Chapter 445: Night Rounds: Hands-On Tests and Honest Conversations

The female patient had no idea what Zhou Can was up to, but trusting her doctor, she stayed quiet and let him work.

Still, every now and then a flicker of pain crossed her face.

After pressing for more than ten seconds, Zhou Can suddenly increased the pressure.

“Ouch!”

She cried out in pain.

Right then, Zhou Can let go of her hand.

“Take another look at the bump on your hand!”

Hearing that, she raised her arm and looked down.

“Huh… Where did it go?”

Shock flooded her face. Eyes wide, she stared in disbelief at her arm.

“That’s incredible!” Luo Shishen gaped at the scene too, just as amazed.

“Wait, could this be a ganglion cyst? It usually shows up on the back of the wrist or behind the knee—benign, but you can treat it with surgery.”

Yang Zhi’s knowledge clearly surpassed Luo Shishen’s.

He rattled off the details without missing a beat.

“Doctor, so do I still need surgery?” The female patient looked stunned and delighted, rubbing the spot where the bump had been.

“Yours is a pretty friendly kind of ganglion cyst. Based on my experience, surgery isn’t necessary. I’ll prescribe you some meds to take and some ointment to apply—just follow those instructions.”

Zhou Can told her with a reassuring smile.

“Really? That’s wonderful! I was terrified of having surgery. I kept picturing ugly scars on the back of my hand. I wouldn’t even be able to wear short sleeves or dresses in the summer!”

Her relief was almost palpable. She could hardly stop smiling.

“While I was waiting in line outside, I heard the other patients talking about a young Dr. Zhou in the Emergency Department with amazing skills. Hearing’s one thing but seeing is believing—now I’m convinced. You’re definitely the doctor they meant.”

Her praise hit all the right notes—Zhou Can felt genuinely pleased.

“There’s no end to medical knowledge, and I’m far from ‘remarkable’. At best, I’ve just seen a lot over the years. These kinds of cysts are usually benign lesions caused by soft tissue injuries. Medically speaking, they’re benign growths that show up near joints, tendons, or ligaments. Even though we just pressed it down, if you don’t take care of it, it could return.”

As he wrote her prescription, Zhou Can explained all the things she should watch out for.

When the patient finished thanking him over and over, Ma Xiaolan led her out.

She was so satisfied with the wait she said it was completely worth it—chances are, she’ll be recommending Tuyu Hospital’s Emergency Department for a long time.

Especially if any of her friends or family need surgery, she’ll send them to Dr. Zhou without hesitation.

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Ma Xiaolan returned quickly with the second patient—a man in his thirties who needed some dead bone removed from his facial bone.

His X-ray showed the affected spot on the lower left mandible was limited in range, with well-defined boundaries, and several pieces of dead bone of different sizes inside.

The surgery required careful avoidance of the surrounding blood vessels and nerves and the removal of the dead bone along with the affected tissue.

It was a high-risk surgery with a considerable degree of difficulty—definitely a challenging level two operation.

For most senior resident doctors in surgery, this kind of procedure is already a tough test. If you don’t have plenty of experience, it’s not something you can just breeze through. Usually, only attending physicians are confident handling it solo.

But Zhou Can had already mastered even level-three, ultra-difficult surgeries by himself. To him, this procedure was almost too easy.

“Dr. Yang, if you were in charge, where would you make the incision?”

He fired off another challenge toward Dr. Yang.

Honestly, it was a bit strange—a junior resident grilling a surgeon at the attending level.

What’s more, the attending actually looked happy to take the test.

“This kind of surgery isn’t something my department usually covers, so I won’t pretend to be an expert. But for safety and convenience, I’d make an intraoral incision.”

Yang Zhi hadn’t done well on the last test case.

This time, he put in his best effort.

“Great minds think alike! I’d make a small transverse incision in the oral vestibule here—just in this spot.”

Zhou Can was clearly satisfied with his answer this time.

“Luo Shishen, remember this—when it comes to these surgeries, if the patient shows systemic failure, you must stabilize them first and open up the affected area for drainage. Never rush straight into surgery, or you risk serious post-op complications—even rapid decline that could get out of hand.”

Zhou Can patiently shared key surgical principles with Luo Shishen.

Luo Shishen whipped out a tiny notebook and jotted everything down.

A dull pencil beats a sharp memory.

Med students should always be taking notes—never get lazy. There’s just too much to remember, and without notes you’ll forget sooner or later.

The surgery began soon after.

“When the necrotic area on the jaw is larger, you should make a standard submandibular incision, not stubbornly insist on operating from the mouth. Especially for female patients who want to avoid scarring, they’ll often request it, but you can’t always give in. Our top priority is patient safety. Only after you guarantee safety can you worry about cosmetic issues.”

Zhou Can shared surgical tips and taboos as he worked.

All of these skills had been slowly accumulated through practice, learning from his mentors, and plenty of reading.

When talking about ‘dead bone,’ he made a point of calling it ‘necrotic bone’—a common convention in the operating room.

Stay away from words like ‘dead,’ ‘cancer,’ or ‘hopeless’.

Not only are they bad luck, but if patients overhear, they’ll panic.

Once the periosteum was incised and reflected, the necrotic bone was fully exposed.

This technique works well for small pieces of dead bone.

If the affected area is too big, the surgeon needs to go back to the standard approach.

Once the dead bone is exposed, free it up along the margin.

Thanks to Zhou Can’s skillful hands, the dead bone was quickly removed.

Don’t think the surgery’s done once you reach this point—it’s not over yet.

“After removing the necrotic bone, you must also thoroughly scrape out surrounding granulation tissue and any little bone fragments. Do your best to clean up the lesion so there’s no need for a second procedure.”

Zhou Can moved quickly throughout the operation.

When that was finished, he took the iodine gauze Qiao Yu had prepared ahead of time and packed it into the bone cavity for drainage.

“Dr. Yang, can you handle the suturing?”

Suturing inside the mouth is definitely harder than on the face—the demands are much higher.

But Zhou Can was fearless, leaving the rest of the suturing to Yang Zhi.

In his opinion, after six years in the OR, Dr. Yang had better be skilled enough to suture like this, or it meant he’d been coasting.

After all, you could practice sutures at home on pigskin or cloth, not just on patients.

Sounds a bit harsh, maybe.

Some rookie doctors in their critical learning phase would even practice making incisions on lab animals—mice, rabbits—then stitch them up.

It’s all done under anesthesia, but if animal rights groups heard, there’d be plenty of complaints.

Practice is what leads to true understanding.

Animal experimentation is allowed in medical training.

Even it’s done on primates, as long as everything’s aboveboard, it’s legal.

One thing to note: after suturing on mice or rabbits, wounds often heal much faster than on people. That can leave you overconfident, only to face disappointment when stitching up actual patients.

That’s because humans heal more slowly than those little lab animals.

Plus, some patients have underlying conditions, or poor health—old age, poor circulation, slow metabolism, limited nutrition—all of which slow down wound healing.

That’s why modern medical technology is such a huge accomplishment.

It’s not like some imagine: just experiment a little and you get results. It takes endless clinical practice and constant improvement to build the medical knowledge we rely on now.

Once Yang Zhi took over the patient, he began suturing.

Zhou Can didn’t rush to call in the next case—he stood by and watched Dr. Yang work.

When Yang Zhi finished, Zhou Can gave a satisfied nod.

He wrote the post-op orders and had Ma Xiaolan lead the patient out.

“Good suture work, Dr. Yang!”

Zhou Can offered sincere praise.

Intraoral suturing really does require careful technique—space is tight and standards are high.

Yang Zhi had done a fantastic job.

“You flatter me! I just make a habit of practicing the basic surgical skills whenever I’ve got free time.”

The implication being, he’s not only good at suturing—he’s solid across the board in surgery.

That’s when Dr. Xu walked in.

“Teacher, this is the surgeon I told you about from anorectal and colorectal surgery, Dr. Yang Zhi. I had him do an intraoral suture for the patient just now, and he was excellent.” Expanding Zhou Can’s surgical team was always something he’d check with Dr. Xu first.

Dr. Xu’s gaze was sharp and intimidating. When he scrutinized Yang Zhi, Yang could feel it in his bones.

But he was determined to join Zhou Can’s surgical team.

Especially after watching Zhou Can treat two patients in a row, he was genuinely in awe of his skills, eager to be part of the team.

He firmly believed that working under a doctor like Zhou Can would only lead to great things.

“Does Director Mi know you want to transfer to the Emergency Department?”

Dr. Xu looked at Yang Zhi and asked bluntly.

“I never brought it up directly with Director Mi, just hinted at it twice that I planned to leave the anorectal department. Both times, he tried to talk me out of it. But honestly, I just don’t see a future there. Sure, there’s less competition and more openings, but that’s not how I want to work. My family situation doesn’t allow me to struggle just to get by. I want to gain experience and, one day, become an associate chief with a steady income.”

Yang Zhi didn’t sugarcoat anything. He laid out his reasons plain and simple.

After hearing his answer, Dr. Xu asked, “So you’re just working for the money?”

“Earning more is a part of it, but it’s not everything. I want to improve my skills. If I keep getting better and work hard, the pay will follow.”

That’s probably what most doctors really think.

To claim you’re working solely for passion is just wishful thinking.

We’re all human, with families to provide for. If you don’t earn, interest and hobbies don’t pay the bills.

That’s just reality.

“You’re an honest guy. Not bad! Zhou, let’s get back to the surgeries.”

That brought Dr. Xu’s line of questioning to a close.

From their first conversation, Yang Zhi seemed to have made a good impression.

He let out a silent sigh of relief.

After all, Dr. Xu was Zhou Can’s mentor. If he disapproved, Yang’s hopes would go up in smoke.

Soon, the third patient was brought in. Zhou Can didn’t let Yang Zhi handle the incisions, but he did put him in charge of suturing, hemostasis, and retractors.

……

They worked nonstop until after eleven at night—all patients’ surgeries went off without a hitch.

By then, Zhou Can already had a good understanding of Yang Zhi—his skill, attitude, and personality.

On the whole, he was very impressed.

Yang’s surgical skills were well above average, and he was reliable, careful, and responsible.

Communication was effortless, too.

Frankly, he didn’t play any mind games during their chats—he just spoke his mind.

Unlike Dr. Lu, who Zhou Can once sent to jail, and who could hide three traps in a single sentence. Dealing with people like that is exhausting.

Another thing: Yang Zhi was eager to learn and took his training seriously.

Whenever he didn’t understand something, he’d jot it in a little notebook he always carried. Judging by how many pages he’d filled, he’d kept the habit for a while.

“Dr. Zhou, Dr. Xu, I’ll head back now. If you need help and I’m still up for it, just give me a call.”

Yang Zhi said goodbye to them both.

“I already ordered some late-night snacks. Don’t rush, eat before you go—or at least take something for the road.”

Zhou Can grinned. As far as he was concerned, Yang Zhi had passed all his tests. But Dr. Xu would still have to weigh in, since transferring staff from other departments was complicated.

Director Mi might be a good guy, but he was also stubborn about the rules.

Poaching his staff could easily stir up conflict.

Doing this right meant handling things with care.

“You two eat, I’ll head home. My wife and kid are waiting. See you!” Yang Zhi didn’t feel right eating with people he’d just met—besides, it was their first real working session.

“At least take a snack for the road! When I ordered, I factored you in, otherwise we’ll just waste it.”

Zhou Can quickly packed up a snack and handed it to him.

“Dr. Yang, don’t be shy. Dr. Zhou is always so generous to the team—we’re all spoiled here,” Ma Xiaolan chimed in, helping ease Yang’s embarrassment.

“Alright, thank you!”

Yang Zhi accepted, still a little bashful.

“What’s your phone number? I’ll save it and it’ll be easier to reach you later.”

Zhou Can took the initiative to ask for his number, which made Yang Zhi visibly pleased.

He wasn’t dumb—nobody would ask for his contact if they weren’t planning to bring him onboard.

He immediately rattled off his number to Zhou Can.

All he could do now was wait for Zhou Can to get in touch.

If he didn’t hear back, that’d be the end of it.

After Yang Zhi left, Zhou Can ate his late-night snack and chatted with Dr. Xu.

“Teacher, what do you think of Dr. Yang? I really like him. Luo Shishen’s internship is almost over—when he leaves, my team will need help.”

Zhou Can shared his thoughts first, giving Dr. Xu something to consider.

Recruiting was ultimately up to Dr. Can, but Dr. Xu’s opinion mattered a lot.

Dr. Xu basically acted as a gatekeeper.

“Bring him in for a trial. We’ll need Director Lou’s help with Director Mi from general surgery—a heads up so there’s no misunderstanding. I’ll see if I can talk to Director Lou tomorrow, and let you know how it goes.”

Dr. Xu also had a high opinion of Yang Zhi.

In fact, for the last couple of months, Zhou Can had been searching for a medical assistant, but just hadn’t found the right person.