All language subtitles for The.Good.Doctor.S04E19.720p.WEB.x265-MiNX

Can you pop the trunk?

Ah!

We made good time.

Thank goodness, or
else we wouldn't have

the full three hours to
wait before our flight.

Great.

Alright. Thanks.

Alright.

Oh.

Starbucks is on me.

No kidding. And I'm
getting a cake pop.

Hey, Dr. Reznick.

I thought this was
a surgical mission.

Uh, we're bring... We're
bringing some support.

Morgan's gonna help with
patient selection and aftercare.

Oh. That's great.

10 days, huh?

Can't have you forgetting me.

I'll be back before you know it.

Tickets, passports,

travel wallet containing
quetzales and American currency.

You've got 'em.

I know, because I checked.

You alright?

Oh, it's not that
heavy. I got it.

That's not what I meant.

I'm okay.

I think this trip will be good.

Change things up.

Focus on helping other people.

For whatever it's worth,
if you ever need to talk,

you can always call me.

I'm not gonna do that.

I know.

We will not have
any time to shop,

but would you or Debbie like
anything from duty-free?

Guatemala is known for its rum.

We're okay. Thanks.

Okay.

You're on this trip, too?

Yeah, got inspired last night,

decided to take some
personal days, go help out.

And you're bringing
a toilet seat?

Spoken like someone

who's never been on one of
these surgical missions.

The airline will find your bag.

We'll get you some clothes
when we get situated.

Would you like some vitamin
B12 to help with exhaustion,

or a motion sickness wristband?

I have an extra.

No, thanks.

I'm glad we're here.

Yes.

After all the loss this year.

It's just... such an amazing way

to be reminded what we
have to be grateful for.

Careful!

Let's see.

Pardon me, sir, could you
please move your flock of sheep?

My sheep don't like to
be rushed. Be patient.

These people are our guests.

Well, I did not invite them.

We're doctors.

It's been a long trip and
we need to get to our hotel.

Doctor?

You're a doctor?

Of course I am.

It's a fungus.

It's... It's a fungus!

It's a fungus.

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Thank you!

Whew!

Ah.

Need help with that?
No, that's a friend thing.

Hello, I'm Dr. Mateo Rendón.

Dr. Saravia and her team have
spent several months gathering cases.

From those, we selected 40.

You're going to want
to save them all.

You will not.

We will perform 12 operations.

I'm Dr. Marcus Andrews,
last-minute addition.

If we could add more cases, I...

Before I heard you
joined the trip,

we were doing 10 surgeries.

My organization has spent
years building trust.

We save 12 people
here, that trust grows,

more patients come to us,
more doctors volunteer.

But if we lose a patient...

We want surgeries we can
do but the locals couldn't.

Surgeries that don't
need a lot of aftercare.

12 patients, one alternate.

Everyone else gets sent home,

no matter how sick they are
or how sad their story is.

Uh, can you please tell
me what this means?

Family...

Your next of kin.

Oh, well, nobody.

Only Ignacio.

Iggy is my only family.

He says his dog, Iggy.

Ugly dog.

Roberto Kantun Diaz?

Yes!

Andrea Torres Tzul?

Aimé Navarro Gomez?

Aimé Navarro Gomez?

Here! Here!

We need to do an abdominal
exam and ultrasound to see...

if there are any signs
of obstruction or strangulation.

Please remove your
bandage and lie back.

Lie down and remove
your bandages.

How long have you had that?

A year... Maybe more.

He's had it for a
year, maybe longer.

My neighbor told me to go
to the hospital in Xela,

but I didn't have
enough for the trip,

and I can't go a long
time without working.

I'm the only one who
takes care of my sisters.

He was told to go
to the hospital,

but he couldn't afford
the trip or to miss work.

He's the sole provider
for his siblings.

Our parents died two years ago.

Their parents died
two years ago.

She has a large patent
ductus arteriosus.

I've only seen this
condition in infants.

The blood is reversed.

It's flowing the wrong way.

We could try going
through the femoral vein,

do a percutaneous
device closure.

She has irreversible
pulmonary hypertension.

It would have been simple
to treat as an infant,

but now closing the hole
will... Will... kill her.

Aimé's condition is
much too advanced.

There's nothing we can do.

I'm sorry.

I'm sorry.

No.

No.

No, no.

Tissue? Uh...

I stock up before
the Americans come.

And the French.

They are surprisingly
sensitive people.

I'm sorry. I know this
isn't helping anyone.

Never
apologize for being human.

I have a strict
policy against it.

This week, you are not
just doing surgery.

You are doing miracles.

You're giving people
hope who had none.

Except for the ones that
we send home to die.

Focus on the miracles,

or else you won't be
able to help any of them.

And I will have to
get more tissues.

Thank you.

Bastion Alonso Ramos.

12-year-old baseball fan.

Roots for the St.
Louis Cardinals.

Also, he has an ameloblastoma.

Not a lot of baseball
fans in Guatemala.

You've been here before, or do
you enjoy reading Wikipedia?

I did a medical mission
here during my residency.

Oh, that explains
"Dr. Toilet Seat."

You already have a nickname.

Good afternoon, Bastion.

I'm Dr. Andrews.

Good afternoon, Bastion.
This is Dr. Andrews.

Hello, Dr. Andrews.

Hello!

What is that? Let me see.

Oh.

That looks like Yadi Molina.

Yes! It's Yadi Molina.

St. Louis Cardinals.

Mm-hmm.

So, are you a better
hitter or catcher?

He has a hepatic adenoma in
the right lobe of his liver.

Does not appear cancerous.

No. For now.

The lesion is localized,
well-circumscribed,

and not close to
portal vein branches.

There's a tumor
in Adelmo's liver,

but it's not cancer.

The doctor believes
they can remove it.

He's a good candidate.

Thank you. Thank you. Thank you.

Cheers! Cheers! Cheers!

I can continue like
this for a long time.

But you have a strange accent.

It's not from
Guatemala, or Mexican.

Did you spend some
time in Venezuela?

In the library where I grew up,

they had some tapes named
"Speak Spanish like a Spaniard."

I listened to them every night

until they broke.

Oh, thank you. I thought you
put this kid in the "no" pile.

I decided to take a
closer look at the images.

See where the mass is
thinning the orbital floor

and extending up
near the skull base?

But that's exactly
what you can't do.

Reconsider? Weigh issues?

Let emotional and
personal attachment

influence treatment decisions.

Chicharrones?

There's no beveling or erosions.

I can stay extracranial

and create a bony plane to
resect the superior tumor.

Did that sound too emotional?

Even if you stay
out of the brain,

two major arteries are
involved. He could bleed out.

Can I get one of those, please?

Apply it twice a
day, for 10 days.

Thank you, Dr. Shaun Murphy.

Thank you.

You're welcome.

My chest hurts,
and so does my arm.

And sometimes, my
hand feels cold,

or it's as if I wasn't
able to feel it at all.

It could be angina
or a blockage,

which requires bypass surgery.

We should do an EKG before
he goes to the cath lab...

You don't have a cath lab.

Stretch out your arm, please.

Turn your head to the side.

Feel his pulse.

There isn't one.

Turn your head forward.

His pulse is back.

It's not a cardiac problem.

He has thoracic outlet syndrome.

Dr. Saravia has just showed me
that the nerves and arteries

in your neck and chest are
being compressed by your ribs.

It's a very rare condition, that may
cause blood clots or an embolism...

He doesn't seem happy.

Did I translate wrong?

No. Your Spanish is perfect.

But you left out that
his problem can be fixed.

It can be remedied.

Oh, okay.

Okay.

I am not good at communication.

In two languages.

The nurse should
come momentarily.

The translator
should be here soon.

Um... If you want,
I can translate.

Oh, you can speak English?

We lived in the U.
S. For a few years.

Uh, my mother cleaned houses.

I watched "Grey's Anatomy."

Oh.

Well, being a surgeon
is not much like that.

Ms. Garza, can you show
me where you feel pain?

Show them where
it hurts you, Mom.

Here.

And do you have
indigestion or cramping

or ever feel like
you might throw up?

She wants to know if you
have indigestion or cramping.

Do you feel like
you might throw up?

Sometimes.

"Sometimes."

But she's lying. It's always.

She has fevers,
too, and throws up.

I need to feel your abdomen.
Can you lie on the bed for me?

She has to feel
your stomach, Mom.

Lie down.

Okay.

Mm.

Ms. Garza, I think
you have gallstones.

We will have to run some tests,

but it is likely that
you will need surgery.

Mom, the doctor believes
you have gallstones.

They need to do a
test to be sure,

but you need surgery.

No, no. Not surgery.

I came here for medicine.

You told me they were
gonna give me medicine.

Don't be stubborn. Do
what the doctor says.

If she doesn't want
surgery, why is she here?

I told her you would have
pills that would help her.

I told her I wouldn't
eat until she came.

I have to work.

I need to take care of you.

She says she can't miss work.

She needs to take care of me.

I-I need you to
translate accurately.

My mother was very sick, too.

Her mother also was very sick.

And she tried to hide her pain,

but children know when
people are suffering

especially their mothers.

She tried to hide her pain,

but kids know when
people are suffering.

Especially when
it's their mother.

You can't take care
of your daughter

if you do not take
care of yourself.

You can't take care
of your daughter

if you don't take
care of yourself.

Did you
review Bastion's file?

Doing a bifrontal trepanation

and reconstructing
the skull base

could prevent brain herniation.

What about risk of CSF leak?

It reduces with a
multilayer duraplasty

using a pericranial flap.

I say five
sentences to a patient.

You say five words.

A nurse wanted me
to give this to you.

Because medical
jargon does nothing

but scare them and
waste our time.

All they care about
is, can we help

yes or no?

Your son's heart
valves are damaged.

Your son's heart
valves are damaged.

It's probably the result of
his rheumatic fever last year.

Probably as a result of the
rheumatic fever he had last year.

Because of his heart,

we can't remove his liver tumor.

I-It makes the
surgery too risky.

I'm very sorry.

Due to his heart, we can't
remove the tumor in his liver

because it makes the
surgery very risky.

We are very sorry.

Thank you, Doctor.

Uh, no, I'm sorry.

W-We can't do the
operation on your son.

He... I'm not sure he...

But you tried.

Thank you for trying.

God bless you.

Everything's gonna be okay.

Don't worry.

León Castillo. 22-year-old male.

Large, non-reducible
umbilical hernia.

He's the sole provider
for his siblings...

No personal details.
They're irrelevant.

Two children's survival
depends on his.

Seems relevant to me.

Decisions need to be based
on medical data alone.

This can't turn into a contest
of whose life is more tragic.

There would be too many winners.

Without surgery,

the hernia's at a very high
risk for strangulation.

It's a fast, simple procedure,

and he will almost certainly
have a full recovery.

From a surgery he could survive
another 15 years without.

Replacing the valve
with a bioprosthetic

means he won't need to be
on blood thinners forever.

But he'll probably
need follow-up surgeries

to replace the replacement.

Well, this guy's an
athlete, a fútbol star.

Is that relevant?

Yes, because his underlying
cardiac health is excellent.

He should make a full recovery.

Unfortunately, his
dental health isn't.

He has cavities, which puts him
at high risk for endocarditis,

which would contribute
to valve deterioration.

A total abdominal colectomy

offers her an 80% to 90%
chance at full recovery.

Otherwise healthy, no
complicating factors.

The tumor could be removed
using ultrasound-guided surgery.

But she has no access to
post-op chemo and radiation.

The mass is round, localized.

No signs of infiltration
in the adjacent structures.

Minimal chance of recurrence.

If you get all of it.

She just got married
last week...

Dr. Reznick.

Which is medically relevant,
because studies have shown

optimistic people have
better long-term prognosis.

And she is full of hope.

Uh, there's a boy.

He needs blankets. Uh.

Blankets, please?

There.

Thank you.

The gallstones are intermittently
blocking the bile duct,

which could lead to ascending
cholangitis, sepsis, and death.

Her condition might
respond to medication.

No, it's extremely unlikely given
how advanced her symptoms are.

But she has a
non-surgical option.

Bastion doesn't.

It's a miracle he made it to 12.

Without surgery,
he will not see 15.

He's unable to eat solid foods.

He's already showing
signs of malnutrition.

Shaun's surgical plan
is very ambitious.

It runs the risk of graft
failure and necrosis.

You could leave
this boy worse off.

Meanwhile, Edna's surgery
is straightforward,

and she is all her
daughter has in the world.

Who a person is cannot be completely
separated from their medical care.

And I'm done
pretending it can be.

We've got a mom who
needs a simple procedure

she might live without,

or a son whose only shot at life
is a very complicated surgery

that may not work.

We have to focus
on the miracles.

Let's go eat.

Okay, so, look at the nail bed.

Karla said if you see
alternating redness

with the pulse, that's a
sign of aortic insufficiency.

So, your heart is fine, and
your cuticles are great.

I get manicures.

Ah, you like?

It's a national treasure.

No. I just wanted
the experience.

I shouldn't have any more.
First day of surgery tomorrow.

Oh, no, I'm good. Mm.

Ah.

You are terrible at this!

I am terrible, but I look
fantastic,Watch this.

I'll get
us another round.

Okay.

Tequila, two, please.

Mm.

What's going on over there?

Uh, I'm getting my
ass kicked in darts.

You're flirting.

Just being nice.

Well, don't be so nice that you
regret it when you get home.

You have nothing to worry about.

I guarantee it.

Alright, I'm gonna grab
a cab back to the hotel.

Okay.

Up, down, to the center
and to the belly.

Good night, guys.

Uh, Hotel Provincia?

Yeah.

Mind if I tag along?

Big day tomorrow. Sure.

I saw you break the
news to that boy's dad.

You want to talk about it?

Morgan.

I just wanted to
know if you're okay.

You don't get to
ask me that anymore.

We're not friends.

You drew a line.

So don't ask me how I am

and then pretend to be some nice
guy who cares, when you obviously don't.

I-I just got a text from
Karla. Miguel is crashing.

Shaun and I are gonna
head back to the hospital.

Eight?

I'm only fluent in six.

I didn't
set out to learn them.

I just picked them
up as I moved around.

Oh, so you're an
accidental language genius?

So, what are some
of these places,

I mean, that you
moved around to?

Uh, I was born in Mexico.

Went to medical
school in New Haven.

Did my residency in Chicago.

Stayed a while in
Syria, Haiti, the Congo.

You throw in your stop
at Yale to impress me?

I threw in my stop at
the Congo to impress you.

Hey, this is not the way
to the Provincia Hotel.

Where are you taking us?

We're gonna make a stop.

Do you want money?

I don't need your money.

What's happening?

Don't be too alarmed, but
we're being kidnapped.

Come in, please! Hurry!

This is my niece.

She's been in
labor for 14 hours.

14 hours like this.

Hello. I'm a doctor.

Uh, can you handle the
additional talking?

We're here to help you
and your baby, okay?

We're going to
examine you, yeah?

It hurts so bad!
Yes, here we go.

Well, the baby's head is down,
so position's not a problem.

I can't hear anything.

The cab driver, he had a-a-a
cup of coffee in his cab.

Have him get it.

Um, a cup of coffee
from the taxi...

Go get it quickly!

Please tell her I have
to check her cervix.

The doctor will
check your cervix.

Okay, yes, that's fine.

She's fully dilated.

Okay, tear out the
bottom, hand it to me.

I can hear a heartbeat.

The baby has decels.

Oh, no, no! Don't
push! Don't push!

He became short of breath
and then lost consciousness.

I believe his thoracic
outlet syndrome

caused a clot in his arm,
which went into his lungs.

That would explain the
drop in blood pressure

and respiratory rate.

But not his elevated
end tidal CO2 level.That is

inconsistent with
a pulmonary embolism.

What is it consistent
with, Shaun?

His brain. A clot that
traveled from his arm

through a hole in his heart
into his aorta and up to his brain.

His gag reflex is only
active on one side.

I was right. He has a small
clot in the brain stem

near the respiratory center.

Well, we can surgically
remove a clot in his lung,

but in his brain...

We can't do that here.

If we have TPA, we
could break it up.

TPA? No.

But we have a snake
venom derivative.

I-It does the same
thing, more or less.

Any movement
at all? None.

No cord presentation.

Maybe her pelvis is too narrow?

The heart rate's getting slower.

Wait, wait, wait.

I can feel a hand by the face.

The baby's sucking its thumb.
That's why it's not progressing.

I can do an episiotomy,
try to pull the baby out,but

with the arm where
it's at, I'm probably gonna

break the clavicle and damage
the brachial plexus nerve.

Reach inside... Yeah.

Find the baby's finger,
and pinch it hard.

It worked.

Okay, dear, now we are
going to push, okay?

Push. Push.

I'm sorry...

Um...

Do you speak English?

No. I don't speak English.

My name is Lea...

I'm with the Americans.

Mm.

I'm Sofía.

He is my husband, Oscar.

And she is Isabela.

Isabela.

She is...

perfect.

Um...

I found these in my suitcase.

My mom got them for

It gets cold in here.

A gift for Isabela.

Thank you.

Would you like to hold her?

Uh.

No, thank you.

Uh, I have to go.

Congratulations, Mom.

What a good-looking boy!

Shaun's keeping
an eye on Miguel.

Yeah.

You know, it's okay
to not be okay.

I j...

Every time I feel like
things are getting better

it's there again.

Yeah, I know.

Like it comes in waves.

Eventually, it subsides.

It's a process.

It's a terrible process.

And it's one you don't
have to go through alone.

Shaun has no idea, does he?

No.

He's doing great,
important work.

I don't want to
interfere with that.

And

he can't fix it.

It's not about fixing it.

It's about the two of you
just being in this together.

He's waking up.

What happened?

You had an embolism,

but we were able to
give you treatment.

Can I still have the
operation tomorrow?

No, I'm afraid not.

Tiziana?

Tiziana wake up

Hey, I need you to tell
your mother something.

We're gonna do her surgery.

Mom, Mom, they're going
to do your operation!

You told me that I could
die without that surgery.

Thank you!

You're welcome.

That was...

It was.

Good night, Audrey Lim.

You know...

I'm... not really tired.

Me either.

Tomorrow, I will be
removing an adenocarcinoma

from a young
woman's mediastinum.

That can be a very dangerous
area because of the vasculature.

It will be an
excellent challenge.

Are you coming to bed?

I would like to
turn off the light.

I don't want to ruin your trip.

You're having such a good time.

But...

I'm not.

W-What's wrong?

Are you sick?

Did you open your
mouth in the shower?

That is very common.

I'm just... sad.

Every time something
reminds me of the baby,

I get even sadder.

I'm glad you're doing
better than I am.

I'm glad you're happy, but

sometimes, you being
happy makes me feel worse.

I hate that I feel that way,

and I didn't even
want to tell you,

but I think I need to tell you.

I'm sorry.

Do you want me to
not talk about work?

No. I can't ask you to do that.

Yes, you can.

I want you to feel better.

It won't help, Shaun.

What will help?

Nothing.

I miss her so much.

I mean, even looking at your
blue eyes breaks my heart,

because I dreamed
she would have them.

My parents
are really worried,

been calling all the time.

They want me to come back
to Hershey for a while.

They think it'll help.

Do you... want to?

I think it would be good for
me to get some time away.

From everything.

I'm sorry you're sad.