Chapter 170: A Pivotal Operation

Director Wen’s endoscopic skills were average, but his prowess in traditional surgery was unquestionably top-notch.

After a series of maneuvers, a small hole was drilled into the skull.

Throughout the procedure, Director Wen exuded the confident manner of a master.

“Alright, Zhou Can, the next part of this surgery is yours!”

Director Wen stepped aside from the chief surgeon’s position.

Zhou Can strode confidently to the chief seat without any formality.

Directors Liu and Dr. Hu exchanged shocked glances.

This was the General Surgery Department’s turf, and with Director Wen’s arrangement, they dared not utter a word.

They could only watch in silence.

Seeing Zhou Can take the lead, both felt a mix of astonishment and anxiety.

It was utterly absurd.

In such a major operation with enormous risks, how could Director Wen allow a trainee to handle critical tasks like clearing the hematoma and achieving hemostasis?

Even if he intended to nurture his talent, this method was excessive!

After all, this was a life on the line!

Respect for life had deeply ingrained itself in every conscientious doctor.

Without losing his cool, Zhou Can picked up the endoscopic electrosurgical tool and made a cross incision on the dura.

This move had Director Liu watching nervously from the side.

He dreaded that a single misstep by Zhou Can might fatally compromise the patient.

At that moment, the patient’s vital signs began to fluctuate dramatically—breathing, blood pressure, and heart rate all plunged.

“Did you cut into the brain tissue?”

Director Liu asked in a mix of terror and anger.

“It’s just the patient reacting to the stimulation,” Zhou Can replied calmly.

He remained remarkably composed.

Director Wen, with a leisurely glance at Director Liu, added, “Calm down!”

Those words hit Director Liu like a tenfold blow.

Had it not been Director Wen speaking, or were it not for his pride, Director Liu would have erupted in anger, condemning their actions as nothing short of murder.

Meanwhile, Zhou Can had already completed the endoscope insertion.

The patient’s blood pressure plummeted, heart rate followed suit, and breathing grew faint.

“This is sheer nonsense! It’s murder!”

Director Liu was beside himself with rage.

Frantically, he helped stabilize the patient’s vital signs.

Seeing the patient’s deteriorating condition, Director Wen’s heart sank.

The other doctors and nurses were even more alarmed.

“Hold on!”

Zhou Can uttered those three simple words and focused intently on the surgery.

As he evacuated the intracranial hematoma, the patient’s vital signs began to recover rapidly.

“It seems the sudden release of high intracranial pressure, compounded by the trauma of the craniotomy, caused a temporary stress reaction—not a mistake on my part,”

explained the anesthesiologist coolly.

Having participated in numerous neurosurgical anesthesia procedures before, he had witnessed Zhou Can’s surgical expertise many times, and found Director Liu’s overreactions rather misplaced.

He was more worried that Director Liu’s reckless outbursts might disrupt Zhou Can’s procedure.

Such behavior was downright dangerous.

That’s why he stepped in to vouch for Zhou Can.

After clearing the hematoma, Zhou Can used the endoscope to get a clear view of the brain tissue inside. He inched closer to the largest bleeding point.

This spot was dangerously close to the brainstem—if even Wu Baihe were to operate here, extreme caution would be paramount.

“The ruptured vessel is quite large with only a small tear. What about direct repair? Electrocautery might jeopardize the brain’s blood supply and induce sequelae,”

Zhou Can asked Director Wen for his opinion.

Even repairing superficial vessels in the limbs is challenging.

Repairing a vessel inside the skull via endoscopy is almost unimaginable in difficulty.

“Are you confident? This is right next to the center of life—with immense difficulty and high risk,”

Director Wen’s instinct was to play it safe.

Every doctor has their own style.

Most shared Director Wen’s sentiment: avoid success at all costs, but ensure no mistakes are made.

Direct electrocautery, though potentially leading to sequelae, minimized risk and was the surest way to save the patient’s life.

“I wouldn’t say I’m 100% sure—about 80% confident,”

Zhou Can modestly admitted.

Director Wen knew him all too well.

Hearing his estimate felt like a reassuring shot of confidence.

“Alright! Proceed with your plan,”

Director Wen delegated the next steps as Directors Liu, Dr. Hu, and the rest watched Zhou Can’s surgical finesse on the endoscopic monitor.

He pinpointed the proximal end of the ruptured vessel, then said to Director Wen, “I’m worried that using a vascular clamp may injure the vessel and hike up the surgery cost. How about we try ligature for hemostasis?”

“That’s acceptable,”

Director Wen nodded again.

Always prioritizing the patient’s best interest, Zhou Can’s noble medical ethics shone through.

The assembled doctors silently admired his dedication.

Directors Liu and Dr. Hu, in particular, gained a deeper respect for him.

With quick, deft movements, Zhou Can swiftly ligated the vessel.

He used a slip knot.

Many surgeons disdain slip knots, but in certain specialized procedures, opting for a square knot, slip knot, or triple knot is all part of the art.

Every knot demands rigorous practice.

Neglecting this skill could leave one vulnerable during critical moments in surgery.

After ligating the vessel, Zhou Can began repairing the rupture.

If the vascular wound is contaminated or uneven, trimming it before repair is necessary.

He then expertly maneuvered the endoscope to quickly suture the vascular wall.

“Incredible suturing technique!”

Director Liu couldn’t help but exclaim in admiration.

“This isn’t ordinary suturing—it’s endoscopic surgery. I’ve never seen anything like it!”

Dr. Hu, witnessing Zhou Can’s prowess, felt an immense sense of inadequacy.

Even though he wasn’t a full-time surgeon, the gap in skill between him and a trainee was astonishing.

The disparity left him feeling deeply ashamed.

The vessel was swiftly repaired.

After a thorough check, everything was in order.

Zhou Can then respectfully sought Director Wen’s approval, mindful of his superior’s reputation.

“Director Wen, please inspect. If everything is satisfactory, I’ll release the ligature and test the vessel’s blood flow.”

“Sutures look great—go ahead with the test,”

Director Wen’s approval not only boosted Zhou Can’s confidence but also endeared him further.

Saving face was critical—after all, dignity is everything.

Upholding a superior’s reputation is a basic professional survival skill.

Those who speak carelessly or act without restraint, tarnishing their superior’s image, eventually face the harsh realities of the profession—either being unappreciated or constantly berated, ultimately getting fired.

Zhou Can released the slip knot and watched as blood flowed back into the repaired vessel.

It was evident that the vessel rapidly filled, and even the smaller downstream vessels were reperfused—the repair was a resounding success.

“Well done, a beautiful operation!”

Director Wen burst into hearty laughter.

The main bleeding point had been sealed and normal circulation restored—meaning the patient’s life was effectively saved.

It is worth mentioning that the repaired segment would naturally become a bit narrowed.

This issue, however, was currently unsolvable.

In lower-risk areas with ample surgical visibility, one might attempt vessel transection and reanastomosis.

But given the proximity to the brainstem and the constraints of endoscopic surgery, attempting vessel transection and reanastomosis here would be tantamount to suicide.

Choosing the lesser of two evils was the best option.

A slight narrowing of a single vessel wouldn’t have a major impact.

This was the best possible outcome given current medical standards.

Next, Zhou Can cleared residual hematoma and quickly used electrocautery on other minor bleeding spots. The other, larger bleed was treated with the same vascular repair technique.

The entire procedure proceeded in a tense yet orderly fashion.

Almost every core part of the surgery was handled solely by Zhou Can.

At that moment, Directors Liu and Dr. Hu finally understood why a mere trainee could converse so directly with the chief neurosurgeon.

Had roles been reversed and they were the chief neurosurgeons, facing such a modest yet exceptionally talented prodigy, their attitudes would have been far more enthusiastic and affable.

After nearly two hours, the operation was finally completed.

The intracranial endoscopic surgery had gone remarkably smoothly, and Zhou Can had gained a wealth of experience.

The biggest reward was pulling the patient back from the brink.

After surgery, the patient’s vital signs stabilized and the ice blanket was removed.

There were no more emergencies requiring immediate rescue.

However, given the severity of the injuries, the patient still needed to remain in intensive care for a while.

Having finished the surgery, Zhou Can did not bask in his success or glory.

At that moment, he was already back in the dormitory, diligently practicing his fast scalpel technique.

After practicing, he balanced work with rest as he reviewed his daytime notes from the ICU.

For any unclear medication dosages or usages, or any obscure points, he tirelessly consulted every available resource until he fully understood them.

Questions that required a superior’s input were carefully noted down.

He planned to seek clarification from his superiors once he was back at work tomorrow.

……

The next day, as Zhou Can arrived at work, Dr. Hu greeted him enthusiastically from afar.

The sudden change in demeanor caught Zhou Can off guard.

It was likely that Dr. Hu, having witnessed Zhou Can’s formidable surgical skill the day before, had completely lowered his guard to forge a good relationship.

At that moment, Director Liu hurried over as well.

Per their arrangement, from today on Zhou Can would no longer follow Dr. Hu but would be under Director Liu’s guidance.

“Dr. Hu, how is the patient in Bed 6 doing after yesterday’s surgery?”

“Night shift was managed by Dr. Shi. During handover, he marveled at how the car accident patient in Bed 6 not only survived the brink of death but is now improving rapidly. He even praised the timely and perfect operation.”

Dr. Hu worked the day shift.

Night shift was under Dr. Shi.

Speaking of the patient in Bed 6, a smile spread uncontrollably across Dr. Hu’s face.

Every doctor feels immense joy when a patient’s condition improves.

“During my shift, the patient in Bed 6 not only maintained stable vitals but also began regaining consciousness. Honestly, I’ve never had such a smooth shift—patients in Beds 6 and 7 all improved visibly, and only the patient in Bed 8 still required occasional attention. With some spare time, I even helped out other units. They’re all quite envious of me,”

Dr. Hu’s animated description was full of pride.

The curse of death on Bed 6 had finally been broken.

Moreover, two of his critical patients were improving, which filled him with honor.

“Haha, it seems our team has a lucky charm!”

Director Liu’s face lit up with joy upon hearing this.

He then turned his gaze toward Zhou Can.

“I couldn’t have done it alone. It’s all thanks to the capable leadership of our senior doctors. Rather than think of me as a lucky charm, consider it that I entered an excellent team.”

Quick to be modest, Zhou Can deflected the praise.

His tactful response only deepened the smiles on Dr. Hu’s and Director Liu’s faces.

Following Director Liu into the ICU, Zhou Can checked on the patient in Bed 6. The once pallid, ashen face had now regained a hint of color.

Blood pressure, oxygen saturation, heart rate, and breathing had all stabilized.

The patient was quite young, with a recovery rate far superior to that of the elderly.

Post-surgery, rapid recovery was expected.

That’s why younger car accident victims have a much higher chance of walking out of the hospital compared to the elderly with similar injuries.

The circulatory efficiency, cellular metabolism, regenerative capacity, and healing speed in the elderly lag far behind those of young people.

The elderly also have the highest mortality rate.

“Everything we did for the patient in Bed 6 yesterday was incredibly meaningful!”

Zhou Can watched as a life on the brink of fading was revived, filling him with a profound sense of accomplishment.

Aside from suctioning, turning, and routine medication, the patient in Bed 6 required little additional care.

No wonder Dr. Hu said today was the smoothest shift ever.

Moving on to Bed 7, Zhou Can inspected the patient’s status and was met with pleasant surprises.

The patient in Bed 7 seemed well aware that Zhou Can had saved him.

Upon seeing Zhou Can approach, the patient nodded vigorously.

“Don’t move—when you’re better, we can talk as much as you like.”

Zhou Can quickly reassured him.

Since the patient still had a tracheal tube, direct conversation was impossible.

“Director Liu, do you think he needs nutritional injections?”

“That depends on his family’s finances. However, I believe nutritional injections can quickly replenish his weakened system and speed up his recovery. It may also reduce his lengthy stay in the ICU, which is costly. Overall, it’s a very sound choice,”

Director Liu considered for a moment before replying earnestly.

Currently, domestically available nutritional injections are not advanced—not to mention far from perfect.

Yet for patients with long-standing illnesses and extreme weakness, appropriate nutritional support is a very good option.

There’s an old saying in traditional Chinese medicine: the weak do not benefit from excessive supplements.

Long-term patients should avoid heavy supplementation and instead take gradual, measured steps.

Nutritional injections are typically administered intravenously, mainly to supplement human serum albumin.

It’s hard not to complain that these injections are ridiculously expensive and only marginally effective.

Research in this field is still very limited and monopolized, which hinders industry development and competition.

If the status of nurses in our country ever reached that of developed nations, the nutritional supplement sector would undoubtedly see rapid growth. Some nurses have even switched careers to become nutritionists.

Compared to international standards, our progress is merely embryonic.

It’s still very immature.

Once they can truly offer cost-effective nutritional support to the public, it would be perfection.

This would likely boost people’s lifespans significantly and drastically shorten hospital stays.

It’s an untapped market, but bound by numerous restrictions and technical challenges—only time will tell.

“I’ll speak with your family later to ensure you get transferred as soon as possible,”

Director Liu consoled the patient upon noticing his pleading eyes.

After checking on the patient in Bed 7, the two moved toward Bed 8, whose condition was relatively stable.

“Let’s go check on the other patients!”

Director Liu was clearly in charge compared to Dr. Hu.

As the team leader, he was responsible for patrolling his entire unit. If any emergency arose in another group, he would rush over to assist immediately.

The higher the rank, the heavier the burden.

And so the day continued with the weight of responsibility on Director Liu’s shoulders.