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1
00:00:06,507 --> 00:00:07,907
Could you pop the trunk?
2
00:00:14,381 --> 00:00:15,246
We made good time.
3
00:00:15,315 --> 00:00:17,875
Thank goodness. Or else we
wouldn't have the full three hours
4
00:00:17,951 --> 00:00:20,386
- to wait before our flight.
- Great.
5
00:00:22,756 --> 00:00:23,849
All right. Thanks.
6
00:00:26,026 --> 00:00:27,026
All right.
7
00:00:30,264 --> 00:00:31,562
Starbucks is on me.
8
00:00:31,632 --> 00:00:33,965
No kidding. And I'm
getting a cake pop.
9
00:00:44,478 --> 00:00:45,707
Hey, Dr. Reznick.
10
00:00:49,182 --> 00:00:50,980
I thought this was
a surgical mission.
11
00:00:51,051 --> 00:00:53,350
We're gonna bring
in some support.
12
00:00:53,420 --> 00:00:56,185
Morgan's gonna help with
patient selection and aftercare.
13
00:00:56,256 --> 00:00:57,451
Oh. That's great.
14
00:00:58,725 --> 00:00:59,852
Ten days, huh?
15
00:01:08,535 --> 00:01:11,596
- Can't have you forgetting me.
- I'll be back before you know it.
16
00:01:20,647 --> 00:01:22,309
Tickets, passports,
17
00:01:22,382 --> 00:01:25,819
travel wallet containing
quetzales and American currency.
18
00:01:25,886 --> 00:01:28,446
- You've got them.
- I know because I checked.
19
00:01:29,189 --> 00:01:31,920
- You all right?
- Oh, it's not that heavy. I got it.
20
00:01:32,492 --> 00:01:33,858
That's not what I meant.
21
00:01:36,129 --> 00:01:38,963
I'm okay. I think
this trip will be good.
22
00:01:39,466 --> 00:01:42,595
Change things up, focus
on helping other people.
23
00:01:43,937 --> 00:01:48,307
For whatever it's worth, if you ever
need to talk, you can always call me.
24
00:01:49,543 --> 00:01:52,103
- I'm not gonna do that.
- I know.
25
00:01:52,980 --> 00:01:55,074
We will not have
any time to shop,
26
00:01:55,148 --> 00:01:57,708
but would you or Debbie
like anything from Duty Free?
27
00:01:59,920 --> 00:02:02,321
Guatemala is known for its rum.
28
00:02:02,990 --> 00:02:04,151
We're okay. Thanks.
29
00:02:06,159 --> 00:02:07,159
Okay.
30
00:02:13,834 --> 00:02:17,396
- You're on this trip too?
- Yeah. I got inspired last night,
31
00:02:17,471 --> 00:02:19,702
decided to take some
personal days, go help out.
32
00:02:20,474 --> 00:02:22,466
And you're bringing
a toilet seat?
33
00:02:24,611 --> 00:02:27,308
Spoken like someone who's never
been on these surgical missions.
34
00:03:08,588 --> 00:03:10,420
The airline will find your bag.
35
00:03:13,493 --> 00:03:15,519
We'll get you some clothes
when we get situated.
36
00:03:29,409 --> 00:03:32,208
Would you like some vitamin
B12 to help with exhaustion
37
00:03:32,279 --> 00:03:34,111
or a motion-sickness wristband?
38
00:03:34,715 --> 00:03:35,842
I have an extra.
39
00:03:35,916 --> 00:03:36,940
No, thanks.
40
00:03:39,386 --> 00:03:40,877
I'm glad we're here.
41
00:03:42,789 --> 00:03:43,789
Yes.
42
00:03:44,391 --> 00:03:46,292
After all the loss this year,
43
00:03:47,160 --> 00:03:49,652
it's just such an amazing way
44
00:03:49,730 --> 00:03:52,222
to be reminded what
we have to be grateful for.
45
00:03:53,467 --> 00:03:54,833
Careful!
46
00:04:03,543 --> 00:04:06,240
Excuse me, sir. Could you
move your flock of sheep.
47
00:04:06,313 --> 00:04:08,633
My sheep don't like to
be hurried. Be patient.
48
00:04:09,082 --> 00:04:10,277
These people are our guests.
49
00:04:10,350 --> 00:04:12,148
Well, I didn't invite them.
50
00:04:12,219 --> 00:04:13,744
Yes, we are doctors.
51
00:04:15,188 --> 00:04:18,750
It has been a long journey
and we need to get to our hotel.
52
00:04:22,829 --> 00:04:23,829
A doctor?
53
00:04:25,465 --> 00:04:26,558
You are a doctor?
54
00:04:28,769 --> 00:04:29,769
Yes.
55
00:04:34,841 --> 00:04:35,968
It's a fungus.
56
00:04:37,210 --> 00:04:38,940
It's a fungus.
57
00:04:40,280 --> 00:04:41,680
It's a fungus.
58
00:04:55,028 --> 00:04:57,228
- Thank you.
- My pleasure.
59
00:05:07,474 --> 00:05:09,875
- Need help with that?
- No. That's a friend thing.
60
00:05:43,210 --> 00:05:45,076
Hola, I'm Dr. Mateo Rendon.
61
00:05:45,779 --> 00:05:47,111
Dr. Saravia and her team
62
00:05:47,180 --> 00:05:49,445
have spent several
months gathering cases.
63
00:05:49,516 --> 00:05:52,782
From those, we selected 40,
you're going to want to save them all.
64
00:05:52,853 --> 00:05:53,912
You will not.
65
00:05:53,987 --> 00:05:55,580
We will perform 12 operations.
66
00:05:55,655 --> 00:05:57,783
I'm Dr. Marcus Andrews,
last-minute addition.
67
00:05:57,858 --> 00:06:00,191
- If we can add more cases...
- Before I heard you joined,
68
00:06:00,260 --> 00:06:01,592
we were doing ten surgeries.
69
00:06:01,661 --> 00:06:05,223
My organization has
spent years building trust.
70
00:06:05,298 --> 00:06:06,732
We save 12 people here,
71
00:06:06,800 --> 00:06:09,964
that trust grows, more
patients come to us,
72
00:06:10,036 --> 00:06:13,404
more doctors volunteer.
But if we lose a patient...
73
00:06:16,543 --> 00:06:19,536
We want surgeries we can
do, but the locals couldn't.
74
00:06:19,613 --> 00:06:22,412
Surgeries that don't
need a lot of aftercare.
75
00:06:22,983 --> 00:06:25,316
Twelve patients, one alternate.
76
00:06:25,385 --> 00:06:27,320
Everyone else gets sent home,
77
00:06:27,387 --> 00:06:31,552
no matter how sick they
are or how sad their story is.
78
00:07:30,016 --> 00:07:32,508
Oh, sorry. May you
tell me what this says?
79
00:07:33,620 --> 00:07:35,486
Your closest relative.
80
00:07:36,156 --> 00:07:39,854
Well, none. Just Ignacio,
he's my only family.
81
00:07:41,328 --> 00:07:43,320
He Says his dog. Iggy.
82
00:07:44,764 --> 00:07:45,764
Ugly dog.
83
00:07:46,299 --> 00:07:48,427
Roberto Kantun Diaz.
84
00:07:49,703 --> 00:07:51,194
Andrea Torres Tzul.
85
00:07:52,872 --> 00:07:54,670
Aimé Navarro Gomez.
86
00:07:57,010 --> 00:07:58,308
Aimé Navarro Gomez?
87
00:07:58,378 --> 00:08:00,142
Here! Here!
88
00:08:03,049 --> 00:08:05,109
We need to do an abdominal
exam and ultrasound
89
00:08:05,185 --> 00:08:08,815
to see if there are any signs
of obstruction or strangulation.
90
00:08:08,888 --> 00:08:10,823
Please remove your
bandage and lie back.
91
00:08:21,067 --> 00:08:22,667
Since when do you have that?
92
00:08:26,373 --> 00:08:28,342
He's had it for a
year. Maybe longer.
93
00:08:37,817 --> 00:08:40,685
He was told to go to the hospital,
but he couldn't afford the trip
94
00:08:40,754 --> 00:08:43,747
or to miss work. He's the
sole provider for his siblings.
95
00:08:47,694 --> 00:08:49,890
Their parents
died two years ago.
96
00:08:54,100 --> 00:08:58,037
She has a large patent
ductus arteriosus.
97
00:08:58,772 --> 00:09:01,264
I have only seen this
condition in infants.
98
00:09:01,341 --> 00:09:03,810
The blood is reversed.
99
00:09:03,877 --> 00:09:05,539
It's flowing the wrong way.
100
00:09:09,616 --> 00:09:11,915
We could try going
through the femoral vein,
101
00:09:11,985 --> 00:09:13,817
do a percutaneous
device closure.
102
00:09:14,421 --> 00:09:17,983
She has irreversible
pulmonary hypertension.
103
00:09:18,058 --> 00:09:20,653
It would have been
simple to treat as an infant,
104
00:09:20,727 --> 00:09:23,526
but now closing the hole will...
105
00:09:25,098 --> 00:09:26,098
kill her.
106
00:09:30,437 --> 00:09:33,566
Her condition has
progressed for quite some time.
107
00:09:35,308 --> 00:09:37,607
There's nothing we can do.
108
00:09:38,645 --> 00:09:39,510
I'm sorry.
109
00:09:39,612 --> 00:09:41,478
No. No.
110
00:09:42,282 --> 00:09:43,282
I'm sorry.
111
00:09:44,284 --> 00:09:46,150
No. No.
112
00:09:49,122 --> 00:09:50,818
No. No.
113
00:10:04,571 --> 00:10:06,039
- Tissue?
- Ah.
114
00:10:09,008 --> 00:10:10,977
I stock up before
the Americans come.
115
00:10:12,312 --> 00:10:16,272
And the French, they are
surprisingly sensitive people.
116
00:10:16,349 --> 00:10:18,750
I'm sorry. I know this
isn't helping anyone.
117
00:10:18,818 --> 00:10:20,844
Never apologize for being human.
118
00:10:20,920 --> 00:10:23,480
I have a strict
policy against it.
119
00:10:24,824 --> 00:10:28,226
This week, you are
not just doing surgery,
120
00:10:28,294 --> 00:10:30,092
you are doing miracles.
121
00:10:30,163 --> 00:10:32,530
You are giving people
hope who had none.
122
00:10:33,566 --> 00:10:35,762
Except for the ones
that we send home to die.
123
00:10:38,505 --> 00:10:40,133
Focus on the miracles,
124
00:10:40,206 --> 00:10:42,402
or else you won't be
able to help any of them.
125
00:10:45,712 --> 00:10:47,874
And I will have to
get more tissues.
126
00:10:50,083 --> 00:10:51,083
Thank you.
127
00:10:58,825 --> 00:11:02,489
Bastion Alonso Ramos,
12-year-old baseball fan,
128
00:11:02,562 --> 00:11:04,622
roots for the St.
Louis Cardinals.
129
00:11:04,697 --> 00:11:06,529
Also, he has an ameloblastoma.
130
00:11:06,599 --> 00:11:08,591
Not a lot of baseball
fans in Guatemala.
131
00:11:08,668 --> 00:11:12,070
You've been here before? Or
do you enjoy reading Wikipedia?
132
00:11:12,605 --> 00:11:15,473
I did a medical mission
here during my residency.
133
00:11:15,909 --> 00:11:18,777
Oh, that explains
"Dr. Toilet Seat."
134
00:11:19,913 --> 00:11:21,609
You already have a nickname.
135
00:11:24,918 --> 00:11:26,113
Good afternoon, Bastion.
136
00:11:29,455 --> 00:11:30,650
I'm Dr. Andrews.
137
00:11:34,294 --> 00:11:36,195
Hi, Dr. Andrews.
138
00:11:36,696 --> 00:11:37,696
Hello.
139
00:11:38,865 --> 00:11:40,766
What is that? Let me see.
140
00:11:46,239 --> 00:11:47,935
That looks like Yadier Molina.
141
00:11:48,007 --> 00:11:51,205
Yes. Yadier Molina.
St. Louis Cardinals.
142
00:11:51,277 --> 00:11:52,277
Mm-hm.
143
00:11:52,879 --> 00:11:55,144
So are you a better
hitter or catcher?
144
00:12:39,425 --> 00:12:43,021
He has a hepatic adenoma
in the right lobe of his liver.
145
00:12:43,096 --> 00:12:46,123
- Does not appear cancerous.
- No, for now.
146
00:12:46,799 --> 00:12:47,994
The lesion is localized,
147
00:12:48,067 --> 00:12:51,128
well-circumscribed and not
close to portal vein branches.
148
00:12:51,204 --> 00:12:53,901
There's a tumor found
in Adelmo's kidney,
149
00:12:53,973 --> 00:12:54,973
but it's not cancerous.
150
00:12:55,575 --> 00:12:58,044
The doctor believes
he can extract it.
151
00:12:58,111 --> 00:12:59,773
He's a good candidate.
152
00:13:08,554 --> 00:13:10,250
Thank you.
153
00:13:10,323 --> 00:13:12,189
- Cheers!
- Cheers!
154
00:13:14,193 --> 00:13:16,594
I can continue like
this for a long time.
155
00:13:16,663 --> 00:13:21,294
But you have a weird accent,
it's not from Guatemala or Mexico.
156
00:13:21,834 --> 00:13:23,530
Did you spend some
time in Venezuela?
157
00:13:23,636 --> 00:13:27,835
In the library where I grew up
in, there were some films called:
158
00:13:27,907 --> 00:13:30,103
"Speak Spanish Like A Spaniard."
159
00:13:30,176 --> 00:13:32,304
I used to listen to
them every night.
160
00:13:32,378 --> 00:13:33,903
Until they broke.
161
00:13:34,814 --> 00:13:36,749
I thought you put
this kid in the "no" pile.
162
00:13:36,816 --> 00:13:38,648
Decided to take a
closer look at the images.
163
00:13:38,718 --> 00:13:40,598
See where the mass is
thinning the orbital floor
164
00:13:40,653 --> 00:13:42,281
and extending up
near the skull base?
165
00:13:42,355 --> 00:13:46,986
- But that's exactly what you can't do.
- Reconsider? Weigh issues?
166
00:13:48,061 --> 00:13:51,930
Let emotion and personal attachment
influence treatment decisions.
167
00:13:52,465 --> 00:13:53,330
Chicharrones?
168
00:13:53,399 --> 00:13:55,334
There's no beveling or erosions.
169
00:13:55,401 --> 00:14:00,840
I can stay extracranial and create a
bony plane to resect the superior tumor.
170
00:14:01,407 --> 00:14:02,739
Did that sound too emotional?
171
00:14:03,576 --> 00:14:07,240
Even if you stay out of the brain,
two major arteries are involved.
172
00:14:07,313 --> 00:14:08,542
He could bleed out.
173
00:14:12,418 --> 00:14:13,511
Can I get one of those?
174
00:14:14,554 --> 00:14:15,554
Thank you.
175
00:14:33,973 --> 00:14:36,101
Take them twice a day
176
00:14:36,209 --> 00:14:37,871
for 10 days.
177
00:14:39,479 --> 00:14:41,914
Thank you, Dr. Shaun
Murphy. Thank you.
178
00:14:42,882 --> 00:14:43,882
You're welcome.
179
00:14:49,856 --> 00:14:51,848
My chest hurts,
as well as my arm,
180
00:14:52,925 --> 00:14:57,420
and I sometimes feel my
hand cold or completely numb.
181
00:14:57,964 --> 00:15:02,664
It could be angina or a blockage,
which requires bypass surgery.
182
00:15:02,735 --> 00:15:05,261
We should do an EKG
before he goes to the cath lab.
183
00:15:05,905 --> 00:15:07,840
You don't have a cath lab.
184
00:15:09,642 --> 00:15:11,201
Strech your arm, please.
185
00:15:11,277 --> 00:15:13,473
Turn your head to the side.
186
00:15:15,248 --> 00:15:16,739
Feel his pulse.
187
00:15:20,453 --> 00:15:21,785
There isn't one.
188
00:15:21,854 --> 00:15:24,483
Turn your head forward.
189
00:15:28,628 --> 00:15:30,256
His pulse is back.
190
00:15:32,465 --> 00:15:35,162
It's not a cardiac problem.
191
00:15:35,234 --> 00:15:36,998
He has thoracic outlet syndrome.
192
00:15:37,537 --> 00:15:39,581
Dr. Saravia has
demonstrated that your nerves
193
00:15:39,605 --> 00:15:42,939
and arteries in your neck and chest
are being compacted by your ribs.
194
00:15:43,009 --> 00:15:45,444
It's an unusual condition
that can cause you
195
00:15:45,511 --> 00:15:47,343
to have blood cots
196
00:15:47,447 --> 00:15:48,938
or an embolism.
197
00:15:49,015 --> 00:15:50,847
He doesn't seem happy.
198
00:15:52,118 --> 00:15:53,381
Did I translate wrong?
199
00:15:53,453 --> 00:15:56,082
No. Your Spanish is perfect.
200
00:15:56,155 --> 00:15:59,148
But you left out that
his problem can be fixed.
201
00:16:00,560 --> 00:16:01,653
It has a cure.
202
00:16:01,727 --> 00:16:02,956
Oh, okay.
203
00:16:04,697 --> 00:16:05,960
Okay.
204
00:16:06,999 --> 00:16:11,130
I am not good at
communication in two languages.
205
00:16:14,040 --> 00:16:16,009
A nurse
206
00:16:16,709 --> 00:16:17,540
um,
207
00:16:17,610 --> 00:16:19,977
will come in a minute.
208
00:16:21,814 --> 00:16:24,215
The translator
should be here soon.
209
00:16:24,283 --> 00:16:27,651
- If you want, I can translate.
- You can speak English.
210
00:16:27,720 --> 00:16:29,416
We lived in the
U.S. for a few years.
211
00:16:29,489 --> 00:16:32,982
My mother cleaned houses.
I watch Grey's Anatomy.
212
00:16:34,093 --> 00:16:37,530
Well, being a surgeon
is not much like that.
213
00:16:38,498 --> 00:16:41,696
Ms. Garza, can you show
me where you feel pain?
214
00:16:46,939 --> 00:16:47,872
Here.
215
00:16:47,940 --> 00:16:51,069
And do you have
indigestion or cramping?
216
00:16:51,143 --> 00:16:53,442
Or ever feel like
you might throw up?
217
00:17:01,254 --> 00:17:02,254
Sometimes.
218
00:17:02,955 --> 00:17:06,323
Sometimes. But she's lying.
219
00:17:06,392 --> 00:17:07,553
It's always.
220
00:17:09,695 --> 00:17:12,187
She has fevers
too and throws up.
221
00:17:14,433 --> 00:17:17,267
I need to feel your abdomen.
Can you lie on the bed for me?
222
00:17:23,543 --> 00:17:25,307
Okay.
223
00:17:31,350 --> 00:17:34,047
Ms. Garza, I think
you have gallstones.
224
00:17:35,054 --> 00:17:36,647
We will have to run some tests,
225
00:17:36,722 --> 00:17:38,953
but it is likely that
you will need surgery.
226
00:17:52,738 --> 00:17:55,298
No, no, no surgery.
227
00:17:55,408 --> 00:17:57,502
I came here for pills.
228
00:17:58,110 --> 00:17:59,476
You told me they were.
229
00:17:59,579 --> 00:18:01,878
Listen to the doctor.
230
00:18:03,449 --> 00:18:05,475
If she doesn't want
surgery, why is she here?
231
00:18:07,320 --> 00:18:10,313
I told her you would have
pills that would help her.
232
00:18:10,923 --> 00:18:13,358
I told her I wouldn't
eat until she came.
233
00:18:19,865 --> 00:18:23,461
She says she can't miss work.
She needs to take care of me.
234
00:18:27,607 --> 00:18:30,873
I... I need you to
translate accurately.
235
00:18:33,279 --> 00:18:35,976
My mother was very sick too.
236
00:18:40,119 --> 00:18:42,054
And she tried to hide her pain,
237
00:18:42,121 --> 00:18:47,025
but children know when people
are suffering, especially their mothers.
238
00:18:59,872 --> 00:19:04,742
You can't take care of your daughter
if you do not take care of yourself.
239
00:19:22,194 --> 00:19:24,254
Did you review Bastion's file?
240
00:19:24,330 --> 00:19:27,323
Doing a bifrontal trepanation
and reconstructing the skull base
241
00:19:27,400 --> 00:19:29,096
could prevent brain herniation.
242
00:19:29,168 --> 00:19:30,830
What about risk of CSF leak?
243
00:19:30,903 --> 00:19:35,034
It reduces with a multilayer
duraplasty using a pericranial flap.
244
00:19:35,107 --> 00:19:38,441
I say five sentences to a
patient, you say five words.
245
00:19:38,511 --> 00:19:40,139
A nurse wanted me
to give this to you.
246
00:19:40,212 --> 00:19:43,410
Because medical jargon does nothing
but scare them and waste our time.
247
00:19:43,482 --> 00:19:46,577
All they care about is,
can we help, yes or no?
248
00:20:07,940 --> 00:20:10,136
Your son's heart
valves are damaged.
249
00:20:14,647 --> 00:20:17,583
It's probably the result of
his rheumatic fever last year.
250
00:20:23,122 --> 00:20:27,924
Because of his heart, we
can't remove his liver tumor.
251
00:20:29,562 --> 00:20:31,531
It makes the surgery too risky.
252
00:20:33,532 --> 00:20:35,023
I'm very sorry.
253
00:20:58,124 --> 00:20:59,752
Thank you, doctor.
254
00:21:01,927 --> 00:21:02,986
No, I'm sorry.
255
00:21:03,062 --> 00:21:06,089
We can't do the
operation on your son.
256
00:21:06,165 --> 00:21:08,031
He... I'm not sure he...
257
00:21:12,171 --> 00:21:15,266
Thank you for
trying. God bless you.
258
00:21:50,042 --> 00:21:55,242
León Castillo. 22-year old male,
large non-reducible umbilical hernia.
259
00:21:55,314 --> 00:21:58,944
- He's the sole provider for his siblings...
- No personal details. They're irrelevant.
260
00:21:59,018 --> 00:22:02,113
Two children's survival depends
on his. Seems relevant to me.
261
00:22:02,188 --> 00:22:05,056
Decisions need to be
based on medical data alone.
262
00:22:05,124 --> 00:22:08,219
This can't turn into a contest
of whose life is more tragic.
263
00:22:08,294 --> 00:22:10,058
There would be too many winners.
264
00:22:13,499 --> 00:22:14,933
Without surgery,
265
00:22:15,000 --> 00:22:17,834
the hernia is at a very
high risk for strangulation.
266
00:22:17,903 --> 00:22:19,701
It's a fast, simple procedure.
267
00:22:19,772 --> 00:22:21,673
He'll almost certainly
have a full recovery...
268
00:22:21,740 --> 00:22:25,700
From a surgery he could
survive another 15 years without.
269
00:22:26,445 --> 00:22:28,937
Replacing the valve with
a bioprosthetic means
270
00:22:29,014 --> 00:22:31,074
he won't need to be on
blood thinners forever.
271
00:22:31,150 --> 00:22:34,018
But he'll need follow-up surgeries
to replace the replacement.
272
00:22:34,086 --> 00:22:36,715
This guy is an
athlete, a fútbol star...
273
00:22:36,789 --> 00:22:37,789
Is that relevant?
274
00:22:40,492 --> 00:22:43,189
Yes, because his underlying
cardiac health is excellent.
275
00:22:43,262 --> 00:22:44,662
He should make a full recovery.
276
00:22:44,730 --> 00:22:48,132
Unfortunately, his dental
health isn't. He has cavities,
277
00:22:48,200 --> 00:22:50,135
which puts him at high
risk for endocarditis,
278
00:22:50,202 --> 00:22:52,603
which would contribute
to valve deterioration.
279
00:22:52,671 --> 00:22:57,871
A total abdominal colectomy offers
her an 80 to 90% chance at full recovery.
280
00:22:57,943 --> 00:23:00,469
Otherwise healthy.
No complicating factors.
281
00:23:00,546 --> 00:23:03,573
The tumor could be removed
using ultrasound-guided surgery.
282
00:23:03,649 --> 00:23:05,880
But she has no access to
post-op chemo and radiation.
283
00:23:05,951 --> 00:23:07,715
The mass is round, localized,
284
00:23:07,786 --> 00:23:10,449
no signs of infiltration in
the adjacent structures.
285
00:23:10,522 --> 00:23:13,424
- Minimal chance of reoccurrence.
- If you get all of it.
286
00:23:15,895 --> 00:23:18,660
- She just got married last week...
- Dr. Reznick...
287
00:23:18,731 --> 00:23:21,064
Which is medically relevant
because studies have shown
288
00:23:21,133 --> 00:23:23,500
optimistic people have
better long-term prognosis.
289
00:23:23,569 --> 00:23:25,128
And she is full of hope.
290
00:23:33,979 --> 00:23:36,710
There's a boy,
he needs blankets.
291
00:23:36,782 --> 00:23:38,216
Blankets, please.
292
00:23:38,284 --> 00:23:39,115
Over there.
293
00:23:39,218 --> 00:23:40,277
Thank you.
294
00:24:09,181 --> 00:24:12,208
The gallstones are intermittently
blocking the bile duct,
295
00:24:12,284 --> 00:24:14,082
which could lead to
ascending cholangitis,
296
00:24:14,153 --> 00:24:15,177
sepsis and death.
297
00:24:15,254 --> 00:24:17,655
Her condition might
respond to medication.
298
00:24:17,723 --> 00:24:19,783
Unlikely, given how
advanced her symptoms are.
299
00:24:19,858 --> 00:24:23,488
But she has a non-surgical
option. Bastion doesn't.
300
00:24:23,562 --> 00:24:27,624
It's a miracle he made it to 12.
Without surgery, he will not see 15.
301
00:24:27,700 --> 00:24:30,602
He's unable to eat solid foods,
he's showing signs of malnutrition.
302
00:24:30,669 --> 00:24:33,002
Shaun's surgical
plan is very ambitious.
303
00:24:33,072 --> 00:24:35,837
It runs the risk of
graft failure necrosis.
304
00:24:35,908 --> 00:24:37,536
You could leave
this boy worse off.
305
00:24:37,609 --> 00:24:40,078
Meanwhile, Edna's
surgery is straightforward,
306
00:24:40,145 --> 00:24:42,580
and she is all her
daughter has in the world.
307
00:24:43,415 --> 00:24:46,852
Who a person is cannot be completely
separated from their medical care,
308
00:24:46,919 --> 00:24:48,512
and I'm done
pretending it can be.
309
00:24:55,594 --> 00:24:57,586
We've got a mom who
needs a simple procedure
310
00:24:57,663 --> 00:24:59,029
she might live without...
311
00:25:00,899 --> 00:25:04,529
or a son whose only shot at
life is a very complicated surgery
312
00:25:05,237 --> 00:25:06,569
that may not work.
313
00:25:36,835 --> 00:25:38,770
We have to focus
on the miracles.
314
00:25:43,075 --> 00:25:44,075
Let's go eat.
315
00:25:49,181 --> 00:25:50,877
Okay, so look at the nail bed.
316
00:25:50,949 --> 00:25:54,386
Karla said if you see alternating
redness with the pulse,
317
00:25:54,453 --> 00:25:56,979
that's a sign of
aortic insufficiency.
318
00:25:57,056 --> 00:26:00,424
Well, your heart is fine.
And your cuticles are great.
319
00:26:00,492 --> 00:26:02,051
I get manicures.
320
00:26:05,364 --> 00:26:08,630
Ah. You like? It's
a national treasure.
321
00:26:09,635 --> 00:26:12,434
No. I just wanted
the experience.
322
00:26:13,338 --> 00:26:16,069
I shouldn't have any more.
First day of surgery tomorrow.
323
00:26:16,141 --> 00:26:17,302
Oh, no. I'm good.
324
00:26:26,618 --> 00:26:28,109
You are terrible at this.
325
00:26:28,187 --> 00:26:30,952
I am terrible, but I look
fantastic. Watch this.
326
00:26:32,825 --> 00:26:34,794
- I'll get us another round.
- Okay.
327
00:26:35,828 --> 00:26:38,423
- Tequila.
- Mmm.
328
00:26:39,631 --> 00:26:40,929
What's going on over there?
329
00:26:43,202 --> 00:26:46,331
- I'm getting my ass kicked in darts.
- You're flirting.
330
00:26:47,506 --> 00:26:48,633
Just being nice.
331
00:26:48,707 --> 00:26:51,768
Well, don't be so nice that
you regret it when you get home.
332
00:26:54,780 --> 00:26:56,681
You have nothing to worry about.
333
00:26:57,449 --> 00:26:58,449
I guarantee it.
334
00:27:00,152 --> 00:27:02,018
All right. I'll grab a
cab back to the hotel.
335
00:27:02,087 --> 00:27:03,087
Okay.
336
00:27:11,063 --> 00:27:12,063
Good night, guys.
337
00:27:18,871 --> 00:27:19,871
Uh...
338
00:27:20,372 --> 00:27:23,035
- Hotel Provincia?
- Yeah.
339
00:27:26,445 --> 00:27:28,676
Mind if I tag along?
Big day tomorrow.
340
00:27:28,747 --> 00:27:29,747
Sure.
341
00:27:44,696 --> 00:27:47,188
I saw you break the
news to that boy's dad.
342
00:27:48,634 --> 00:27:49,863
You wanna talk about it?
343
00:28:00,078 --> 00:28:01,078
Morgan.
344
00:28:03,916 --> 00:28:05,509
I just wanted to
know if you're okay.
345
00:28:06,552 --> 00:28:09,454
You don't get to ask me that
anymore. We're not friends.
346
00:28:10,589 --> 00:28:12,080
You drew a line.
347
00:28:12,157 --> 00:28:13,921
So don't ask me how I am
348
00:28:13,992 --> 00:28:17,394
and then pretend to be some nice
guy who cares when you obviously don't.
349
00:28:24,269 --> 00:28:27,137
I just got a text from
Karla. Miguel is crashing.
350
00:28:27,206 --> 00:28:29,266
Shaun and I are gonna
head back to the hospital.
351
00:28:43,388 --> 00:28:46,017
- Eight?
- I'm only fluent in six.
352
00:28:47,626 --> 00:28:50,824
I didn't set out to learn them. I just
picked them up as I moved around.
353
00:28:50,896 --> 00:28:54,663
Oh, so you're an
accidental language genius?
354
00:28:59,371 --> 00:29:03,331
So, what are some of these places?
I mean, that you moved around to.
355
00:29:03,408 --> 00:29:07,106
I was born in Mexico, went to
medical school in New Haven,
356
00:29:07,179 --> 00:29:08,841
did my residency in Chicago.
357
00:29:08,914 --> 00:29:12,009
Stayed a while in
Syria, Haiti, the Congo.
358
00:29:12,618 --> 00:29:14,780
You throw in your stop
at Yale to impress me?
359
00:29:14,853 --> 00:29:16,981
I threw in my stop at the
Congo to impress you.
360
00:29:25,631 --> 00:29:28,692
This is not the road to Hotel
Provincia. Where you taking us?
361
00:29:29,201 --> 00:29:30,801
We are going to make a stop.
362
00:29:31,970 --> 00:29:33,268
Do you want money?
363
00:29:33,338 --> 00:29:34,966
I don't need your money.
364
00:29:39,645 --> 00:29:40,645
What's happening?
365
00:29:41,947 --> 00:29:45,076
Don't be too alarmed,
but we're being kidnapped.
366
00:30:15,747 --> 00:30:17,807
Come in, please. Hurry!
367
00:30:23,755 --> 00:30:24,755
She is my niece.
368
00:30:24,856 --> 00:30:26,324
She's been in
labor for 14 hours.
369
00:30:26,925 --> 00:30:28,245
Fourteen hours like this.
370
00:30:30,495 --> 00:30:32,259
Hi, I'm a doctor.
371
00:30:32,331 --> 00:30:34,331
Can you handle the
additional talking?
372
00:30:34,366 --> 00:30:37,495
We came to help you and your
baby, OK? We'll check you up.
373
00:30:37,569 --> 00:30:38,680
- OK.
- It hurts a lot.
374
00:30:38,704 --> 00:30:39,704
Here we go.
375
00:30:41,340 --> 00:30:44,208
Well, the baby's head is down,
so the position's not a problem.
376
00:30:49,281 --> 00:30:50,281
I can't hear anything.
377
00:30:52,751 --> 00:30:55,585
The cab driver, he had a cup of
coffee in his cab. Have him get it.
378
00:30:56,888 --> 00:30:59,357
A cup of coffee in
the cab, bring it, now.
379
00:31:01,159 --> 00:31:02,889
Tell her I have to
check her cervix.
380
00:31:02,961 --> 00:31:04,520
The doctor will touch you.
381
00:31:05,063 --> 00:31:07,032
Okay.
382
00:31:10,102 --> 00:31:11,468
She's fully dilated.
383
00:31:14,272 --> 00:31:16,605
All right, tear out the
bottom, hand it to me.
384
00:31:23,248 --> 00:31:24,409
I can hear a heartbeat.
385
00:31:25,684 --> 00:31:26,913
The baby has decels.
386
00:31:28,320 --> 00:31:30,289
No, no, no. Don't push!
387
00:31:31,723 --> 00:31:34,989
He became short of breath
and then lost consciousness.
388
00:31:35,060 --> 00:31:38,622
I believe his thoracic outlet
syndrome caused a clot in his arm
389
00:31:38,697 --> 00:31:40,256
which went into his lungs.
390
00:31:40,332 --> 00:31:43,166
That would explain the drop in
blood pressure and respiratory rate.
391
00:31:43,235 --> 00:31:45,704
But not his elevated
end-tidal CO2 level.
392
00:31:45,771 --> 00:31:48,900
That is inconsistent with
a pulmonary embolism.
393
00:31:51,643 --> 00:31:53,134
What is it consistent
with, Shaun?
394
00:32:07,459 --> 00:32:11,191
His brain. A clot that traveled from
his arm through a hole in his heart
395
00:32:11,263 --> 00:32:13,357
into his aorta and
up to his brain.
396
00:32:20,672 --> 00:32:23,107
His gag reflex is only
active on one side.
397
00:32:23,775 --> 00:32:24,674
I was right.
398
00:32:24,743 --> 00:32:27,645
He has a small clot in the brain
stem, near the respiratory center.
399
00:32:28,880 --> 00:32:31,111
Well, we can surgically
remove a clot in his lung.
400
00:32:31,183 --> 00:32:34,483
But in his brain, we
can't do that here.
401
00:32:34,553 --> 00:32:38,115
If we have tPA, we
could break it up.
402
00:32:38,190 --> 00:32:39,749
TPA, no.
403
00:32:40,492 --> 00:32:43,223
But we have a snake
venom derivative.
404
00:32:44,429 --> 00:32:46,660
It does the same
thing, more or less.
405
00:32:51,203 --> 00:32:52,694
Any movement at all?
406
00:32:52,771 --> 00:32:54,933
None. No cord presentation.
407
00:32:55,006 --> 00:32:57,566
- Maybe her pelvis is too narrow.
- Heart rate's getting slower.
408
00:32:58,577 --> 00:33:00,569
Wait. I can feel a
hand by the face.
409
00:33:01,947 --> 00:33:04,644
The baby's sucking its thumb.
That's why it's not progressing.
410
00:33:04,716 --> 00:33:07,413
I can do an episiotomy,
try to pull the baby out,
411
00:33:07,486 --> 00:33:09,921
but with the arm where it's
at, I'm gonna break the clavicle
412
00:33:09,988 --> 00:33:12,014
and damage the
brachial plexus nerve.
413
00:33:12,858 --> 00:33:16,351
Reach inside, find the
baby's finger and pinch it hard.
414
00:33:28,440 --> 00:33:29,703
It worked.
415
00:33:31,243 --> 00:33:32,404
OK, honey.
416
00:33:32,511 --> 00:33:34,776
Now you will push.
417
00:33:34,846 --> 00:33:36,178
- Push.
- Push.
418
00:33:50,362 --> 00:33:52,354
I'm sorry.
419
00:33:55,267 --> 00:33:56,860
Do you speak English?
420
00:33:57,402 --> 00:33:59,633
No, no, I don't speak English.
421
00:34:02,374 --> 00:34:06,038
Me llamo Lea. I'm
with the Americans.
422
00:34:07,412 --> 00:34:09,745
Hmm. I'm Sofia.
423
00:34:10,549 --> 00:34:13,383
He is my husband, Oscar.
424
00:34:14,219 --> 00:34:15,847
And she...
425
00:34:16,454 --> 00:34:17,888
is Isabela.
426
00:34:21,426 --> 00:34:22,985
Isabela.
427
00:34:24,496 --> 00:34:26,624
She is perfecta.
428
00:34:31,002 --> 00:34:32,002
Um...
429
00:34:36,875 --> 00:34:39,811
I found these in my suitcase.
430
00:34:39,878 --> 00:34:41,107
My mom got them for...
431
00:34:43,515 --> 00:34:47,282
It gets cold in here.
A gift for Isabela.
432
00:34:51,923 --> 00:34:53,152
Gracias.
433
00:34:56,461 --> 00:34:59,260
Would you like to carry her?
434
00:35:09,708 --> 00:35:13,338
No, gracias. I have to go.
435
00:35:30,862 --> 00:35:32,222
Congratulations, Mom.
436
00:35:34,032 --> 00:35:35,694
What a beautiful son.
437
00:35:56,955 --> 00:35:58,685
Shaun's keeping
an eye on Miguel.
438
00:36:00,091 --> 00:36:01,091
Okay.
439
00:36:12,871 --> 00:36:16,137
You know, it's
okay to not be okay.
440
00:36:19,010 --> 00:36:20,010
It's...
441
00:36:20,912 --> 00:36:23,211
Every time I feel like
things are getting better...
442
00:36:24,582 --> 00:36:25,606
it's there again.
443
00:36:28,553 --> 00:36:30,078
Yeah, I know.
444
00:36:31,623 --> 00:36:33,114
Like it comes in waves.
445
00:36:33,925 --> 00:36:34,925
Yeah.
446
00:36:35,226 --> 00:36:37,024
Eventually, it subsides.
447
00:36:38,563 --> 00:36:40,054
It's a process.
448
00:36:41,232 --> 00:36:43,531
It's a terrible process.
449
00:36:45,270 --> 00:36:47,762
And it's one you don't
have to go through alone.
450
00:36:52,410 --> 00:36:54,106
Shaun has no idea, does he?
451
00:36:55,280 --> 00:36:56,280
No.
452
00:37:00,919 --> 00:37:04,947
He's doing great, important work.
I don't wanna interfere with that.
453
00:37:06,558 --> 00:37:07,558
And...
454
00:37:09,928 --> 00:37:11,226
he can't fix it.
455
00:37:13,164 --> 00:37:14,655
It's not about fixing it.
456
00:37:16,301 --> 00:37:19,829
It's about the two of you
just being in this together.
457
00:37:27,912 --> 00:37:30,108
He's waking up.
458
00:37:31,483 --> 00:37:32,610
What...?
459
00:37:32,917 --> 00:37:34,112
What happened?
460
00:37:35,186 --> 00:37:39,282
You had an embolism, but
we were able to treat you.
461
00:37:40,925 --> 00:37:45,124
Will I still be able to get
the surgery tomorrow?
462
00:37:46,965 --> 00:37:49,594
No, you will not.
463
00:37:52,003 --> 00:37:54,871
Tiziana. Tiziana, wake up.
464
00:37:55,373 --> 00:37:57,638
Hey, I need you to tell
your mother something.
465
00:37:58,309 --> 00:37:59,675
We're gonna do her surgery.
466
00:38:01,479 --> 00:38:04,074
Mom, you will get the surgery.
467
00:38:06,851 --> 00:38:10,185
♪ And when you wake up ♪
468
00:38:11,623 --> 00:38:14,092
I could die without
that surgery.
469
00:38:18,696 --> 00:38:23,930
♪ We've got the time
To take the world ♪
470
00:38:24,002 --> 00:38:25,002
Thank you.
471
00:38:25,670 --> 00:38:26,714
You're welcome.
472
00:38:26,738 --> 00:38:33,736
♪ And make it better
than it ever was ♪
473
00:38:42,253 --> 00:38:43,253
That was...
474
00:38:44,422 --> 00:38:45,422
It was.
475
00:38:54,332 --> 00:38:55,823
Buenas noches, Audrey Lim.
476
00:39:02,207 --> 00:39:03,207
You know...
477
00:39:06,511 --> 00:39:08,844
I'm not really tired.
478
00:39:13,918 --> 00:39:14,918
Me either.
479
00:39:24,362 --> 00:39:27,890
Tomorrow, I will be
removing an adenocarcinoma
480
00:39:27,966 --> 00:39:30,060
from a young
woman's mediastinum.
481
00:39:31,169 --> 00:39:35,197
That can be a very dangerous
area because of the vasculature.
482
00:39:38,243 --> 00:39:40,269
It will be an
excellent challenge.
483
00:39:41,813 --> 00:39:45,443
Are you coming to bed? I
would like to turn off the light.
484
00:39:50,922 --> 00:39:53,551
I don't wanna ruin your trip.
485
00:39:55,560 --> 00:40:00,123
You're having such a
good time, but... I'm not.
486
00:40:00,899 --> 00:40:03,630
What's wrong? Are you sick?
487
00:40:03,701 --> 00:40:07,502
Did you open your mouth in the
shower? That is very common.
488
00:40:08,840 --> 00:40:11,207
I'm just sad.
489
00:40:12,610 --> 00:40:16,138
Every time something reminds
me of the baby, I get even sadder.
490
00:40:16,214 --> 00:40:20,345
I'm glad you're doing better
than I am, I'm glad you're happy.
491
00:40:20,418 --> 00:40:24,913
But sometimes you being
happy makes me feel worse.
492
00:40:27,025 --> 00:40:29,859
I hate that I feel that way and
I didn't even wanna tell you,
493
00:40:29,928 --> 00:40:31,590
but I think I need to tell you.
494
00:40:32,997 --> 00:40:34,124
I'm sorry.
495
00:40:35,867 --> 00:40:39,360
Do you want me to
not talk about work?
496
00:40:40,071 --> 00:40:42,802
No. I can't ask you to do that.
497
00:40:42,874 --> 00:40:45,776
Yes, you can. I want
you to feel better.
498
00:40:45,843 --> 00:40:47,368
It won't help, Shaun.
499
00:40:48,279 --> 00:40:50,271
What will help?
500
00:40:54,986 --> 00:40:56,010
Nothing.
501
00:40:59,857 --> 00:41:01,849
I miss her so much.
502
00:41:03,761 --> 00:41:06,993
I mean, even looking at your
blue eyes breaks my heart
503
00:41:07,065 --> 00:41:09,000
because I dreamed
she would have them.
504
00:41:16,407 --> 00:41:21,209
My parents are really worried,
been calling all the time.
505
00:41:22,914 --> 00:41:25,782
They want me to come
back to Hershey for a while.
506
00:41:27,018 --> 00:41:28,384
They think it'll help.
507
00:41:32,290 --> 00:41:33,290
Do you...
508
00:41:35,326 --> 00:41:36,326
want to?
509
00:41:40,298 --> 00:41:46,363
I think it would be good for me to
get some time away from everything.
510
00:41:57,115 --> 00:41:58,947
I'm sorry you're sad.
35836
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