Chapter 53 If You Can Do Better, You Do It

Wang Qian bought Zhang Fan another complete outfit from head to toe. When Zhang Fan hesitated, she grew displeased. With her child studying abroad and her husband completely absorbed in his career—though going to work was somewhat better, the evenings were dreadfully boring—her husband's prominent position also made it inconvenient for her to mingle casually with just anyone. She had witnessed firsthand how genuine Zhang Fan’s character was and how deeply loyal and dedicated he was to Batu. Because of this, she held him in very high regard, recognizing not only his exceptional medical skills but also his fine moral character. Li Xiao and Dong Hua also held very favorable opinions of Zhang Fan.

Wang Qian had a stash of shopping vouchers issued by her workplace, some of which she couldn't even remember who had given them to her. After touring the department store, Zhang Fan drove Wang Qian home and was made to stay for dinner before finally being allowed to leave. Upon his departure, she showered him with cartons of cigarettes and packages of tea. This happened every single time Zhang Fan visited, making him feel almost too embarrassed to keep coming to her house.

Through that game of *Shuanghou*, Dong Hua had gotten to know Li Xiao. With Wang Qian interceding on her behalf, Dong Hua finally secured an opportunity for a personal audience with the senior leader—the outcome of which was exceptionally favorable, resulting in her appointment as County Head D. All of this felt worlds away from Zhang Fan. Whether someone served in an acting capacity or was formally appointed mattered little to him; he felt entirely indifferent to such matters. This, perhaps, was the tragedy of a technical specialist: their world revolved solely around their craft, believing that technical proficiency was the ultimate truth.

With the New Year approaching, the hospital was overflowing with various employee benefits. Rice, flour, cooking oil, and even vermicelli were distributed in abundance. This being Ouyang’s first year as head of the hospital, she was determined to let everyone share in a joyful celebration with her. Since Zhao Jun was not on night duty, Zhang Fan was likewise spared from working the night shift. This month turned out to be the most leisurely period Zhang Fan had experienced in over a year.

Early in the morning, the Hepatobiliary Surgery department had a scheduled operation. The condition was a pathology exceptionally prevalent in the Northwest: hepatic echinococcosis, also known as hydatid disease of the liver. This disease is predominantly endemic in provinces and regions with robust pastoral industries. Its etiology involves the canine tapeworm, which parasitizes the small intestines of dogs. The parasite's eggs, excreted in feces, frequently adhere to the fur of dogs and sheep. Humans become infected upon ingesting food or water contaminated by these eggs. Once inside the body, the digestive fluids in the intestinal tract cause the larvae to hatch from their shells. They penetrate the intestinal mucosa, enter the portal venous system, and are largely trapped within the liver. Within three weeks inside the host, the larvae develop into hydatid cysts. These cysts gradually enlarge within the liver, causing compression symptoms in adjacent organs depending on their location, and can lead to complications such as secondary infection, rupture with dissemination, and obstruction of hollow viscera.

In layman's terms, anyone living in pastoral areas must exercise extreme caution regarding contact with dogs or water sources and food contaminated by canine feces, as carelessness could easily result in hepatic echinococcosis. These parasites parasitize and multiply within the human liver. As time passes, the worms grow increasingly numerous and massive, exerting relentless pressure on the liver and triggering symptoms such as nausea, vomiting, and jaundice.

The department had a heavy surgical schedule that day. Several doctors rotating through the department scrambled to assist with gallbladder operations, while none wanted anything to do with the hydatid cyst surgery. It was simply too repulsive; opening a cyst revealed a massive mass of white, gelatinous parasites, enough to instantly induce vertigo in anyone suffering from trypophobia. Furthermore, if these procedures were not meticulously executed, recurrences were exceptionally common due to residual parasite eggs. Zhao Jun served as the primary surgeon, marking the first time Zhang Fan assisted him at the operating table.

From opening the abdomen and achieving hemostasis to suctioning fluids, Zhang Fan’s assistance put Zhao Jun completely at ease. The surgical field was impeccably exposed, and whatever Zhao Jun needed next, Zhang Fan had already prepared well in advance. Following the enucleation of the endocyst, the surgical site was directly flushed with alcohol. The procedure was essentially complete, leaving only the suturing. Intending to test Zhang Fan’s foundational competence, Zhao Jun remarked, "General surgery procedures are somewhat different from orthopedics. Are you familiar with abdominal closure? Would you like to take over the suturing?"

Although Zhao Jun had heard rumors that Zhang Fan was exceptionally gifted in orthopedics, he had never witnessed it firsthand and remained somewhat skeptical, prompting him to verify his skills first. Zhang Fan looked up at Zhao Jun and replied, "Certainly, Director Zhao, there shouldn't be any problem." With that, he immediately set to work. peritoneum, fascia, and muscle—Zhang Fan sutured with such extraordinary speed that the scrub nurse struggled to keep up with threading the needles. His movements were exceedingly practiced and his hands remarkably deft. Zhang Fan had no intention of showing off; this was simply his natural operating speed.

Watching Zhang Fan’s suturing technique, Zhao Jun paused in mild contemplation before saying, "Zhang Fan, you've been in hepatobiliary for a month now. How have you found observing the surgeries? Are you familiar with hepatobiliary procedures by now?" He viewed Zhang Fan as a resident with nimble hands, asking quite naturally and with a touch of admiration for his solid fundamentals. Having spent a rather stifling month in the department, Zhang Fan gave no thought to sparing Zhao Jun's feelings and replied bluntly, "Hepatobiliary surgeries aren't difficult."

"What!" Zhao Jun choked back a breath. "Very well, let's schedule a gallbladder procedure for tomorrow. Think you can handle it?"

"I can." Having already spoken the words, there was no sense in backing down or offering a timid retreat; it was entirely unnecessary.

Zhao Jun was genuinely angered. You could criticize his own personal technical skill, but you could not dismiss hepatobiliary surgery as lacking in difficulty—doing so was a direct negation of a lifetime of arduous effort and earned accolades. It was impossible not to be furious. Given the unique pastoral demographics of the frontier, the Hepatobiliary Surgery department held a prominent and undisputed ranking nationwide in China. Though provoked, he was far too mature to engage in a petty verbal argument with Zhang Fan.

At the morning meeting the following day, after reviewing the scheduled operations, Zhao Jun announced, "The hospital has organized rotations for resident doctors with the objective of familiarizing young physicians with the basic pathologies of each department and enabling them to perform simple, foundational surgeries. We cannot simply go through the motions. Since the rotating doctors are about to finish their tenure here, our department will hold an examination, the results of which will be recorded in their rotation reports. Today's gallbladder procedure on Patient in Bed 5 will be performed by Dr. Zhang Fan as his graduation examination for this rotation."

Hearing this, the faces of the other rotating doctors turned pale. Even with daily exposure to surgeries, it had only been a month! A cholecystectomy? Had the department director lost his mind and started talking nonsense in his sleep? And to have it recorded in their rotation reports—wasn't that sheer murder?

Part of Zhao Jun's motivation stemmed from bruised pride. Within the hospital's general surgery division, hepatobiliary had been the first specialty to break away and establish its own department. Yet to this day, aside from hydatid cyst procedures which they performed quite brilliantly, their repertoire was essentially limited to cholecystectomies, while other advanced procedures were poorly developed; currently, even pancreatic pseudocysts were rarely tackled. The veteran head of general surgery frequently remarked that they never should have broken off. Therefore, upon hearing Zhang Fan's remark yesterday, he deliberately assigned him the case today to let Zhang Fan see for himself whether it was difficult or not.

Despite acting out of spite, the patient he selected was relatively young, exhibited minimal gallbladder adhesions, and presented a very low surgical risk. His sole intention was to make everyone understand that hepatobiliary surgery was no trivial matter, and he personally served as Zhang Fan’s first assistant.

Inside the operating room, routine laparoscopic procedures typically did not permit rotating doctors to handle the trocar insertions out of fear of complications; an improper application of force resulting in the perforation of an internal organ would spell serious trouble. After scrubbing and sterilizing, Zhang Fan commenced the operation. Initially, Zhao Jun intended to let him try, fully expecting clumsy mechanics that would prompt him to immediately relieve Zhang Fan of the instruments, followed by a stern lecture on the necessity of keeping one's feet on the ground rather than aiming too high. Instead, from the very first trocar insertion, Zhang Fan executed every step flawlessly.

Exposing the cystic duct, dissecting and ligating the cystic artery, removing the gallbladder, and achieving hemostasis—the entire sequence was executed with astonishing proficiency. Zhao Jun had planned to intervene if Zhang Fan even showed awkwardness in handling the laparoscope, but the progression evolved from initial anxiety to reassurance, and finally to sheer shock. Throughout the entire procedure, Zhao Jun did not utter a single word. As the surgery concluded, gas was evacuated, and the puncture sites were sutured, Zhao Jun stepped away from the operating table and walked straight out of the operating room.

The second assistant, an attending physician, was equally dumbfounded. "Dr. Zhang, you're a beast! You left the boss utterly speechless. That surgery was so clean and crisp—even I couldn't reach that level of proficiency. Why are you even bothering with rotations? Just have the boss speak to the president and have you permanently assigned to our department!"

Emerging from the operating room, Zhao Jun walked back to his office, dropped heavily into his chair, and sat in a daze for a long while. Having quit smoking long ago, he pulled out a cigarette and lit it. "Can it be that grassroots hospitals truly shouldn't split off hepatobiliary surgery? Is it really that simple?" His worldview was on the verge of collapse.

The next day, the rotation of doctors through surgeries resumed. One of them nearly caused a disaster during trocar insertion and was instantly chased away from the operating table by Zhao Jun, leaving the young resident on the verge of tears. With only a month in total and never once being allowed to handle the trocar, how could anyone pass such an examination? Yet, despite booting the doctor out, Zhao Jun was not angry; in fact, he felt rather pleased. Zhang Fan was an exception—an absolute anomaly. Hepatobiliary surgery did indeed possess genuine difficulty. Comforted by this thought, his equilibrium was largely restored.

In the director's office, Zhang Fan sat across from Zhao Jun. Old Zhao tossed a cigarette to Zhang Fan, who deftly struck a match and lit it for him. Zhao Jun then said, "Not bad, you've put in some serious hard work this past month. Truth be told, hepatobiliary surgery offers vast potential. Liver transplants and pancreatic tumors are world-class procedures in terms of difficulty. What do you say, are you interested? If you are, once your rotation finishes, I'll go to the president and personally request you." He had experienced firsthand just how exceptional Zhang Fan was, and he had no intention of letting such talent slip away.

While advanced programs like liver transplants had not yet been established at the hospital, the volume of hepatobiliary cases was genuinely staggering. Due to dietary habits in the Northwest, stones were exceptionally prevalent, and being situated in a pastoral region, the incidence of hydatid disease was the highest nationwide. His primary goal was to accumulate surgical volume, making the specific department largely irrelevant. "Director, since you hold me in such high regard and show me this favor, as long as no other department claims me, I'll come here." Zhang Fan refrained from making an absolute commitment, knowing that general surgery, urology, and cardiothoracic surgery all offered substantial surgical opportunities as well.

"What!" Zhao Jun was thrown into disarray. The kid wasn't even entirely enthusiastic about joining them!