Chapter 504: A Surgeon’s Dilemma

It wasn’t until 12:43 that Zhou Can finally finished all the emergency surgeries and dealt with the patients he’d admitted yesterday who were waiting for surgery.

Some injuries and urgent cases in the Emergency Department have to be treated right away.

There’s just no way to put those off.

Whenever patients like this come in, you have to act fast. Do some quick tests, figure out the cause, and as the attending doctor, decide if the case can be handled there in the ER. If not, you either ring up the appropriate department to have them take the patient off your hands…

But more often than not, even if the ER can’t handle it alone, you at least have to start some lifesaving procedures right away.

Stopping the bleeding, defibrillating, establishing an airway—things like that.

As for those patients who can be operated on directly in the ER, they pretty much line up one after the other for surgery, like an assembly line.

Lately, Zhou Can had been intentionally doing fewer basic Level I and II surgeries, letting the other surgeons in the OR handle them.

He focused more on the tougher surgical cases.

He’d gone from doing just two major (Level III) surgeries a day to three or even four.

If a Level I or II surgery looked tricky but another doctor was confident, they’d do it. If not, Zhou Can or Dr. Xu always got the case.

Splitting it up this way was helpful for Zhou Can and the rest of the surgical team in the ER.

By now, Zhou Can had pretty much become the new star of the Emergency Department OR. Sticking him with just simple surgeries wasn’t good for his growth—and the department’s leaders wanted him to get as strong as possible.

After all, how can a leader take the Emergency Department to new heights if he’s too weak?

Giving the simpler cases to the others also gives them a chance to hone their own skills.

As their surgical abilities grow, they’ll be ready to tackle even harder operations.

And if things go right, all of this builds into a virtuous cycle.

Stepping out of the OR, Zhou Can immediately spotted a man in his forties sitting on the bench across the hall. The guy had short, neatly styled hair, dressed well, a calm gaze, but looked terribly worn out.

“Excuse me, are you Dr. Zhou?”

As soon as Zhou Can exited, the man stood up to ask.

“That’s me!”

Zhou Can walked straight over to him.

“Are you the patient who specifically asked to see me?”

“Yes, yes, that’s me!”

The man nodded quickly, but before he could say more, he pressed a hand to his chest and started coughing—a harsh, raspy cough that clearly hurt him.

[Due to the current environment, this website may close at any time. Please switch to the permanently available Huanyuan app as soon as possible.]

“What’s hurting? Come, have a seat and tell me slowly. There’s no rush.”

Even though Zhou Can was a good dozen years younger, he spoke to the man with real concern, almost like an older brother.

“It’s all right! I had heart surgery once. Ever since, I’ve had constant coughing. Recently, I’ve been having heart palpitations and shortness of breath, and sometimes, sharp pains in my upper abdomen. I’ve been to a few major hospitals—everyone said I have a really severe aortic dissection.”

He picked up a folder from the bench as he spoke.

He handed Zhou Can the scans from his other hospital visits.

Zhou Can glanced at the images, and his face changed in an instant.

“Oh wow, this is serious. The dissection runs all down the main branch. Honestly, I’ve never seen a tear this huge. And that’s the aorta—if it ruptures, there won’t even be time for rescue. You really can’t wait any longer. This needs to be addressed immediately.”

Zhou Can had assisted Dr. Hu Kan on his fair share of major surgeries.

He’d helped with some dangerous aortic dissections before.

But never anything as severe as what he saw in this patient. The torn area was just too long.

Blood from the dissection had pooled into a long, shadowy water sac in the chest and abdomen.

With something this massive, the risk of rupture is sky high.

Even at a top hospital like Tuyu, if a patient gets diagnosed with aortic dissection—even if they haven’t had angina yet—the doctors immediately issue a critical emergency notice.

Only doctors truly understand how dangerous aortic dissection really is.

“I asked several major hospitals, and they all told me the only option was to replace the entire diseased section of my aorta with an artificial blood vessel. The incision starts at the chest and goes down to the thigh. They said the risks are huge: paralysis, even death during surgery.”

The man was composed and organized, fully aware of the risks and details of the procedure.

Clearly, he’d consulted other surgeons and understood exactly what was involved.

With a tear this long, putting in a stent is almost impossible.

This aorta has lots of branches supplying blood to the organs in the chest and abdomen.

If you block the dissection with a stent, you’ll also block those other branches—and then multiple organs would lose their blood supply. That’s not saving someone, that’s pushing them closer to death.

Replacing the entire aorta is hard, but if your surgical skills are strong enough, it’s still possible.

If Zhou Can could bring his ligature technique up to level six, he’d have the skill to try this kind of operation.

“The trauma is big, and the risks—during and after surgery—are impossible to predict. But honestly, with your dissection this severe, every day you wait is like walking around with a ticking time bomb. It’s even worse than that.”

This was not something that could be delayed.

Any sudden emotions or an uncontrolled blood pressure spike might make the dissection rupture.

And then, blood would pour through the chest and abdomen like a dam burst out of control.

There’d be no way to save them, not fast enough.

A ruptured aorta is deadlier than even a severed carotid artery.

Outcomes are almost always terrible. The fatality rate is nearly 100%.

Cutting someone’s throat is horrifying, but as long as they get to the hospital quickly, most can be saved.

But the aorta is deep in the chest and abdomen. If it bursts, there’s no way to stop the bleeding without opening up the chest.

And even after opening the chest, it probably still won’t help.

If you tie off or clamp the aorta, it cuts off blood to almost the entire body. If the limbs go without blood for over half an hour, they risk necrosis.

Organs are even more delicate. Some start dying in as little as three minutes without blood.

Once an organ starts dying, there’s usually no turning back.

“Dr. Zhou, the reason I came all this way to see you is because I’m hoping you have a solution. I really want to avoid having my entire aorta swapped out. One of my subordinates told me they watched your livestream surgery yesterday, where you cured a heart condition that not even a Japanese expert from Imperial Capital Renhe Hospital could handle.”

For this man to make his way here so quickly shows he’s not ordinary.

His accent didn’t sound local, either.

“Where are you from, if you don’t mind my asking?”

“Oh, I’m from Magic City. My family runs a small business. After hearing your story last night, I thought it over and flew out early this morning just to see you.”

“Thanks for your trust. Honestly, I’m just a regular doctor at Tuyu Hospital. That surgery yesterday only worked out half because of luck—I’m really not as amazing as you’d think.”

Zhou Can didn’t buy the line about a ‘small business’ for a second.

He’d dealt with his fair share of tycoons and power brokers.

There was a quiet authority about this man, a confidence you couldn’t quite put your finger on. If Zhou had to guess, this guy was strong both financially and in terms of connections.

He was probably either from a top family or an influential government background.

If his treatment failed, Zhou Can had no interest in becoming the next Master Yi Yidao.

He’d seen firsthand just how miserable Dr. Xu’s situation was.

So, if he could avoid taking the risk, he absolutely would.

Doctors have to look out for themselves too, or they won’t last long enough to save anyone else.

“How about this—go grab some food first. I know your time’s important, we can talk when you’re ready. I can tell there’s a hint of worry deep in your eyes about me. Trust me, I’m not unreasonable or a bully. And gratitude means a lot to me.”

The man was sharp—he even spotted that tiny flicker of unease in Zhou Can’s eyes.

For all that Zhou Can was now worth over a hundred million, he found himself crushed by the man’s sheer presence.

From start to finish, this man’s aura was overwhelming.

A person’s aura comes from every part of who they are—their wealth, their knowledge, skills, connections, and family background, plus the resources they control.

When it comes to resources, officials always come first, business tycoons second.

It’s always been that way, all throughout history.

But in modern times, money has started beating everything else.

The man made it clear—he never forgets a debt. Meaning, if Zhou Can cured him, he’d be a lifelong benefactor.

There would probably be plenty more interactions in the future.

He never revealed his real identity, but he was definitely using it as leverage.

“Have you eaten yet? If not, I’d be happy to invite you to our staff meal at the hospital cafeteria.”

He had come all the way to see him, after all.

Even if Zhou Can didn’t treat him, a cafeteria meal wasn’t much to offer.

“I’ve already eaten. Don’t worry—just go. Let me know when you’re available, I’ll come back then.”

The man replied.

“I have a packed afternoon with more surgeries, so I probably won’t be free until evening. Since you traveled so far, how about you leave the files with me? I’ll review everything as I eat and give you a concrete answer by the time you come back.”

With that, he was gently signaling that if the case proved too difficult, the man should seek another expert.

When dealing with these second-generation elites, attitude was everything.

So long as you showed enough sincerity, even if you turned someone down, they probably wouldn’t hold a grudge.

“Here! I’m counting on you!”

The man handed over the folder.

“No need to thank me. It’s just what doctors do.”

Zhou Can took the file and hurried to the cafeteria.

Qiao Yu had already picked out his meal.

Watching Zhou Can eat while reviewing the scans, Qiao Yu grew curious. “That patient didn’t look like a regular man. What’s he got?”

“Aortic dissection. And it’s pretty severe.”

“Looks like your livestream surgery yesterday made you famous. I bet more people will come to you now.”

Qiao Yu teased with a grin.

“Sigh. Humans fear fame just like pigs fear getting fat. The moment a pig fattens up, it’s headed for the knife. When people get famous, trouble follows. I just hope for more ordinary patients so I have time to grow. Fewer big bosses and rich kids would really be better.”

Zhou Can gave a heavy sigh.

Other doctors dreamed of fame.

He, on the other hand, was troubled by all these hard-to-treat patients seeking him out now.

It all came down to not being skilled enough yet.

Kind of like always wishing you had more money.

On paper, he was worth a lot, but there was a limit to what he could actually do.

Buy an apartment in a top-tier city, and you could burn through it all in one shot.

Same thing for surgical skill. No matter how strong you get, it always feels like it’s not enough. Compared to before, he’d grown immensely.

But he was still far, far away from the peak of medical mastery.

“If that patient’s got a sensitive identity, it’s safest to just refuse. Anyone important struck by a serious illness will search the world for the best. If even the top experts couldn’t help, you’d better not try—the risks aren’t worth it.”

Qiao Yu was sharp; she immediately sensed this wasn’t an ordinary patient.

“You’re right, Sister Qiao. If I have to push him away, I won’t hesitate. And if it gets awkward, I’ll have you turn him down for me.”

Ma Xiaolan always had a spicy personality and a quick tongue.

She had one good side—tough on patients, but she always looked out for the team and those close to her.

Whether Zhou Can was having trouble with a tough patient or another nurse was in a bind, she always had their backs.

Sometimes when she argued with patients or their families, Zhou Can actually admired her even more.

Everyone has flaws, and Ma Xiaolan certainly had plenty. But the more Zhou Can worked with her, the less he ever thought of having her leave.

“No need. I already warned the patient: if his case is beyond me, he’ll have to look elsewhere. He did come all this way, so I have to do my best.”

Zhou Can always did his best by his conscience.

After reviewing the scans and lab results, Zhou Can fell deep into thought.

The man’s name was Chen Zhongzhi—age 42, no other major illnesses.

It all came down to this aortic dissection.

A full aortic replacement was risky and traumatic. But putting in a stent could choke off the other vital branches.

This was a truly thorny operation!

Even after he finished eating, Zhou Can couldn’t figure out a way to solve the problem without a total aorta replacement.

He grabbed the folder and got ready to tell the patient it was better to see another expert.

But after searching, he found that Chen Zhongzhi had already left the Emergency Department.

Left with no other choice, Zhou Can put the folder in his office and went back into surgery.

He figured the man would return by the end of the day.

One by one, patients came through, and with the help of the whole team, their illnesses were cured.

Most patients recovered quickly and could go home to rest with just some medication.

The more severe cases needed inpatient treatment for a while.

“Ow, ow, ow… ow…”

A patient groaning in pain was wheeled in.

Anyone in this much agony surely isn’t here for something minor.