Chapter 215: New Beginnings in the Operating Room

“The schedule is set. Everyone, please review it. If you have any objections, bring them up now. Otherwise, I’ll submit it as is.”

Mr. Liu once held the highest office he ever had—leading a team as its head.

Now, being in charge of an entire department, he’s clearly struggling to adjust.

“This setup is blatantly unfair!”

A young female resident mumbled in frustration.

Though her voice was soft, Zhou Can heard every word clearly.

Most of the doctor schedules were meticulously arranged by Zhou Can with one goal in mind—to ensure the department runs efficiently.

“Where do you see the unfairness?”

Zhou Can didn’t know her name; all he knew was that she was from Director Mo’s team.

“They’ve assigned us nothing but paperwork, bed management, and the grunt work of assisting in surgeries, while you get all the high-caliber cases like surgeries and outpatient consultations with senior doctors. It’s totally unfair. We get stuck with the exhausting, mundane tasks, while you get to grow quickly with your technical cases. We hardly learn anything useful.”

The young resident revealed a pair of small canine teeth as she spoke.

Coupled with her spirited demeanor and striking looks, it was hard not to like her.

In fact, her frank and cute personality made her quite endearing.

“Do you think it’s too much that I’ve taken away most of the surgical cases that originally belonged to you?”

Zhou Can didn’t rush to explain; instead, he smiled and countered.

“What do you mean by that?”

The resident arched an eyebrow, matching his defiance with a steady gaze.

“Wu Ziyu, stop talking back! Zhou Can may be young, but compared to him, you simply can’t measure up!” Director Mo Ke Duo interjected—clearly worried that his residents might incur Zhou Can’s wrath and face dire consequences later.

After all, they were all new members of this department.

Mr. Liu’s original team members were still the core of the unit.

Even though Zhou Can was just a trainee, his standing within the team was exceptionally high.

Add in the favor shown by Deputy Director Ye and other top leaders, and how could someone like her, an ordinary resident, hope to challenge him?

“I bet many of you share Wu Ziyu’s thoughts—that I’ve monopolized the high-end cases for myself while dumping the menial work on you all. Wu Ziyu, thank you for speaking your mind.”

Zhou Can wasn’t angry at all; he even expressed his gratitude towards her.

This left everyone dumbfounded.

Was this kid a hypocrite, putting on a show in front of everyone?

“Let me explain why I arranged things this way. Although the hospital allowed each subunit a seven-day adjustment period to handle their own patients, I wanted our department to hit the ground running. The best way was to shorten that period, quickly clear the backlog, and free up our time to focus on treating more Jiaru Surgery patients.”

Hearing Zhou Can’s explanation, the other doctors began nodding, their earlier discontent replaced with trust.

Their expressions now held a newfound respect.

“I won’t hide the truth—I’m fast with surgery. Plus, I’m soon leaving Jiaru Surgery for Internal Medicine training. I wanted to contribute one last push to our department by taking on as many surgical cases as I could. That way, you all have more time and energy to welcome the new Jiaru patients.”

What Zhou Can did wasn’t about lining his pockets; it was a well-thought-out move for the department’s benefit.

Wu Ziyu’s face flushed with embarrassment as she realized her mistake.

“If what you say is true, I will apologize to you properly,” she said, a hint of contrition in her voice.

“Why is Dr. Zhou helping us?” another voice queried.

Human nature is selfish—everyone tends to look out for their own interests first.

It was hard to believe Zhou Can was so selfless.

“Because we’re all in this department together—as family. That’s all there is to it.” With one sentence, Zhou Can left the doubter utterly chastened.

The other new doctors were visibly moved.

At the same time,

they felt a warm sense of belonging.

Hearing ‘we’re family’ instantly united the hearts of the twenty-something team members.

The cohesion in this new department soared overnight.

People’s hearts are incredibly complex.

A loyal friend would sacrifice everything, and one would go out of their way to please a loved one.

Their sense of belonging in the new department had risen dramatically.

“Dr. Zhou said it so perfectly! You all used to be in different teams, but now that you’re part of Jiaru Surgery, we’re one family. When we pull together, I truly believe Jiaru Surgery will achieve great things and eventually become Tuyu Hospital’s new hallmark.”

Mr. Liu admired Zhou Can deeply from the bottom of his heart.

When Wu Ziyu publicly challenged Zhou Can earlier, Mr. Liu felt a twinge of displeasure and worry.

The department was just being newly formed and morale was unstable.

Her outburst was almost a deliberate attempt to cause trouble.

Inwardly, Mr. Liu cursed the unruly behavior of the girl.

Fortunately, Zhou Can’s quick thinking not only prevented an argument with Wu Ziyu but even managed to thank her with grace.

After a thorough explanation, his simple remark about being family further solidified the department’s unity.

A true master can turn adversity into advantage.

Zhou Can had already demonstrated that quality.

“This kid really is my lucky charm. With his help, Jiaru Surgery is destined to thrive!”

Mr. Liu’s fondness for Zhou Can grew even stronger.

The schedule and department roster were successfully submitted. The hospital would update everyone’s records, including changes to outpatient consultation times and departmental assignments in the registration system.

……

Inside the operating room, a man nearing sixty lay quietly on the surgical table.

Mr. Liu, Director Mo, Wu Ziyu, and Zhou Can were all set to operate on him together.

A massive tumor, roughly the size of a large bowl, loomed near the left clavicle—an intimidating sight.

The patient’s thyroid lump had been discovered over twenty years ago but was ignored due to lack of symptoms. It wasn’t until he developed signs of hyperthyroidism that he sought treatment at a local clinic.

He had been taking methimazole—commonly known as carbimazole.

Recently, the thyroid mass had grown, begun to compress his windpipe, and made breathing difficult, especially when lying on his side.

Worried that the enormous thyroid tumor threatened his life, his family had brought him to Tuyu Hospital, hoping for surgical treatment.

The patient was admitted by Director Mo after days on the waiting list, eventually securing a hospital bed.

He was now scheduled for inpatient surgery.

Zhou Can took on the surgical case. Concerned, Director Mo, along with resident Wu Ziyu, wanted to see if Zhou Can’s rapid surgical skills were truly as swift as rumored.

Thus, Director Mo invited her to assist in the operation.

Director Mo himself was eager to witness Zhou Can’s surgical prowess.

After all, people are naturally curious to witness something impressive.

Zhou Can was busy assisting the anesthesiologist with the preoperative procedures. With professional finesse, he quickly prepped the patient for anesthesia.

This included intubation, connecting the ventilator, and making necessary provisions in case of emergencies during the surgery.

Since acquiring his anesthesia skills, his proficiency had steadily improved.

However, one thing frustrated him—only general or spinal anesthesia contributed to his experience points. Local anesthesia did nothing for his progress.

At first, he thought the system was acting up.

It wasn’t until he reached level two in anesthesia—a trainee level—that he realized this was a completely different kind of anesthesia.

The technique he mastered involved not only administering anesthesia but also managing life support, monitoring vital signs, and even establishing extracorporeal circulation. It was an intricate art.

Injecting local anesthetic was seen by the system as a simple task with little technical value.

That’s why no experience was granted.

So far, his anesthesia experience stood at 98/100—a stellar mark for a trainee. Just 2 more points would elevate him to resident level.

Advancement was no easy feat.

“May I handle the anesthesia?” Zhou Can asked the anesthesiologist.

“Sure, but take it easy! This patient is older and might not tolerate a rapid process,” replied the anesthesiologist.

This anesthesiologist was none other than the familiar Dr. Guan.

He had collaborated with Zhou Can countless times, so his trust was well earned.

Even with the high risks of anesthesia dosing, he allowed Zhou Can to take charge.

Not only did Dr. Guan grant him latitude, but Dr. Feng was equally willing to empower him.

Over half of Zhou Can’s 98 anesthesia experience points were earned under these two doctors’ watchful guidance.

There are two common methods for general anesthesia.

One involves inhalation of anesthetic gases through the respiratory tract, combined with intravenous injection to temporarily suppress the central nervous system—rendering the patient unconscious with relaxed skeletal muscles.

Local anesthesia typically involves a heavier reliance on intramuscular injections.

This illustrates why general anesthesia carries far more risk than its local counterpart.

Modern general anesthesia usually employs endotracheal intubation and inhaled agents, which are safer than intravenous methods. Should complications arise, dosing can be halted immediately.

This also allows for a quicker recovery from anesthesia.

This patient was receiving inhalation anesthesia.

Zhou Can carefully adjusted the dosage while the anesthesia machine ensured proper ventilation.

Once inhalation anesthesia took effect, the patient’s breathing would cease, necessitating immediate connection of the endotracheal tube to the anesthesia machine for mechanical ventilation.

Overall, this procedure, though relatively safe, still carried significant risks.

Gradually, the patient lost consciousness, as if falling into a deep sleep.

Zhou Can called out his name, and even a pat on the shoulder got no response.

He monitored the patient’s vital signs, which remained stable.

[Anesthesia Experience +1]

His anesthesia experience was now just 1 point shy of advancing to resident level. Today, he was likely to upgrade.

He had taken on most of the backlog of surgical cases from other department doctors.

Most of these were level two or higher surgeries.

In reality, level one surgeries rarely require hospitalization. Most cases are handled on an outpatient basis.

Especially in a large hospital like Tuyu, where operating room slots are extremely limited; if postoperative evaluations show no major issues, patients rarely stay in the hospital.

“Anesthesia successful. Patient’s vitals are stable. Ready for surgery!”

“Alright, come to the main table!”

Mr. Liu’s face was stern.

Performing major surgery comes with enormous pressure on senior doctors.

Their stern expressions served as a silent warning to the juniors—be careful and don’t mess things up.

Zhou Can took his position at the main surgical table while a nurse fitted him with sterile gloves.

Director Mo and Wu Ziyu watched from the sidelines.

So far, Zhou Can had shown exceptional skill with intubation and operating various instruments during anesthesia.

Both onlookers found themselves increasingly impressed with his surgical prowess.

Wu Ziyu, in particular, was stunned to see Zhou Can confidently handle anesthesia procedures and even set up a complete general anesthesia pathway for the patient.

Although surgical trainees are required to rotate through the anesthesia department for at least a month, many only grasp the basics.

They might understand the overall anesthesia process, but not how to handle emergencies intraoperatively or choose the best anesthesia method for major surgeries—with all its necessary preparations and contraindications.

After all, each specialty has its own expertise.

Surgeons excel with their scalpel, but anesthesiologists must master both internal and surgical medicine.

A top anesthesiologist continually builds up a repertoire of surgical and resuscitation experiences to boost patient safety during the perioperative period.

It’s important to note that an anesthesiologist’s role doesn’t end with maintaining intraoperative safety.

A proficient anesthesiologist assesses the patient’s entire perioperative period—from preoperative preparations to postoperative care until the patient is safely discharged.

This involvement starts long before the patient enters the operating room, where they’re involved in planning the surgical strategy.

Once Zhou Can secured his position at the main table, he began mentally reviewing the patient’s test results.

The MRI revealed a massive mass in the left lobe of the thyroid, measuring 81 x 110 x 115 mm, partially extending into the chest, compressing and shifting the trachea and mediastinum with local narrowing.

A contrast-enhanced neck CT showed a tumor of similar, slightly larger size, with clear boundaries, heterogeneous density, and a central low-density area.

Based on these tests, the tumor, albeit large, was likely benign.

However, given the patient’s advanced age and abnormal thyroid function—and a preoperative chest X-ray indicating bilateral pulmonary emphysema—the surgical risk was extremely high.

Zhou Can was on high alert as he carefully made the incision.

The moment his scalpel cut through, both Director Mo and Wu Ziyu’s eyes widened in shock.

They had always known Zhou Can was far superior to the average trainee, but they hadn’t expected his incision skills to be so precise and swift.

In a swift, decisive motion, Zhou Can exposed the tumor, quickly dissected the surrounding tissue, and removed it completely.

Incredibly, he managed to extract a tumor over 100 mm in diameter with ease. During the process, he also cleared multiple cystic-solid nodules in the right thyroid lobe.

His control over bleeding and his ligature technique during the operation left the observers in sheer awe.

Even after the surgery ended, the two remained in a state of stunned silence, unable to fully process what they had witnessed.

“I can’t believe surgery can be done like this! My God, it’s unbelievable,” exclaimed Wu Ziyu, her eyes filled with shock and inexplicable admiration.

Watching Zhou Can operate felt like a window had been flung open to an entirely new world.

Previously, she had only seen senior doctors operate with utmost caution and deliberation. Now, witnessing Zhou Can was like watching someone play a thrilling game—so fast it almost blurred before her eyes.

Yet, every move was executed with flawless precision. During dissection, he avoided damaging vital blood vessels and nerves by a hair’s breadth.

Every preemptive ligation and every burst of electrocautery appeared remarkably stylish in her eyes.

The overall blood loss during the surgery was minimal.

This was a testament to Zhou Can’s exceptional hemostasis technique.

The incision was impeccably clean, and his suturing was so smooth it made her believe she was observing an immensely experienced chief surgeon.

Moreover, she had never seen Zhou Can perform suturing like this before.

Once the wound was closed, it looked almost too perfect.

It was obvious that the patient’s healing time would be significantly reduced with minimal scarring.

Only then did she understand why Mr. Liu’s team had performed nearly 900 surgeries last month, achieving not only a high success rate of 98.4% but also an average quality score of 4.8.

Given Zhou Can’s skill level, such outstanding outcomes were hardly surprising.

A success rate above 90% is considered very good; over 95% is exceptional, and each additional percentage point beyond that is nearly miraculous.

Zhou Can had literally pushed his already extraordinary success rate up by another 3.4 percentage points, nearing the pinnacle of surgical achievement.

“After watching Dr. Zhou’s performance today, I realize I was just a frog at the bottom of a well. There will always be someone better, and nothing compares to his lightning-fast and immaculate surgical skills. I can only apologize—yesterday, I doubted his case assignments. Now, I sincerely apologize. I’m so sorry!”

She bowed deeply to Zhou Can, her words dripping with remorse while her eyes sparkled with admiration.

“Dr. Wu, you’re exaggerating. Once misunderstandings are cleared, there’s no need for such a grand apology. We’re all in this department together. We should trust and help one another,” Zhou Can replied gently.

He couldn’t bring himself to pat her back—after all, she was a woman—but making her see reason was satisfying enough.