Chapter 4
Rushing through red lights and lightning, the patient was wheeled into the operating room.
“Good morning, Director Liu! Good morning to all senior doctors!”
Zhou Can saw that there were already seventeen or eighteen people inside, each dressed in surgical protective clothing with masks and head covers. Honestly, without careful identification, it’s quite easy to mistake one person for another.
Greeting people, he now had the experience.
He would greet Director Liu, who held the highest position, separately, and could just use “senior doctors” to collectively address the others and be done with it.
Typically, Director Liu would be at the outpatient clinic in the mornings.
The early surgery today probably meant there was a temporary change in schedule.
“In the afternoon, I need to attend a seminar at the Provincial Medical Association. I’ll leave after finishing this surgery. Let’s start promptly!”
Director Liu’s qualifications are actually quite senior, but he’s a bit lacking in academic achievements, and has been stuck at the associate chief physician level without advancing. Shedding that “associate” title is what he most longs for before retirement.
His eagerness can be seen from his frequent participation in various academic conferences.
The patient was lifted onto the operating table with combined efforts.
The circulatory nurse asked the patient to take off his upper garments and performed another skin preparation. Then the anesthetist came over to check the patient before anesthesia, and after ensuring he met the criteria, started to install various life-monitoring probes on the patient’s body, put on the breathing mask, and so on.
In a major surgery, the importance of an anesthetist is no less than that of the chief surgeon.
He is responsible for monitoring the patient’s vital signs throughout the procedure and providing timely suggestions.
This was a surgery for the excision of cervical lymph node tuberculosis, classified as a Level 3 general surgery.
Surgery of this caliber requires at least a director-level surgeon to be the chief surgeon.
Even experienced attending physicians could only take part as first or second assistants.
The danger of the surgery goes without saying.
Zhou Can is just an intern, he only had a moment of glory while transporting the patient to the ward. Now that the patient was on the operating table, he didn’t even have the chance to hold a retractor.
He could only stand at the back and observe for learning.
In fact, observing such major surgeries a couple of times can still be novel. But without getting hands-on experience after watching it several times, what you learn is very limited.
Interns often mock themselves with the phrase “a fleeting glimpse.”
Which tool to use in which part of the surgery, how to operate, it’s fundamentally impossible to remember.
Only some emergency situations that require the use of life-saving drugs make a lasting impression.
“Mr. Gao, can you hear me speak?”
The anesthetist had administered anesthesia through inhalation, and the patient’s eyes had already listlessly closed.
Calling the patient is a way to test their responsiveness.
The patient seemed to be in deep sleep with no reaction.
The anesthetist checked the patient’s limbs again, then turned to look at the life-monitoring screen to check the various indicators.
“Anesthesia is successful, the patient’s vital signs are stable, we can begin the surgery.”
Clearly, this was directed at the chief surgeon.
Director Liu had the scrub nurse help him put on his gloves, and the first, second, and third assistants all took their respective places.
This preparation was very much like the charge before a battle begins.
Except the warriors’ enemy to be vanquished was disease.
“Make the incision!”
The chief surgeon said to the first assistant.
For such a major surgery, the chief surgeon generally only does the most critical part of the procedure.
That’s also the most challenging part.
You see, the first assistant holds the knife at the marked position, cutting through the patient’s cervical skin with calm steadiness.
With the area being densely populated with blood vessels and lymph nodes, Zhou Can felt a tingling on his scalp.
If it were him making the incision, he wouldn’t dare to cut.
With the incision, dissection, and other preparations in place, the second and third assistants were also vigorously using hooks to widen the surgical wound, increasing the chief surgeon’s field of vision and creating favorable conditions for the surgery.
A lymph node the size of an egg could be seen, surrounded by several other lymph nodes of varying sizes. The carotid artery was pulsating vigorously.
Excising these diseased tissues in an area dense with blood vessels and nerves greatly increases the difficulty of the surgery.
The lead surgeon was fully concentrated on dissecting the largest lymph node.
His expression was focused, his movements steady, delicate, and skillful.
The assistant was also coordinating very well.
Whenever there was a bleeding point, it was immediately cauterized. Just like playing whack-a-mole, precise and swift.
Zhou Can watched with great admiration.
Just as the surgery reached the halfway point, the patient suddenly began to convulse, and their vital signs dropped sharply.
Following that, the monitor started emitting a beeping alarm.
“Not good, the patient’s blood pressure has plummeted to below 60, breathing is abnormal, heart rate 160… Director Liu, did you injure the patient’s carotid artery?”
The anesthesiologist asked anxiously.
“No!”
Director Liu had seen all sorts of dangerous situations, was not panicked amidst crisis, and always remained calm.
“It’s also very unlikely that we’ve injured any major nerves. There are no respiratory nerves in this area.”
The first assistant added.
The resident doctors behind them were at a loss. The interns were even worse, overcome by panic and feeling completely helpless.
During this very brief interval, the anesthesiologist told everyone more bad news: the patient’s condition had rapidly deteriorated and they had entered a state of shock.
Shock is very close to death.
Director Liu’s forehead was suddenly covered in sweat.
“Wipe the sweat!”
The scrub nurse quickly stepped forward to wipe Director Liu’s forehead.
Panic spread quickly in the operating room.
If the patient were to die on the operating table due to an unknown cause, Director Liu’s lifelong reputation would be ruined, and everyone involved in the surgery would be shamed.
Zhou Can took a deep breath, exhaled, and adjusted his tense mood.
Forced himself to remain calm.
At this moment, he actually felt an invisible responsibility weighing on his shoulders.
Protecting the patient’s life and health is the mission of every doctor.
Even knowing his own capabilities were limited, he still wanted to contribute.
This patient happened to be under his care for the surgery, so he was very familiar with the patient’s condition, symptoms, and all the test results.
He began to ponder over the patient’s medical records, medical history, and various examinations.
Then, he accidentally noticed some red rashes appearing on the patient’s skin.
He seemed to have thought of something.
“Yes, it must be this!”
Zhou Can suddenly blurted out something that seemed nonsensical, catching everyone by surprise.
“Xiao Zhou, be quiet. Didn’t you see that Director Liu and the attending physicians are thinking?” The Resident Chief reprimanded him coldly.
“Director Liu, I’ve found the reason for the patient’s sudden shock.”
Zhou Can ignored the Resident Chief’s warning and looked excitedly at Director Liu.
This time, everyone was shocked.
They all turned to look at the intern standing in the back row.
Even the experienced Director Liu and attendings couldn’t find the cause; could an intern, who usually performed very ordinarily, find the reason for the patient’s shock?
They didn’t believe it.
“Let’s hear it!”
After recovering from his initial surprise, Director Liu decided to listen to the intern’s opinion.
But he didn’t hold much hope.
In his many years of teaching, he had seen too many young proteges with high aspirations but fragile as paper. They thought they were so great after a few days of reading books and learning some medical knowledge, arrogantly thinking they were so impressive.
Their analysis of various diseases was also very unrealistic, based solely on personal subjective conjecture. In the end, it was laughable.