Chapter 422: Late-Night Emergency: The Price of Trust

It was clear this whole situation had weighed heavily on Associate Director He.

Once the seed of paranoia is planted, it only grows, quickly turning into a wild, uncontrollable weed—impossible to burn away or cut down.

“Alright!”

Zhou Can agreed to his small additional condition.

You could say the two had reached a kind of gentleman’s agreement.

Director Xueyan couldn’t help but smile when she saw Associate Director He—the department’s biggest ‘antagonist’—finally back down. With He no longer working against her, she was hopeful the department’s internal strife would soon return to normal levels.

Back when Dr. Hu Kan was alive, the Cardiothoracic Surgery department was close-knit. There was almost no internal friction.

Internal conflict usually means scheming, toxic competition, all that backstabbing.

Take this: if Doctor A’s patient is showing serious signs of trouble, Doctor B might stay quiet—just waiting for something bad to happen so Doctor A takes the fall. That’s internal strife.

And don’t even get started on things like doing the bare minimum, playing both sides, dodging responsibility. That’s par for the course.

But thanks to this incident, with their biggest thorn finally tamed, the cardiothoracic department could soon unite for real.

Which would give the entire department a massive boost in overall strength.

Honestly, today was turning out pretty great.

She’d regained the confidence she’d lost on the operating table, and with Zhou Can’s help, managed to cut down the department’s biggest troublemaker.

“Dr. Zhou, now that we’re on good terms, could you help me analyze why the patient had so much bleeding after surgery?”

Associate Director He was growing desperate about the situation.

Especially after Zhou Can had put the fear of god into him earlier. He was terrified this patient would ruin his whole career.

After all, life was pretty comfortable for him right now.

With his senior title and the cushy post as associate director, things wouldn’t get bad for him any time soon. He was bringing home tens of thousands a month—like it was nothing.

His social status was high, too.

“No problem! Let’s take a look at the possible causes of the patient’s post-op bleeding.”

Zhou Can immediately started helping out with the root cause analysis.

“I’ve already looked at the patient’s surgical site. There are about five common causes for post-op bleeding. If I could get a look at the surgical record, that’d help a lot.”

It’s not like he’s some miracle worker who can just take one look and instantly know where the bleeding is. That’s just unreasonable.

If it were that easy to figure out, Associate Director He wouldn’t be in this mess.

“I have the surgical record on my work computer. Why don’t you both come to my office and I’ll pull it up right away.” Normally, surgical records wouldn’t be on his work computer.

That suggested he’d already tried getting to the bottom of this himself but came up empty.

The three of them headed to Associate Director He’s office.

He powered on the computer and opened the surgical record.

“Director Xue, Dr. Zhou—this is the surgical record. Please have a look!”

“Sister Yan, take a seat. I’ll just stand and look from here.”

Zhou Can was young and full of energy. Director Xueyan, after working all day and now well past midnight, was clearly exhausted.

She and Zhou Can were on close terms now, so she didn’t stand on ceremony.

Associate Director He, however, had pinned all his hopes on Zhou Can. When it came to finding the cause, Zhou Can had always been solid.

“Dr. Zhou, sorry you have to make do with this little stool.”

He brought over a plastic stool for Zhou Can.

That was some thoughtful service.

The adult world is driven by self-interest. There are no permanent enemies or friends—only shifting alliances.

They had barely sat down when an on-duty nurse burst in, panic written all over her face.

“Director Xue, Director He, we have a problem. The family of the patient in bed 12 just called the emergency bell. When I checked, the patient showed signs of shock.”

Nothing annoys a night-shift nurse more than those call bells going off non-stop during their shift.

On busy nights, it was nearly impossible to get any sleep, even shut your eyes for a second.

Sometimes, as soon as she handled one patient and tried to catch her breath, another call bell would go off down the row. Two or three could sound at once, leaving nurses completely frazzled.

“I’ll go right away!”

As soon as He heard the patient was showing signs of shock, he panicked.

Of course. The thing he feared most just had to happen.

They were still working out the cause for all this bleeding, and the patient couldn’t wait—he was already going into shock.

Zhou Can had warned him earlier—the patient was looking seriously anemic, which meant the bleeding had gotten worse. Now it was coming true.

“Dr. Zhou, you’re the best when it comes to critical situations. Care to have a look with me?”

He felt deeply embarrassed asking for help.

He was a veteran and a senior physician, but here he was, begging this young doctor for help now that the patient was in shock.

If it was an ordinary emergency, he would never have been rattled.

But he already knew this patient’s situation in detail, and right now, he had absolutely no idea where this internal bleeding was coming from. He was completely at a loss.

Post-op internal bleeding like this is deadly—if you can’t stop it fast, no amount of transfusions will keep up.

On top of that, too much blood transfusion brings its own problems.

After all, they’re transfusing treated blood products, not the patient’s own blood. Large infusions of blood from others can make it tricky to maintain the right temperature.

And there are so many possible complications—like congestive heart failure, pulmonary edema, sodium citrate poisoning, allergic reactions, you name it.

Think about it: when a patient needs this much blood, their vital signs are already dangerously unstable.

If complications come up now, the patient’s life is like a candle flickering in the wind—the smallest disturbance could snuff it out.

He’s years of experience in emergencies only made him more aware of the dangers, and that’s why he swallowed his pride to ask Zhou Can for help.

“Let’s go. I’ll go with you!”

Zhou Can didn’t hesitate. He stood and followed He out.

When you help someone in trouble, preserving their dignity matters most.

If dignity gets thrown to the ground, it’s shattered.

Offering help while acting superior just isn’t help at all.

Even if you do help, the other person won’t feel grateful.

Chances are, they’ll end up resenting you for it.

Director Xueyan stayed behind to keep reviewing the surgical record. She had a strong theoretical background and had learned a lot from Dr. Hu Kan. She might discover something on her own.

Back in the ward, Zhou Can saw the middle-aged man staring blankly, even paler than before and trembling all over.

The fluid draining out was all blood, but the color wasn’t that bright red.

“Dr. Zhou, what’s our safest course of action now?”

He was sweating right through his forehead.

The family was clutching the bedside, sobbing nonstop—they’d probably already braced for the worst.

“Transfuse blood and fluids—do conservative management for now!”

After checking the patient, Zhou Can gave his answer.

“But the internal bleeding isn’t stopping. No matter how much we transfuse, it’s a bottomless pit!”

He hadn’t expected to get such a basic answer from Zhou Can.

Conservative management was common sense—why even ask him?

“The priority is keeping the patient alive while we hunt for the source of the bleeding. Once we know for sure, we can get a targeted treatment plan in place.”

Zhou Can had been through all kinds of emergencies—ten times worse than this, even.

Which is why he stayed perfectly calm.

There’s a world of difference between someone who’s seen it all and someone who hasn’t. It shows in a crisis.

Those masters who can stare down disaster without blinking only got that way after countless brushes with danger.

Three years of residency had fully changed Zhou Can. Maybe not a true master, but he’d gotten pretty close to the calm and poise a top doctor should have.

“Alright, I’ll issue the emergency orders right away!”

He also issued a critical condition notice, which needed to go to the patient’s family.

By hospital policy, when a doctor determines a patient’s life is in danger, a critical notice must be given. It helps the family prepare mentally.

After blood and fluids were given, the patient’s vitals picked up a little.

But everyone knew it was just a temporary reprieve.

Back in the office, because time was so tight, Zhou Can could only skim the surgical record. At least he’d be able to see which parts had been cut and which procedures were performed.

“Since time’s short, I’ll jump right to the five likely causes of bleeding. First, if there was a cut or separation of adhesion between the chest wall, diaphragm, or pleura and the bleeding wasn’t fully stopped. Based on the surgical record and on your usual surgical… style, this is the most likely culprit.”

He nearly said He’s surgeries were a bit sloppy, but that would have hurt too much—so he just called it ‘style’ instead.

“I suspected that step, too. To be safe, I even had the first assistant check it again and clean up any bleeding points. The assistant for this case was Dr. Yao—he’s always precise, and he’s very good at hemostasis, so the chance of something going wrong there is extremely low.”

He ruled out the first cause.

Zhou Can nodded and continued, “Let me ask, who did the chest closure suturing?”

“One of my attending doctors did it, and he’s very skilled. After he finished, I checked—everything was neat and the tissue layers held tightly together. There shouldn’t be a problem there.”

With a major surgery like this, He wouldn’t dare cut any corners.

You could tell he kept a tight rein on every surgical step.

Honestly, with any major surgery, no chief physician dares be careless—lives are literally on the line. If something goes wrong, it can destroy their whole career.

Worst-case scenario, it could land them in legal trouble.

And unless the chief has political connections that can cover up everything, even the tiniest mistake will come to light if there’s an investigation.

“If we rule out the first cause, I think the most likely problem is that the closure suturing damaged an intercostal artery or vein. If that’s not it, then it could be that the chest tube placement hurt a vessel instead. The drained fluid isn’t bright red, so odds are the artery wasn’t hit. If it was a vein, the bleeding rate should be much slower.”

“So, all things considered, I believe the most likely scenario is that an artery was injured during chest closure suturing.” Zhou Can wrapped up his analysis.

“I suspected a vascular injury, too. After hearing Zhou Can’s analysis, I completely agree—the most likely cause is an arterial injury at closure. Only that would explain the rapid blood loss.”

Director Xueyan hadn’t voiced any theories yet.

At that point, Zhou Can had already cut to the heart of the issue, locking onto closure suturing as the likely culprit. Xueyan went ahead and aligned with his conclusion.

“So what’s the next step?”

He was totally frazzled by now, all sense of direction gone.

“The only way is to reopen along the original incision, clear out the blood clots, suction out the pooled blood, and repair the damaged vessel. During all that, we need to transfuse blood and fluids fast.”

Zhou Can gave his solution.

If it weren’t absolutely necessary, no one would ever reopen a patient’s chest barely a day after surgery.

It’s just too much trauma for the patient.

But with the patient’s life on the line, it was the only choice.

“That… everything else is fine, but repairing an arterial injury isn’t exactly easy. I’m worried it’ll take too long—the patient might not make it through another closure.”

He knew just how risky a resternotomy could be.

“I’ll handle it.”

Zhou Can volunteered before He could even ask for help.

“Thank you! Thank you so much!”

He gripped Zhou Can’s hand tightly.

He knew full well Zhou Can had stayed late, working surgeries with Director Xueyan all the way past midnight; the guy was already running on fumes.

And now, just to help save He’s patient, Zhou Can was volunteering for another procedure.

He didn’t even have to be asked.

People aren’t made of stone—they have feelings.

Even if He’s heart was made of iron, he couldn’t help but feel deeply grateful to Zhou Can in that moment.

Who could say if things would sour again later on? But right now, that gratitude was real.

……

After one in the morning, Zhou Can finally dragged himself, exhausted, out of the operating room.

Director Xueyan looked even more spent, yawning nonstop and barely able to keep her eyes open.

In fact, she’d only been there for support—she hadn’t actually scrubbed in.

For almost the entire procedure, Zhou Can had been the lead surgeon.

When a speedy resternotomy, swift clearing, vessel repair, and closure were called for, Zhou Can’s rapid surgical technique was the one thing that could give the patient a fighting chance.

Using that quick style made him realize just how crucial surgical speed could be.

Go too slow, and you let fate slip through your fingers.

“Director Xue, Dr. Zhou, thank you both for everything!”

Seeing the patient stabilized after surgery, He finally let out a sigh of relief.

Just in case, the patient was sent straight to their small ICU.

Basically, it was a special intensive care unit built right into the cardiothoracic department.

Departments like Respiratory, Neurosurgery, Cardiac Surgery, Thoracic Surgery, Emergency—they all tried to set up their own ICU if they could.

“Think nothing of it!”

Zhou Can just waved it off, but deep down he hoped this old guy would remember tonight’s help and steer clear of any shady business from now on.

“Sister Yan, it’s late and you’re visibly exhausted. I’d recommend just staying at the hospital tonight.”

He told her.

“Yeah, I was thinking the same.”

Xueyan nodded.

Zhou Can glanced at the clock. Almost one-thirty—if they tried to head back to Baying Lake now, they wouldn’t get home till after two.

A doctor’s life really was exhausting.

Still, they saved a life tonight and managed to calm the department’s unrest for now. That made it all worth it.