“Who gave you permission to use Operating Room 7?” I had just taken off my mask, my hands not completely out of the sterile field, when the words were thrown in my face. I looked up to see Eric Crawford standing in the middle of the hallway. His white coat was crisp, and his name badge gleamed glaringly under the lights. “Effective immediately, you’re suspended.” The surrounding area suddenly went quiet. The lights at the nurses’ station were on. Several doctors stopped in their tracks, all turning to look at us. I let out a short laugh. “Excuse me?” Eric took a step forward, raising his voice. “I said, you’re suspended. Operating Room 7 is no longer open to you.” “And whose authority is that on?” Right in front of everyone, he reached out and ripped the schedule off the wall at the nurses’ station with a loud tear. “The Chief Administrator’s.” I nodded and didn't say another word. In that moment, I knew this wasn't a spur-of-the-moment decision. I took out my phone and sent a text to the Mayor. “I apologize, but my surgical privileges have been revoked. I'm afraid I won't be able to perform your wife's liver transplant.” 01 The operating room doors slid shut behind me. The moment the red light above them went out, the tension in my shoulders finally released. For ten straight hours, I had stood at the operating table, performing a highly complex organ transplant. I had personally verified every single suture. When they wheeled the patient out, the curves on the monitor were clean and sharp. I took off my surgical mask, the sharp smell of antiseptic still lingering in my breath. Just as I rounded the corner of the hallway, a figure stepped directly into my path. “Dr. Zhang.” The tone was disrespectful, the volume intentionally loud. I looked up and saw Eric Crawford. He was wearing a spotless white coat, his name badge so new it reflected the light. An intern on the surgical team, personally mentored by Chief Administrator Lauren Chen. He stood ramrod straight, as if he had been waiting here for a long time. At the nurses' station and in the waiting area, several doctors stopped what they were doing, drawn by his shout. “Who gave you permission to use Operating Room 7?” Eric raised his chin, projecting his voice so everyone could hear. “Effective immediately, you’re suspended.” The air instantly tightened. I froze for a second. It wasn't that I'd never encountered arrogance before, I just hadn't expected it now. I gave a slight smile and tossed my gloves into the biohazard bin. My tone was very light. “Oh? And whose authority is that on?” He sneered, as if he had been waiting for that exact question. Right in front of me, he reached out and ripped the schedule off the wall at the nurses' station. The sound of the paper tearing was unusually loud in the quiet hallway. “The Chief Administrator’s.” After saying that, he tossed the torn schedule aside, a corner of the paper brushing against a nurse's hand. No one made a sound. I saw a few young doctors lower their heads, pretending to organize charts. The head nurse's lips moved, but she ultimately said nothing. I nodded. “Understood.” My tone was so calm it surprised even me. Eric was visibly taken aback, clearly not getting the reaction he wanted. He took another step forward and lowered his voice, though still loud enough for those nearby to hear clearly. “Elias Zhang, know your place. You should know perfectly well who runs the surgical department now.” I didn't answer him. The light for Operating Room 7 was still on. Through the glass window, I could see them finishing up at the instrument table. That surgery was my first since returning to the States. It was also the first time since my fellowship abroad that I was truly standing at the core of this hospital. I walked past him toward the locker room. A scoff came from behind me. “Keep pretending.” In the locker room, I washed my hands for a long time. The sound of the water drowned out the noise outside. The man in the mirror had dark circles under his eyes and a red indentation on his forehead from the surgical mask. Elias Zhang, forty-two, surgeon. I had completed numerous complex transplant surgeries abroad. According to protocol, I was supposed to be a key pillar in the hospital's next phase of development. And now, I had been publicly suspended by an intern. My phone vibrated in my pocket. I pulled it out and saw the name: Lauren Chen. She was the Chief Administrator of this hospital, and also my wife. The message was brief. “Don't cause a scene yet. Let me handle this.” I stared at that line of text for a few seconds before the screen went dark. She hadn't shown up. No explanation, no denial. That scene in the hallway wouldn't have happened if she hadn't given the nod. It suddenly became very clear to me: this was no misunderstanding. When I returned to my office, the door was slightly ajar. On the desk, my nameplate had already been removed, leaving only a faint residue of adhesive. Administration moved fast. I stood there for a moment, then began packing my personal belongings into my bag. I moved unhurriedly, even neatly organizing the documents one by one. Someone knocked on the door. It was an older colleague from the surgical department, his voice kept very low. “Elias... why don't you head home and rest for a few days?” I nodded. “Okay.” He hesitated, wanting to say more, but ultimately just let out a sigh. When I walked out of the administration building, the sky was already dark. I stood on the steps and lit a cigarette for myself. As the smoke rose, I remembered when Mayor Richard Evans came to inspect the hospital three years ago. Mayor Evans was a man of few words. He stood in the hospital room, his gaze direct when he looked at people. At the time, he asked me a question: “If the risks become uncontrollable, will you stop?” I answered: “Yes.” He said: “Good.” Later, the Mayor's wife, Sarah Evans, was diagnosed as needing an organ transplant. After several rounds of evaluation, it was finally decided that I would be the lead surgeon. It was a surgery with zero margin for error. My phone lit up again. Without hesitation, I opened my contacts and sent a message. It wasn't long, but every word was clear. “I apologize, but my surgical privileges have been revoked. I'm afraid I won't be able to perform your wife's liver transplant.” Sent successfully. The cigarette burned down to the filter, and I stubbed it out in the ashtray. In the distance, the lights in the inpatient building flickered on one by one. Down the hallway, Eric Crawford was standing amidst a group, talking excitedly, looking as if he was already used to being the center of attention. No one noticed me. Right now, everyone thought I was just a suspended doctor. But I knew that some things were just beginning to change. 02 Early the next morning, I arrived at the hospital as usual. When the security scanner at the entrance read my ID badge, the red light flashed once before the turnstile opened. The security guard glanced at me but said nothing, quickly looking away. I entered the inpatient building. The elevator was packed with white coats. Normally, people would nod and greet me, but today, everyone seemed suddenly fascinated by the floor indicator, staring intently at the changing numbers. The elevator reached the sixth floor. The sign for the surgical department was still there, but the air inside was noticeably different. The whiteboard at the nurses' station had a fresh sheet of paper. The handwriting was neat and clean. Under the "Lead Surgeon" column for several operations, "Elias Zhang" was missing. I put my bag down, pulled out my phone, and opened the hospital's internal system. A prompt popped up on the login screen: Insufficient Privileges. I tried switching accounts, but it still didn't work. I clicked on the surgical schedule. The screen looked as if it had been wiped clean. All the surgeries that were originally assigned to me were empty, showing only "Pending Assignment." I looked up to see the head nurse standing behind the counter, clutching a clipboard, her lips pressed tightly together, turning white. “Who changed the schedule?” I asked. Her voice was very small. “The administration office sent down a notice... they said you are to suspend all surgery-related duties and wait for further arrangements from the board.” “Where is the notice?” The head nurse hesitated for a moment, then opened a drawer and handed me a stamped document. The bold title read: Decision Regarding the Suspension of Surgical Privileges and Clinical Duties for Dr. Elias Zhang. It was issued by the administrative office, and the signature block bore Lauren Chen's name. I placed the paper back on the counter without furrowing my brow. A young nurse nearby whispered, “Dr. Zhang...” She had just opened her mouth when someone coughed lightly behind her. She immediately swallowed her words and lowered her head to continue organizing medication orders, though her fingers were trembling noticeably. The light cough came from Eric Crawford. He walked down from the end of the hallway, not hurrying, as if he were on patrol, accompanied by two interns. “Morning, Dr. Zhang.” He smiled politely, but his eyes looked as if he were taking roll. “Can't log into the system, right? That's normal. The Chief Administrator had someone handle it last night.” I looked at him. “Are you in charge of the surgical schedule now?” “Assisting temporarily.” Eric enunciated the word "temporarily" very clearly. “The Chief Administrator asked me to keep an eye on things, to prevent anyone from messing around. Don't blame me; rules are rules.” The area around the nurses' station grew even quieter. I didn't bother arguing with him and turned toward the department head's office. The door was unlocked. I pushed the door open to find two people sitting inside: the Deputy Director of Administration and a coordinator from Medical Affairs. There were folders laid out on the desk, as if they were waiting for me. The Deputy Director spoke first, his tone bureaucratic. “Dr. Zhang, we are just executing the board's decision. We need you to hand over your operating room access card, your anesthesia consultation sign-off privileges, and your emergency green-channel authorization.” “Even the emergency green channel?” I asked. The coordinator chimed in quickly to explain, “It's not stopping emergency care, it's just that you can no longer be the final signatory. The board has arranged a replacement.” “Who is the replacement?” The Deputy Director shot a glance at the coordinator and didn't answer directly. He just pushed a sign-off sheet across the desk. “Please sign this.” I didn't pick up a pen. The Deputy Director's smile stiffened slightly. “Dr. Zhang, please don't make this difficult for us.” I flipped to the last page of the sign-off sheet and saw a name written under the "Replacement" column: Eric Crawford. I looked up. “An intern as the final signatory?” The coordinator's face changed, and he quickly explained, “It's not the final signature, he's just assisting... the actual sign-off is still done by the Chief Administrator.” I closed the form. “I won't sign this kind of document.” The Deputy Director's voice grew colder. “Dr. Zhang, you are currently suspended from clinical duties. According to regulations, you must cooperate with the handover. If you refuse, we will have to report this through the proper channels.” “Then report it.” I stood up. “Tell the Chief Administrator to tell me herself.” I walked out of the office and bumped into an old classmate from anesthesiology in the hallway. When he saw me, he clearly hesitated, as if he wanted to say something but was afraid of being overheard. “Elias...” he lowered his voice. “Don't fight this head-on. The winds are changing in the hospital.” I nodded. “I know.” He sighed and hurried away. I went back to the locker room to change. Just as I hung up my white coat, my phone rang. Caller ID: Lauren Chen. I answered. She skipped the pleasantries and got straight to the point: “Why are you making a scene at the administration office? They are just doing their jobs.” “I was clarifying the name on the sign-off sheet,” I said. She paused for two seconds, her tone adopting that familiar "rational" edge. “Don't get hung up on these details. The hospital needs order right now. You just got back, you haven't adapted to many of the procedures yet. Taking a step back for a while is a good thing for you.” “Suspending surgical privileges is 'taking a step back'?” “Elias, don't put it so harshly.” Her voice grew tighter. “You're too emotional right now. If you keep going into the OR, there will be problems.” I gave her no room to maneuver. “Last night's surgery was a success. If you want to talk about risks, let the data speak for itself.” Silence on the other end. Then, she opted for a more direct approach: “I won't beat around the bush with you. The hospital needs to move forward, and we need people who listen. You are too domineering, and it makes many people uncomfortable.” “Who are these 'many people'?” “Don't push me.” Lauren's tone was clearly annoyed. “You've been abroad too long, you don't understand the rules here. The surgical department isn't your one-man show.” I heard footsteps and a knock on a door on her end, as if she were in a meeting. She lowered her voice, sounding like a warning: “Don't go looking for Mayor Evans again, and don't use the Mayor's wife as leverage. That is a patient, not your bargaining chip.” I didn't argue, nor did I explain. She took my silence as a concession, and her tone softened slightly. “I'm doing this for your own good. Go home and rest for a few days, don't hang around the hospital. Once this blows over, I'll make arrangements for you.” “Arrangements for what?” I asked. “You can do research, mentor the younger staff, write proposals,” she said breezily. “You don't necessarily have to always be on the front lines dealing with high-pressure clinical work.” I hung up the phone. The only sound in the locker room was the exhaust fan, monotonously annoying. I grabbed my bag and walked out of the surgical area. Just as I reached the elevator bank, Eric Crawford appeared again. He seemed to be deliberately guarding the main thoroughfare. Seeing me, his eyes flashed before he smiled even more warmly. “Dr. Zhang, the Chief Administrator talked to you, right? Head home and rest. The hospital has a lot of inspections coming up; don't make trouble for yourself.” “Inspections?” I stopped. Eric feigned casualness. “People from the city are coming to review procedures. I hear they're looking into OR management. Someone like you, just back from abroad, shouldn't get mixed up in this. Don't worry, I'll help the Chief Administrator keep an eye on the surgical department.” He emphasized the words "help the Chief Administrator" very loudly, seemingly to make sure the passing nurses heard him. The elevator doors opened. I didn't get in, turning instead toward the other side of the inpatient building. Over there was the ward consultation room. I originally had post-op follow-ups with two transplant patients today, and I needed to see them. Just as I pushed the door open, the attending physician inside immediately stood up. He moved so fast that his chair legs scraped harshly against the floor. “Dr. Zhang... this consultation has been changed,” he said. “Changed to when?” “Medical Affairs sent a notice... another team is taking over.” He avoided my eyes. “Don't show your face for now. The patients' families are very emotional. If they make a scene, it'll be hard to clean up.” “Who is taking over?” He paused for a moment before saying, “Eric Crawford is following along... it's an arrangement from the Chief Administrator.” I stared at him. He couldn't hold my gaze and added in a low voice, “There's nothing I can do. The paperwork has already been issued.” I didn't ask anything else and turned to leave. At the end of the hallway, a patient's family was waiting. When they saw me, their eyes visibly lit up. “Dr. Zhang, how is the patient from last night's surgery doing?” someone asked urgently. “We heard you were back and wanted you to look at my dad's report.” I stopped, keeping my tone as steady as possible. “You can give me the report, I'll look at it. But the hospital is reorganizing all your surgical arrangements now. Medical Affairs will inform you of the specifics.” The family member was stunned. “You're not doing it anymore? Weren't you always in charge?” I didn't give any emotional response, just said: “The hospital has made a decision.” The moment those words left my mouth, I could feel the surrounding stares become denser. A few nurses standing nearby seemed to suddenly find their trays very heavy. I flipped through two pages of the report, marked two key indicators, and handed it back. “Control it with this regimen for a week, then recheck.” The family thanked me profusely, but they still weren't satisfied. “Dr. Zhang, we only trust you.” I didn't acknowledge the comment, just nodded and walked away. I didn't need anyone to cry foul for me. Every step I took here was being watched. When I reached the lobby on the first floor, I saw a new notice posted on the bulletin board. “During the special rectification period for the standardization of surgical operating rooms, the allocation of operating rooms, authorization sign-offs, and personnel deployment will be centrally managed by the Administrative Office.” The notice was stamped at the bottom. A few people nearby were whispering, but they immediately scattered when they saw me approach. I stood in front of the notice board for a while before turning and heading toward the parking lot. Just as I started the car, my phone vibrated again. It wasn't Lauren, nor was it anyone from the hospital. It was a reply from the Mayor's Office. Just two words. “Please wait.” 03 I didn't go back to the hospital. By the time I pulled up to the gate of our community, it was completely dark. The guard at the booth saw me and raised the barrier as usual, without a second glance. The lights were on at home. I went in and changed my shoes. The living room was very quiet; the TV was off. Two plates of food that had already gone cold sat on the dining table. Lauren was sitting on the sofa, holding a tablet, seemingly reading over some materials. Hearing the noise, she looked up at me, her tone flat. “You're back?” I placed my keys in the tray on the entryway table and didn't reply, walking to the dining table to pour a glass of water. “You don't need to go back to the hospital anymore,” she said, closing the tablet and standing up. “I've already made it clear to administration. I told them to stop bothering you.” “Made what clear?” I asked. “That your emotional state isn't suitable right now, and you need to take a break,” she said, walking over and picking up the cold dishes to carry into the kitchen. “You acting like this will only make things more rigid.” I followed her into the kitchen and watched as she dumped the food into the trash. “The sign-off sheet for Eric Crawford—did you authorize that?” Her hands paused, but she didn't turn around immediately. “He's just acting as a proxy,” she said. “The final process still comes to me.” “He's an intern,” I stated. “So what?” She turned around, her tone growing impatient. “Stop constantly using status as an excuse. Young people need to be trained; someone always has to take over eventually. Is there any point in you fixating on one name right now?” I leaned against the doorframe, watching her. “That transplant surgery was my patient.” “I know,” she frowned. “But the hospital doesn't revolve solely around you. How long have you even been back in the country? Can you keep up with the changes in the surgical department over these past few years?” “You think I can't keep up?” She didn't answer directly, just sighed. “Elias, you're too stubborn. The way they do things abroad doesn't apply everywhere.” I gave a small smile. “So which way applies here? Putting an intern on the front lines?” Her face finally darkened. “Do you have to talk like this?” She tied a knot in the trash bag. “You just can't accept change right now. Do you think you're still the only option, like back then?” I stopped smiling. “You already have your answer,” I said. She stared at me, as if weighing the gravity of my words. The living room fell silent, save for the low hum of the refrigerator compressor. After a few seconds, her tone softened slightly. “I won't deny it. What I have to consider right now is the entire hospital. The Chief Administrator position cannot be empty, and someone in the surgical department must be able to hold the fort. It's unrealistic for you to come back and expect to pull everything back to the way it was.” “So you chose him,” I said. She didn't deny it. “Eric is at least obedient, and he's willing to work,” she said. “He knows which side to stand on.” That sentence landed more clearly than any accusation. I nodded. “Understood.” She seemed surprised that I agreed so quickly and was taken aback for a moment. “What do you understand?” “What you want isn't a successful surgery,” I said. “It's for the positions to align with your ideas.” Her brow twitched, and she lowered her voice. “Don't make it sound so ugly.” “Then make it clear.” I looked her straight in the eye. “If someone else had been suspended today, would you have been so decisive?” She avoided my gaze and went to pour some water. “You're too sensitive,” she said. “Between husband and wife, we shouldn't always assume we're on opposing sides.” “But you've already taken a side.” The water glass clicked lightly as she set it on the counter. She looked up at me, her eyes showing clear impatience for the first time. “Elias, this attitude of yours right now isn't doing anyone any good.” “I'm not sure if it does you any good,” I said. “But for me, no, it doesn't.” She was silent for a moment before her tone became more direct: “You have zero authority and zero say right now. Continuing to make a fuss will only make this harder to clean up.” “So this is a warning?” “This is a fact.” I didn't continue the conversation, turning instead toward the study. The door to the study was ajar, and it looked exactly as I had left it. A few medical journals were piled on the desk, and the suitcase I had brought back, still not fully unpacked, sat in the corner. I pulled the suitcase out and started throwing clothes in. She followed me in and stood in the doorway. “What are you doing?” “Moving out for a while,” I said. “Is that necessary?” Her voice rose slightly. “Your home is right here.” “Here, what I say doesn't count.” I zipped up the suitcase. “A change of scenery will be quieter.” She stared at me, as if looking at a stranger who had suddenly appeared. “Are you trying to go against me now?” she asked. “No.” I stood the suitcase up. “I just don't want to be a part of your decisions anymore.” She let out a cold laugh. “You think taking a step back will completely wash your hands of this?” “At least I won't be used as an excuse anymore,” I said. Her expression turned entirely cold. “Elias Zhang, don't forget, you have absolutely nothing right now.” I paused what I was doing and looked at her. “I have my expertise,” I said. It was as if that sentence struck a nerve, and her tone became suddenly sharp. “Expertise? Who only looks at that nowadays? You are too naive.” I didn't argue. Some things only need to be said once. I pushed the suitcase to the door and grabbed a stack of files from the study to put in my bag. They were case analyses I had compiled over the past few years, which I had intended to use gradually after returning. She stood in the middle of the living room, watching me, as if waiting for me to say something. I changed my shoes and picked up my jacket. “You'll regret this,” she suddenly said. I stopped for a moment, not looking back. “You always think you're in control of everything,” I said. “But you even switch the order of patients.” As the door closed, her voice was sealed inside. 04 I checked into a hotel outside. The room wasn't large, but it was quiet. After unpacking my luggage, I opened my laptop and reviewed several transplant cases I had handled over the past few years. The data was sound; the protocols were sound. The problem wasn't the surgery. The next morning, I received a call from an unfamiliar number. The caller identified himself as a staff member from the Mayor's Office. His tone was restrained as he asked a single question: "Dr. Zhang, is it a convenient time to talk?" I said yes. He didn't elaborate, only confirming one thing: "You were responsible for the preoperative evaluation of the Mayor's wife, correct?" "Yes, I was." There was a slight pause on the other end. "Alright, we will contact you again if we need your cooperation moving forward." The call ended. I didn't return to the hospital, and no one reached out to me. In the afternoon, I went to an imaging center I often worked with and requested a follow-up report from another facility. It was the scan Sarah Evans had just done two days ago. The indicators weren't good. Her liver function was fluctuating significantly, with some values already approaching the warning line. According to the original plan, if the transplant wasn't expedited, subsequent management would become much more reactive. I placed the report back in the folder without making any extra moves. With a patient of this caliber, any delay would leave a trail. On the third day, there started to be movement at the hospital. First, my old classmate from anesthesiology sent a brief message: "You've been replaced on that surgery." I replied with "I know." Not long after, another message: "The replacement is Eric Crawford. The Chief Administrator personally selected him." I stared at the screen for a few seconds before placing my phone face down on the table. I knew Eric's resume. His fundamentals were decent, but he had never actually been the lead surgeon on a transplant of this magnitude. At best, he had stood as a second assistant, passing instruments and keeping time. Pushing him to the forefront wasn't bold; it was reckless. That evening, I received a third call. This time it was the Deputy Director of Administration. "Dr. Zhang, just giving you a heads-up," he said vaguely. "The city might inquire about the arrangements for that surgery. If anyone asks you, just tell them the truth." "Who is inquiring?" "The Mayor," he lowered his voice. "Richard Evans." He hung up quickly, as if afraid of being overheard. The next morning, the hospital held an emergency coordination meeting. I wasn't there, but word of what happened inside quickly spread. Sarah Evans' latest test results were delivered to the conference table. Medical Affairs, Surgery, and Anesthesiology were all present. The originally finalized surgical plan was brought back out, and the comparative data was laid out page by page. Someone suggested changing the lead surgeon. The reasoning was very official: young, driven, able to handle pressure. Eric Crawford volunteered. "I can do it," he said crisply. "I've been involved in the entire prep process and am very familiar with the patient's condition." No one objected on the spot. But no one nodded either. Mid-meeting, a secretary entered and whispered something in Lauren's ear. Her expression shifted slightly before she regained her composure. The meeting continued. Not long after, Richard Evans himself arrived. No pleasantries, no excess emotion. After taking a seat, his first question wasn't about the surgical plan, but directed at the head of Medical Affairs. "Who was the originally designated lead surgeon?" There was a brief moment of silence in the conference room. The head of Medical Affairs stood up. "The original plan was Dr. Elias Zhang." "Then why the change now?" This time, no one answered immediately. Lauren spoke up, her tone composed: "Dr. Zhang's current condition makes him unsuitable to continue taking on high-intensity surgeries. The hospital made the adjustment based on risk considerations." Mayor Evans nodded and asked another question: "Who conducted the evaluation?" "A comprehensive hospital evaluation." "Where is the evaluation report?" The air in the room noticeably tightened. Administration handed over a document. It wasn't thick, consisting mostly of procedural explanations. Evans flipped through two pages without commenting. He turned to Eric: "Are you the new candidate?" Eric stood ramrod straight. "Yes. I will give it my all." "How many surgeries of this type have you led?" "Completed as lead surgeon... none yet." "How many have you participated in?" "Seven." Evans closed the file. "Seven participations, and you're taking on the ultimate responsibility?" His tone wasn't heavy, but it was clear enough for everyone to hear. "Who made the final call?" Lauren answered, "I did." Evans looked at her and didn't pursue the question further. He shifted gears: "Have you all seen Sarah Evans' test results?" "We have." "With such massive fluctuations in her indicators, why are you still adjusting personnel?" This time, no one rushed to answer. The only sound in the room was the rustling of paper. Evans pushed the report back to the center of the table. "I don't interfere with your hospital's personnel arrangements. But when it comes to patients, there's no room for trial and error." He stood up after saying that. "Compile the approval process for this surgery from inception to now, the records of personnel changes, and the risk assessments, and submit them to the Mayor's Office." "By today." With that, he left the conference room. The sound of the door closing wasn't loud, but it left everyone unsettled. After that day, the hospital's rhythm changed completely. The operating rooms were subjected to repeated inspections, protocols checked item by item. Approvals that usually went through quickly were paused. Eric's name was brought into discussions for the first time, rather than being treated as a foregone conclusion. I was notified that evening. Someone from the Mayor's Office contacted me, asking me to prepare a written statement concerning only one thing. "Why your surgical privileges were revoked." I agreed. After hanging up, I sat for a while. Things were starting to head in a different direction, but it was far from a conclusion. Some people had already sensed the changing winds, but no one dared to make the first move. Early the next morning, I sent the compiled materials over. When the "sent successfully" notification popped up, dawn had just broken outside the window. A new problem was already on the table.
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