Chapter 377: Victory in the Storm: A Night of High-Stakes Surgery

Zhou Can never cared about the way others looked at him.

Aortic dissection comes in two main types. Type A is the more dangerous one, requiring open-chest surgery. The risks are sky-high, and the entire procedure is incredibly complicated, demanding both experience and exceptional skill from the surgical team.

Even with all that, the mortality rate for Type A dissection surgery stays above 30 percent.

There are some truly outstanding surgical teams out there with a specialty in this kind of operation—they can push the mortality rate down to around 10 percent.

But that still means one out of every ten patients doesn’t make it. Even with the best in the business, the risk is incredibly high.

The other type is called Type B dissection. This one usually can be fixed with an endovascular procedure, placing a covered stent to solve the problem.

That is, it’s an aortic endovascular repair. Surgeons access the artery by puncturing the femoral artery and guide the covered stent right to the site of the rupture, sealing it off and preventing further damage—an effective clinical treatment.

These days, traditional open surgery for dissection has become rare.

Because it’s so risky and technically challenging, only a handful of surgical teams can actually pull it off.

Unfortunately, this expectant mother was diagnosed with aortic dissection during her pregnancy—and it was Type A. With her life at risk and her baby’s fate on the line, the hospital’s experts held several discussions and finally decided to perform a C-section and the dissection repair at the same time.

They hadn’t even entered the operating room when the family received a critical condition notice.

To be honest, at this point, everyone was acting purely out of the conscience that comes with being a doctor.

If they could save this mother, her newborn would grow up wrapped in her love. But if things went wrong, the child would face the world without a mother from day one—a heartbreaking thought.

Why is the mortality rate for Type A dissection surgery so high?

Because it’s an open-chest procedure. The heart needs to be stopped, and either an artificial blood vessel is implanted or a bypass surgery is performed. Every part is complex, the surgery takes a long time, and the complications afterward are many.

Every patient undergoing surgery for Type A dissection is really facing life and death.

Some patients, even after a technically successful operation, still pass away after surgery.

Throughout the operation, the patient is closely monitored with ECG and hemodynamics. The blood pressure must be strictly maintained at 120 over 80 mmHg.

Just looking at these requirements and basic steps, it’s easy to see why this is such a challenging operation.

During the procedure, they have to surgically separate both brachial arteries, the left external carotid artery, and one side’s femoral artery. Four guidewires are threaded through the femoral artery into catheters. After real-time X-ray imaging to observe the situation, the team decides on the exact surgical approach.

This patient needed an aortic replacement.

Director Xueyan’s skills are good, but she hit a wall at the hardest, most critical step.

When Zhou Can took over, the two OB-GYN doctors realized there was no such thing as ‘the scariest’—just scarier.

He went to work, operating fast and boldly.

Compared to Director Xueyan’s gentle, unhurried style, Zhou Can’s surgical technique was like a sudden summer storm. The two couldn’t be more different.

“Done!”

Thirty minutes later, Zhou Can let out a relieved breath—he’d done it. The aortic replacement was a success.

“Sister Yan, why don’t you finish up the rest?”

With the toughest part of the procedure behind him, Zhou Can was ready to step back.

What’s more, he now addressed Director Xueyan openly, with no need to hide the familiarity.

Right in front of everyone, he called her Sister Yan.

“Your hands are faster—time is life. You should see the whole operation through. I’ll assist you.”

Director Xueyan had always treated him well.

Any time there was a surgery to be done and Zhou Can could handle it, she’d gladly let him take charge.

She was grooming him on purpose, helping him become one of the core experts the Cardiothoracic Surgery Department desperately needed.

Now Zhou Can’s skills were growing by the day. Handling almost all of the department’s most challenging surgeries, his standing in the OR was higher than ever.

A new, dynamic surgical team was forming around Zhou Can as its centerpiece.

There had always been signs of this, but now it was more obvious than ever.

Everyone understood—with their abilities and potential, none of them could replace Director Hu Kan right away. Only Zhou Can gave them hope.

These days, the Cardiothoracic Surgery Department was in turmoil, beset by crisis and danger.

If no new leader stepped up before Director Hu Kan had to leave, the department could quickly fall behind, losing its place among the hospital’s top specialties.

For more than a year already, the signs were painfully clear.

Just look at the numbers: the department’s total monthly surgeries had been steadily dropping. The pace wasn’t catastrophic, but compared to its heyday, both emergency and routine admissions and surgeries had dropped by nearly a third.

Lower patient volume meant one thing—everyone’s pay was going down.

A lot of people probably felt that pinch already.

……

Nearly an hour later, the surgery was over. Thanks to the entire team’s efforts, the mother survived.

However, she probably wouldn’t be able to breastfeed her baby.

She needed intensive care in the cardiothoracic ICU, and the newborn was premature at less than 37 weeks. The baby was undernourished and might need a week in the incubator.

All in all, the operation was a big success.

Both mother and child made it—no tragedy that day.

“Dr. Zhou, your surgical skills are incredible! I’m Zhao Jie, an OB-GYN surgeon. This is my assistant, Qin Feifei. It’s a pleasure to meet you.”

Dr. Zhao, the OB-GYN surgeon, took off her mask, smiling as she introduced herself to Zhou Can.

She was a woman in her forties with an ordinary appearance.

But her skills were first-rate. It was her team that performed the C-section.

Her assistant, Dr. Qin, was a tall man who nodded politely at Zhou Can, offering a friendly greeting.

“You flatter me! I’m glad to meet you and Dr. Qin as well.”

Zhou Can took off his gloves and offered a handshake first.

Anyone capable of leading a C-section must be at least an associate chief physician. Since she initiated the introduction, Zhou Can—a newly certified resident—made sure to stay humble and friendly.

“If there’s a chance, I hope we can collaborate again with Cardiothoracic Surgery. Thank you all so much! Director Hu, if there’s nothing else, we’ll head out now.”

After their introduction, Dr. Zhao didn’t linger in the operating room.

This was just for becoming acquainted.

She’d seen Zhou Can’s impressive skills and heard about his growing reputation, which explained her warm attitude.

Gone are the days when doctors worked solo. Tough cases often mean asking for cross-department help or even joint consultations.

It’s handy to know skilled colleagues like Zhou Can—makes it easier to ask for help when a tricky case comes up.

In the end, networking in medicine is all about mutual benefit.

After the mother was transferred to the ICU, a new patient was soon rolled into the operating room.

Not every patient gets wheeled in for surgery.

Usually, the ones on stretchers are severe cases who can’t walk on their own.

If a patient can still walk, a nurse typically escorts them into the OR.

This next patient could walk, but every step looked exhausting, and she was clearly having trouble breathing.

Once she was on the table, they quickly put her under anesthesia.

While the anesthesiologist worked, Zhou Can didn’t assist. Instead, he picked up her chart to get familiar with the case.

“Xiao Zhou, this one’s yours. Repairing a bronchopleural fistula is a top-tier surgery—so be extremely careful every step of the way. I’ll guide you through each part. Director Xueyan has nearly mastered this already, and Director Le is getting there—so he can be your first assistant and get another round of practice.”

Director Hu Kan mapped out the strategy.

“Okay!”

Director Le agreed cheerfully.

Right now, the core of this surgical team was Director Xueyan, Director Le, and Zhou Can—the department’s three heavy hitters.

Each had their strengths, but overall, Zhou Can was the strongest.

Even they had to admit this.

Sometimes, talent just sweeps away the age gap.

Director Le was a bit older than Director Xueyan. They both had over fifteen years of surgical experience—true veterans—but compared to Zhou Can, their overall skills now lagged behind.

Consider this: Zhou Can had been holding a scalpel for, at most, three years.

To reach (and surpass) the level of chief physicians with fifteen years of training in just three years—talent really makes all the difference.

……

The busy day didn’t end until after nine PM.

Zhou Can looked at how much his multi-department surgical experience had grown, his heart full of satisfaction and pride.

He especially loved that feeling of getting a bit better every day.

After so much practice and time spent on the fast scalpel technique, he could feel it on the verge of leveling up.

He’d already advanced his incision surgery skill to level five more than three months ago—now it matched an associate chief physician’s entry level. His ability in pharmacological reasoning was also impressive, already moving toward mid-level associate chief standards.

That skill was also at level five and progressing fast.

Still, once you hit level five, the experience points needed to upgrade jumped to a hundred thousand. It wasn’t something he could do overnight, even with occasional big bonuses of a hundred points during surgery.

But a hundred thousand is a long grind. It’ll take real patience.

These days, all his important skills reached the associate chief physician standard—plenty for most operations. Only the hardest cases still gave him trouble.

As for the truly extreme operations, there were plenty he still couldn’t handle.

“Teacher, your breathing’s really labored. Why not rest at home for a few days?” Director Xueyan asked with concern, looking at Director Hu Kan.

“I’m just happy! Watching you all complete Type A dissection and bronchopleural fistula repairs proves that our department’s future is in good hands. As long as you keep it up, I’m confident we’ll return to our peak within five years.”

Director Hu Kan’s face shone with pride.

Seeing the department’s future secured brought him heartfelt joy.

“Xiao Zhou, make sure you reflect on today’s two major surgeries after you head home. I’ve seen even riskier Type A dissections—one time, because the blood pressure wasn’t kept under control, the blood vessel burst. More than ten of us worked for four hours, but still couldn’t save the patient…”

Director Hu Kan’s favorite was always Zhou Can.

Every time, he reminded Zhou Can: stay humble, learn from your work, and never stop thinking.

“It’s late—everyone must be hungry, right? As surgeons, we work harder than anyone! I ordered egg-fried rice noodles today. I’m getting old and have to mind my health, so today I’ll eat whatever you all are having.”

Looking at the dozen or so core team members, Director Hu Kan’s gaze was as warm as a father’s.

These people were the very heart of the Cardiothoracic Surgery Department.

Zhou Can grabbed a bottle of pure milk, warmed it up, popped in a straw, and handed it to Director Hu Kan.

“Director Hu, please have some milk to supplement your nutrition and avoid getting overworked! You’re our greatest mentor and the anchor for all of us. As long as you’re healthy, we can always look to you for guidance. For me, just having you nearby—even if you never say a word—makes me feel at ease. I always think, even if I run into something I really can’t handle, you’ll help me through it.”

Zhou Can’s words brought laughter from many in the team.

“Honestly, I feel the same way. Even after fifteen or sixteen years as a surgeon, whenever there’s a major operation, I turn back into a kid. With Director Hu there, my courage doubles.”

Director Xueyan spoke in all seriousness.

“So you’ve always felt that too? I used to be embarrassed, since I’m already forty-five—what if people laughed at me for acting like a child!”

Director Le’s remark set the whole group roaring with laughter.

The three of them were all personally trained by Director Hu Kan, getting the most guidance of anyone.

Naturally, with limited time and energy, he couldn’t treat everyone exactly the same—he focused on nurturing these three. Even Jin Mingxi received lots of mentorship this past year.

“To me, you’re all like my own children. Watching you grow and face challenges, my job is to support and guide you like a parent would. Xueyan, remember the first time you handled a scalpel and accidentally cut a blood vessel? You got so scared you started crying.”

Director Hu Kan got lost in memories, nostalgia softening his face.

“Teacher, give me a break! That was ages ago. I can’t believe you still remember it so well!”

Director Xueyan blushed like a shy girl.

“Don’t worry about it! Everyone faces setbacks and embarrassment as they grow. As long as we keep growing, we’ll shine brighter and brighter. Wasn’t I knocked down by the operating table too? Listen, don’t measure yourself against others—compare yourself with who you used to be. As long as you’re better than yesterday, that’s enough.”

Director Hu Kan shared some words of wisdom with the team.

Comparing yourself to others only brings frustration.

The quickest way to grow is to compare yourself with who you were before—not everyone else.