesia now,” Dr. Xu said to the Anesthesiologist before starting his critique.

“Overall, you did well. In terms of safety, you were extremely cautious and I noticed you paid attention to nearly every detail. Although it wasn’t perfect, for your first time reaching this level, it’s commendable. However, there are areas to improve—for instance, during the initial incision, you should have cut through the skin layer of the abdominal wall, yet you ended up cutting some subcutaneous tissue. And when separating the omentum, why were your hands shaking so much?”

Dr. Xu pointed out several shortcomings.

These were aspects that needed refinement.

In the end, Zhou Can’s middling surgical skills still left room for improvement.

He had been very careful while incising the skin of the abdominal wall.

Yet, he still inadvertently cut into the subcutaneous tissue.

Though his extreme nervousness played a role, it wasn’t the primary cause.

A lack of mastery in the incision technique was also to blame.

Fortunately, the operation was ultimately completed smoothly and safely.

“Are the patient’s vital signs stable?”

Dr. Xu asked the Anesthesiologist.

“Everything’s normal,” the Anesthesiologist replied.

“Good job. Now, help take the patient to the recovery room. Once the patient wakes up and is stable, transfer them to the ward.”

The patient was quickly moved out of the operating room.

The recovery room, situated outside, had dedicated staff. Typically, the Anesthesiologist waits until the patient wakes up before leaving.

Patients under local anesthesia tend to fare better.

But those under general anesthesia could encounter complications at any moment.

“Both of you, continue performing surgeries independently! There are undoubtedly many patients waiting outside,”

Dr. Xu said to Zhou Can and Jin Mingxi.

Still absorbed in his surgical success, Zhou Can felt satisfied after completing a moderately challenging level 2 surgery.

The significant gains from the operation would need time to sink in.

It was a process of gradual accumulation.

After Dr. Xu’s orders, Zhou Can and Jin Mingxi ramped up their output.

One level 1 surgery patient after another was brought in.

Both worked at full throttle, alleviating the pain of various surgical patients.

Dr. Lu, assisting Dr. Xu, even began showing marked enthusiasm—asking questions when unsure and volunteering for tasks he once dismissed.

His newfound drive was a far cry from his former indolence.

But how long that burst of enthusiasm would last remained uncertain.

……

By four in the afternoon, shift change arrived, and Zhou Can had performed a total of fourteen surgeries today.

Of those, eight were simple procedures like suturing and debridement, while the remaining six included one level 2 appendectomy and five riskier level 1 surgeries.

These extra cases were special assignments arranged through Dr. Xu’s recommendation.

Jin Mingxi performed a total of eleven surgeries.

Although that number is only three fewer than Zhou Can’s, she had conducted eight simple debridements and suturings, with only three being somewhat challenging.

The performance gap between them was significant.

Zhou Can was very pleased with the experience he gained today.

He earned 112 incision experience points—including a bonus 100 points.

His separation experience increased by 116 points.

These were marks of high-level surgical skill.

Gaining over a hundred experience points in a single session delighted him immensely.

Especially since his Tissue Separation skill had reached level four, meaning he could no longer practice on White Mice to gain experience.

“For certain challenging and risky procedures, if you successfully perform them on a patient for the first time, you get 100 bonus experience points. Isn’t that amazing?”

Through reflection, Zhou Can discovered another quick way to earn experience points.

Additionally, his anastomosis and debridement techniques also saw slight improvements.

As for suturing, ligation, hemostasis, and injection, each gained several dozen points.

Among the basic surgical skills, aside from incision—which was the hardest to improve—the rest were relatively easier to develop.

He wasn’t in a hurry; there was plenty of time.

His residency lasts for three years.

Even a single year in the Emergency Department would yield enormous benefits.

These skills could at least elevate him to a mid-level attending, with some even reaching associate chief levels.

Right now, there were two skills from which it was particularly hard to gain experience.

One was the Device Implantation technique—currently, the only way he could practice on patients was by inserting urinary catheters.

But opportunities for that were very rare.

Perhaps working in the Resuscitation Room or ICU would offer more chances to insert catheters.

The other was the Grasping Technique.

Since few patients require fishbone removal, opportunities to practice this skill are likewise scarce.

It seemed these two techniques would have to be honed on his own time.

After changing his clothes and leaving the operating room, Zhou Can saw Dr. Lu once again hounding Qiao Yu.

This idiot—doesn’t he know that forced affection never tastes sweet?

“Look, you’re taking the bus every day. Walking to and from work isn’t easy. I even bought a car—since we travel the same route, you can ride with me!”

Dr. Lu said with a smile.

Goodness, so he bought a car just to boost his chances with Qiao Yu.

Previously, Dr. Lu had lamented about being late and played the poor card, but it turns out he isn’t that poor after all.

These days, second-hand cars are available for as little as a few thousand dollars—dirt cheap. Plus, with low or zero down payments, many get to enjoy life sooner.

A senior resident like Dr. Lu doesn’t earn a fortune—around eighty to ninety thousand a year, plus bonuses and allowances, totaling over one hundred thousand.

After all, this is a provincial top hospital with good benefits.

If Dr. Lu doesn’t lead a lavish lifestyle, he can easily afford a car.

In Zhou Can’s eyes, a car is merely a means of transport.

He might buy a high-end ride—a million-dollar car—but he felt he doesn’t really need one now.

Instead, he prefers to invest his money where it counts.

He didn’t rush to intervene as Dr. Lu continued pestering Qiao Yu.

They were colleagues, after all, and Dr. Lu hadn’t done anything illegal—just pursuing Qiao Yu in a completely normal way.

Whether she accepts or rejects is entirely her choice.

If Dr. Lu ever resorts to threats or coercion, Zhou Can will step in immediately.

After all, as her instrument nurse, he cannot allow anyone to bully her.

“Thanks, Dr. Lu. Walking is healthier, anyway,” Qiao Yu replied coolly.

“If you prefer walking, that’s fine! I can give you a lift and drop you near the hospital!” Dr. Lu persisted.

Zhou Can silently wondered—Dr. Lu not staying in the hospital dorm is completely normal.

After all, for a senior resident in his mid-thirties, dorm living is highly impractical.

Couples can only manage hotels when dating.

Isn’t Qiao Yu a trainee nurse? Why isn’t she in the hospital dorm?

For example, the dorm where Zhou Can stayed was very close to the hospital—a ten-minute walk at most.

And from Dr. Lu’s remark, it seems Qiao Yu’s commute coincides with his.

That wraps it up.