All language subtitles for The Good Doctor 6x04 - Shrapnel (English)

Previously on The Good Doctor...

I feel something. A crush.

Shaun, did you change
the surgical plan?

The parameters it was based on changed.

I adjusted accordingly.

And ignored my instructions?

Your bedside manner is impressive.

I spent two years in Afghanistan.

- You okay?
- No, I am not okay.

I'm so sick of this chair.

And I hate that my body
won't do what I want.

And I hate Shaun Murphy.

What exactly do you want from me?

I am sitting in this chair
because of that surgery.

And everybody here
seems completely fine with it.

I'm not fine with it.

I don't want you to ask
me about my personal life,

and I don't want to hear about yours.

From now on, our
relationship is medicine only.

Weather, San Francisco Bay Area.

Monday, 66.

Tuesday, partly cloudy, 67.

Wednesday, 72, sunny. 61 low.

Good morning.

- You had the volume up very loud.
- Sorry.

I was watching Hairspray
before you got home last night.

At those decibels, damage to
the inner ear is very possible.

Daddy, chill. It was
only for the last song.

- Couldn't sleep again?
- I needed to read these.

If you're feeling anxious or upset,

you know you can talk to me.

I'm not anxious or upset.

You've already read all those.

Information retention is increased

by multiple exposures over time.

I'm sure Lim just needs some time.

She's struggling to adjust,
which is understandable.

Yes, it's okay.

I still have Dr. Glassman
and Dr. Andrews

as mentors and other friends

I can go to for advice.

Steve always said that if
someone didn't want to be my friend,

it's their problem.

So I shouldn't worry about it.

Your brother was pretty smart.

Yes, he was.

I have to go.

I'm meeting Dr. Glassman for pancakes.

Good morning.

I haven't seen you around lately.

Yeah, I've been really busy at work.

I know the feeling.

That Murphy guy still
making your life miserable?

Actually, no.

We had a very... honest discussion.

I set some boundaries,
feel good about it.

Nice.

I bet that's a relief.

Sorry I was such a mess
in the garage last week.

It was nothing.

Not true, but thank you.

I owe you.

Actually, I could use a
ride to the airport tomorrow.

I have a 6:00 a.m. flight.

- Okay.
- I'm kidding.

I was happy to help.

- Have a good one.
- You too.

That was nice.

For once, my complete
clumsiness actually paid off.

Might change your mind
when you get the cleaning bill.

It was worth every penny.

I'd gladly sacrifice another
shirt to do it all again.

Hopefully soon?

Or not.

Sorry. I was only in town to finalize
the sale of our West Coast distributor.

And now that it's done...

Well, I've been looking for
an excuse to visit New York.

I would love that,

but I'm pretty sure
my husband wouldn't.

Don't hate me.

We had fun.

_

_

We've got some powder burns

and a penetrating shrapnel wound.

From playing airsoft?

I'm in a historical
battle reenactment club.

I thought some explosions would
make it more realistic and fun.

One of the fireworks went
off when I was setting it up.

It doesn't look too bad.

It was gushing blood.

It's bleeding. It's not gushing.

I spent a year as a Navy
corpsman in Afghanistan,

treated hundreds of shrapnel
wounds that actually were gushing.

You're gonna be fine.

Can you move your arm?

Yeah.

Yeah.

A little.

No step-offs, good range of motion.

The humerus isn't fractured,

which means Dr. Powell is right.

You're going to be fine.

Irrigate with antibiotic saline and
get a CT to locate the fragments.

Page me to the OR when
he's prepped for surgery.

Yes. Will do.

Need help over here.

He's in and out of consciousness.

BP's in the toilet from
massive blood loss.

Damn.

Fluid resuscitation initiated en route.

- Shark bite?
- Speedboat.

Got run over on a predawn skinny-dip.

Luckily his girlfriend's
a former lifeguard,

got him to shore, applied a tourniquet.

What do we got?

An attending who's 20
minutes late to his call shift.

Total amputation of the left lower
extremity at the tibiotalar joint.

- Speedboat propeller.
- Thank you.

See how easy and productive that was?

Grumpy as well as late.
Must've been a rough night.

It was a great night, and
an even better morning,

not that it's any of your business.

- Then why tell me?
- Because it bothers you.

What's weird is, this isn't much
different than when they were dating.

One of the many reasons
we're not anymore.

Transfuse four units
PRBC and stay four ahead.

- On it.
- It's a clean cut.

We got six to eight hours
max of ischemic time.

You're gonna try to reattach it?

I'm gonna do more than try.

And the proper term is "replant."

Call it whatever you
want, it's still a bad idea.

Lack of a sensate plantar surface

would make it likely no
better than a prosthetic.

I disagree, and seeing
as I'm the only attending

who's an actual surgeon,
I'll take it from here.

- Where's the foot?
- I assume at the bottom of the lake.

You mean the top.

Not unless he was
skinny-dipping with his shoes on.

- Bodies float.
- Severed feet sink.

Okay, wherever it is,
we need to find it fast.

Get police search and
rescue out there ASAP.

Good luck.

I'll call.

Increase fluid and blood resuscitation.

If we don't get his BP up,
finding his foot won't matter.

www.TUSUBTITULO.com
-DIFUNDE LA CULTURA-

Vitals have stabilized.

He's opening his eyes.

I'm Dr. Park.

You're at St. Bonaventure Hospital.

Can you tell me your name?

Andy.

You know what city you're in?

San Jose.

Is Brittany here?

Your girlfriend couldn't
ride in the ambulance,

but the EMT said she
was gonna follow in her car.

She's not my girlfriend.

It was our first date.

She saved your life.
Sounds like a keeper.

How many stitches did I need?

She said the cut was pretty bad.

Andy, I'm sorry, but your left foot

was completely severed at the ankle.

What?

It didn't even hurt that much.

You were in hypovolemic shock,

nearly died from the blood loss.

We need to get you into an OR
to clean and debride the wound.

We'll leave it open for now,

and if we can find the foot,

we'll attempt to replant it.

What do you mean, if you can find it?

It's in the lake?

Search and rescue headed to the lake.

I want you guys out there, as well.

You need to start antibiotic irrigation

with pulse lavage
as soon as it's found,

and then get it in an
organ transplant unit

and perfuse during transport.

We're on a clock. Every second counts.

That lake's huge.

You really think they're gonna find it?

Well, police divers find weapons

perps toss in the ocean all the time.

With metal detectors,
which obviously won't...

Go.

He's lucky.

Not even any occult fractures.

It still blows my mind
you fought in a war.

I wish that we could get a better view

of the recon images

at the level of the
mid to distal humerus.

We can.

Watch and learn, young Padawan.

Thanks.

That's... a big one.

What made you decide to enlist?

- Did you have family in the...
- I didn't enlist.

I went to the Naval Academy

and got an officer's
commission after graduation.

There's a brachial
artery pseudoaneurysm.

Looks like the only thing
stopping it from rupturing

is the shrapnel wedged
against the vessel wall.

That's... not good.

We have to get him to the OR.

I'll page Dr. Murphy.

What're you doing?

This lamp was in the wrong place.

It seemed fine to me.

You're not as easily distracted
by the environment as I am.

Well, I understand, but next time,

you mind checking with me

before you start rearranging furniture?

I think you'll like the lamps here.

That's not the point.

I have to get to the OR.

Park has more confidence
in the cops than I do.

There's no way they're
gonna find it in time.

I had a cousin who lost her engagement
ring in a Halloween corn maze.

A year later, the farmer
found it inside an ear of corn.

If you believe that, there's a Nigerian
prince I'd love to introduce you to.

- It's true.
- No, it's not.

The farmer found it the same day
she lost it, probably in the bathroom.

He figured he'd let the commotion
die down before he tried to sell it.

Then someone in his family got cancer or
something else he needed the Lord's help with.

He couldn't very well
pray for divine intervention

with a hot diamond in his sock drawer.

You have a very fertile
and cynical imagination.

Thank you.

I've been listening to that
Ten Percent Happier podcast,

so I'm all about the positive vibes.

Our foot will be found.

I got 20 bucks says you're wrong.

Come on,
Mr. Positive, you can't lose.

- It's a bet.
- Okay.

Stop being so dramatic.

You stop being so dramatic.

The next one is... is the top one.

Stop second dealing.

I don't want a pilonidal cyst.

I just had a guy with jock-itch

that was up to his belly button.

And I just had a guy with a plantar
wart infection who hasn't changed socks

since the Carter Administration.

The next one is the top one.

Take it.

Do you have a minute?

Yes.

I was just curious about how
your breakfast with Shaun went.

I canceled.

I'm worried about him.

He won't admit it, but I can tell what
Lim said is still really bothering him.

If you're worried about him,
then you should talk to Shaun.

I tried that. He says he's fine.

It's not just about Shaun.
You know that, right?

No, it's not. Lim is shutting him out.

'Cause Lim is hurting.

Shaun's gotta take some
kind of responsibility for that.

Why? He didn't hurt her.

It's not so cut and
dried, certainly not to Lim.

- Well, what about for you?
- What about for me?

If Shaun's got a problem with
Lim, then he's gotta deal with it.

A medial longitudinal incision

is used to extend the
wound above and below.

Next steps, Dr. Powell?

Place clamps both proximal and
distal, locate the foreign bodies,

and remove and suture
with a 6-0 running.

That's exactly right.

Place the vascular clamps.

The Navy definitely gave you

some good training in trauma care.

Is that why you went to the Academy?

Thought it would help
you get into med school?

Can we get a little bit
more irrigation, please?

Did you ever want
work on a fishing boat?

At my high school, the people
who talked about joining the military

also wanted to work on
fishing boats in Alaska.

I hate fishing. It's
both cruel and boring.

I'm guessing the
shrapnel in Afghanistan

didn't have clown faces printed on it?

Nope.

Wait, can I see that?

That looks like it's from a
propulsive charge, not a shell.

- What's the difference?
- Shut off the electrocautery.

- There's still some bleeding...
- No, no, no, don't!

What the hell was that?

Firework mortar the
electrocautery detonated.

His brachial artery's shredded.

We stopped the bleeding and
restored blood flow to your arm,

but it's only a partial fix.

You'll need more tests and
then surgery to do a tissue flap

and to stabilize the shattered humerus.

How could it explode again?

Aerial fireworks have
two explosive charges.

The shrapnel from the propulsive charge

obstructed the CT view
of the undetonated mortar.

You're very lucky. If it
had exploded in the field,

you would've bled to
death in under 90 seconds.

I don't feel very lucky.

We can increase your hydromorphone.

You can pretend that you're
in a combat support hospital.

Make it all part of
the "realistic fun."

I doubt that will
help, but you can try.

It feels like it's on fire.

Almost done. For now.

We'll need to repeat
this every two hours

to make sure you're ready to
go the moment the foot arrives.

Can you check my phone again?

Nothing yet. Sorry.

I know it was just a first date,

but... I thought it
was going really well.

I always think that,

and then find out I talked
too much or not enough,

or she actually did like me,

but she's heading off to grad school

or doesn't want anything exclusive.

She's probably stuck in traffic.

Maybe... Maybe some people
are just meant to be alone.

Yeah, I met a great woman last night.

Found out this morning she was married.

That's in the wake of a divorce

and a serious relationship that
crashed and burned a few months ago.

You know, finding the right
person, it's pretty damn hard.

You gotta keep trying.

Dr. Park and I are very different.

You can't have your own office, Murphy.

But prior attendings...

Were hired when we had
different budgetary constraints.

Okay, Dr. Park and I have
different work methods.

Neither of us can perform
at our best in a shared office.

There are no other offices available,

and I'm quite confident you
and Park can make it work.

You're just gonna have to
make a few compromises.

- But...
- And if I know Park,

I'm guessing he's already
made a few, which means...

it's your turn.

Officer Baxter?

That's me.

Dr. Perez, this is Dr. Allen.

No foot yet.

Just a bunch of old ball caps,

beer bottles, and dirty diapers.

Some people just don't
deserve nice things.

- Was that on the bottom?
- Yeah.

Actually got us excited for a minute.

I'd find some shade.

We're gonna be here a while.

It's really important that we
find it as soon as possible.

We'll find it when we find it.

Okay.

All right, well, I'll be right back.

I got a beach towel in my trunk.

You going for a swim?

No, just want to be able to sit
down without getting my pants dirty.

Look at you, all prepared.

- Yep.
- Such a Boy Scout!

What about me?

It's big enough for both of us.

Severe trauma to the distal subclavian.

We can do the bypass more
proximally than we'd planned.

I've seen it done in a
Role 3 field hospital.

It'll work.

Surprised you're so invested.

You certainly didn't seem
that sympathetic in the room.

I shouldn't have said that.

I can see how it would be
upsetting to deal with a guy

who thinks combat
is a fun game to play.

- Were you ever in actual...
- I was wrong.

Well, it's okay. We
all let our personal...

No, I mean about the bypass.

There's avulsion of multiple
nerves just beyond the plexus.

So even if we can restore blood flow,

the arm would still be
immobile and without sensation.

We're gonna have to amputate.

We're not going to do that.

We can use external fixation
to stabilize the fracture,

thoracotomy for the
subclavian artery bypass,

and repair the peripheral nerves
with sural grafts from his leg.

There are multiple nerves damaged.

Then we will find multiple solutions.

We are not going to amputate.

Dr. Murphy, we need to talk.

I'm busy.

So am I, so I'll make it fast.

Keep looking for a solution
to those nerve injuries.

I will be right back.

Really?

And my desk is facing a window?

I also moved my desk several inches.

Dr. Andrews said we both
needed to make compromises.

Okay, Shaun, I told you this morning...

Yes, now neither of us will be bothered

because we won't be
facing each other as we work.

I'm not bothered by
that, and if you are,

then you should turn your desk around.

No, no, no, no, no. I
can't work facing a window.

People constantly walking by outside...

You're not the only person who
needs a comfortable environment

to do their job.

Now, I don't care what
you do with your stuff,

but do not move or touch
anything that belongs to me again.

Page me if you find
a surgical solution.

Murphy wants his own office.

- Is that surprising?
- No.

What was surprising was him
coming to me instead of his supervisor.

Okay. I'm not sure why
you're sharing that with me.

Is there a problem between
Murphy and Lim I should be aware of?

Maybe.

Care to elaborate?

If there's a problem between Lim
and Shaun, why are you asking me?

Because I value your insight,

and I'm under the impression

that they're both
close friends of yours.

Okay, so it's definitely my
responsibility to sort that out.

Not a bad spot for a
post-date skinny-dip.

As long as you stay out
of the speedboat lane.

You're not a skinny-dipper?

Definitely not.

A strong aversion. Interesting.

Is it the... the cold water,
the nudity, or you just hate swimming?

All of the above.

I don't do outdoor naked
or outdoor hookups.

Same goes for cars,
airplanes, elevators.

I'm more of a comfortable,
private spot type of girl.

Good to know.

I definitely agree on
the planes and elevators,

and I'm not a big fan of cars myself,

but, tractor combines...

they're a whole 'nother story.

Tractor combines?

I don't know. Just something
about being high up,

looking out over a few hundred
acres of alfalfa blowing in the breeze.

- What?
- You are a strange dude.

And why do you keep a
beach towel in your trunk?

I do yoga in the park after work.

Yes, the yoga.

You should try it sometime.

Might help soften up
some of that cynicism.

I'd rather be cynical than gullible.

Found a diamond ring in an ear of corn.

Oh, God. It's true, all
right? You can ask my dad.

He's known that farmer his entire life.

And now I know where you got it from.

The apple doesn't
fall far from the alfalfa.

Okay.

There's an active bleed
at the debridement site.

- BP's plummeting.
- Damn it.

We have to get the stump closed.

No, that'll make it
impossible to replant his foot.

There's still time for them to find it.

I just need to stop the bleed.

I can't get the bleeding under control.

If I ligate, it'll
clot, but if I don't,

the reduced flow will destroy
everything we've already fixed.

Still no word?

I just got off the
phone with Dr. Allen.

They still haven't found it.

Let's get him to the OR. We
need to fully close the wound.

You tried your best.

What're you doing, Murphy?

Setting up my new office.

No, you're not. I told you
there was no extra space.

But you were wrong.

Nurse Hawks told me this room

has not been used by anyone in months.

Because we need it for storage.

We can still use it for storage.

There's room for my new
desk and all this other stuff,

which won't distract me by
sharpening pencils, doing back stretches,

looking at me, or breathing.

Fine. For now.

But as soon as someone
needs it, I'm kicking you out.

Thank you, Dr. Andrews!

Yeah.

Okay.

Got it.

You owe me 20 bucks.

We still have another hour.

Park couldn't control the bleeding.

He's moving the guy to
the OR to close the wound.

We can still scrub
in if we beat traffic.

Hey! Where are you going?

I got five little piggies
that need to go home.

Page Park.

Already am.

We need to repair the
left subclavian artery first.

But we still need a
way to get distal control.

Couldn't we just extend the incision

to the supraclavicular one?

No. That risks transection
of the phrenic nerve.

So, why did you want to join the Navy?

Couldn't afford to pay for college?

You wanted to see the world?

Why are you so obsessed with this?

I'm just... curious. I'm
trying to get to know you.

Clearly, you have some
sort of judgmental notion

about the type of people
that join the military.

I'm not judging you.
I'm genuinely impressed.

Because I know how to treat a
puncture wound and read a CT?

Do you have such low expectations
of all veterans or just the amputees?

Hello. I have resolved the issue.

We use biopolymer grafts
to repair multiple nerves.

I can definitely think
more clearly in my new office.

Great.

Forceps.

Some of the tissues
edges look necrotic.

You gonna be able to remove it all?

Hope so. Grab the DeBakey scissors

and cut off the non-viable tissue.

You mind keeping your eyes on the road?

Sorry. It's just... that's pretty cool.

6-0 on a prolene castro.

Get the transplant unit open and ready.

It's been seven hours
of cold ischemia time.

We gotta get it perfused ASAP.

All right.

It's nearing the eight-hour mark.

They got off the
freeway four minutes ago.

Could be traffic.

No, they're in a
squad car with a siren.

Which you'd think would
make people get out of the way,

but apparently not.

Nice color. Healthy edges.

Great work. Scrub
in, and let's do this.

Biopolymer grafts aren't going to work.

The gap's too wide.

Nerve defects from the
explosion are too big.

Even if we bridge the nerves,

what do we do about all this bleeding?

We have to amputate.

We have no choice.

Dr. Murphy?

We can do an end-to-side neurorrhaphy

with coaptation of the distal stump

of the transected nerves
to adjacent donor nerves.

But what do we do about the bleeding?

- If we can't stop it...
- We can facilitate anastomosis

by using the parachute technique.

- We're running out of time.
- I can do it.

Stabilizing the ankle joint.

Matching the ends of the posterior
tibial and dorsalis pedis arteries.

His date ever show up?

- Nope.
- Use 7-0 prolenes.

I sort of feel bad for the guy.

In all fairness, was it right
for him to expect her to?

Well, seems like the
decent thing to do.

Repairing the vena
comitans and saphenous vein.

Saving his life wasn't enough?

She still could show up,

and this could be a crazy
story they tell their kids one day.

Sorry, Mr. Positive, but
that will definitely not happen.

You never know. Most
of the people I know

who are in great relationships
had super rocky starts.

I can't get any pulse on the foot.

The anastomosis sites are hemostatic.

Hey, check Doppler at the femoral,

then work your way down
to where the flow stops.

Good in the groin.

No flow here.

He's thrombosed all
the way to his popliteal.

We may have just saved
his foot, but killed his leg.

Shaun?

I just saved my patient's arm.

I heard that. That...
That's good... good work.

Do you like my new office?

No, I don't. I don't like it.

I've already talked to Dr. Andrews.

- He agreed...
- It's a bad idea.

No. Dr. Park and I distract
and annoy each other.

We will both do better work if...

- That's the reason? Really?
- Yes, it is.

Why are you isolating yourself?

I'm not.

You're the one who
canceled our breakfast.

Because I don't want to
have to deal with this, Shaun.

I'm a...

I'm angry with you.

- Why?
- "Why?"

Because of Lim's surgery. Because
I told you exactly what to do...

- No. No.
- and you didn't listen to me.

- The parameters changed.
- You went ahead and you...

and you did the procedure
you wanted to do all along.

Yes, the parameters changed.
I made the right decision.

Shaun, Lim is paralyzed.

You're the surgeon. You have to take
some kind of responsibility for that.

You shouldn't be angry with me.

- Dr. Lim shouldn't be angry with me.
- She...

She is paralyzed, Shaun.

I saved her life. I
made the right choice.

You're acting like a child.

No. No. I'm not.

You're acting like you
did back in high school,

like you did at... at the
beginning of med school.

You're a grown man, Shaun.

You're... You're a married man now.

You got to take some kind of
responsibility, accountability.

You're running away.
You're... You're...

You're... You're... You're
shrinking your world around you.

You're... You're retreating.

You're wrong.

You are being mean
and calling me a child.

- Shaun...
- And you are taking Dr. Lim's side...

Shaun, you can't shrug this off.

I do not want you in my office.

Leave now!

We successfully repaired your shoulder.

Thank you.

Please don't play with
any more fireworks.

You are lucky to have
survived your own ignorance.

Yeah.

At the very least, stick
to the non-explosive ones.

I'll just, stick to watching
them on the 4th of July.

Probably for the best.

With lots of rehab, you should
regain full function of your arm.

Feel that?

Just a small pinch.

Well, that's exactly what we want.

Six months of PT, and you should
be up on your feet walking again.

Thanks, Doc, for holding
out and not giving up on me...

and my foot.

Do me a favor?

Take a picture of me
and that gnarly scar.

- This for Brittany?
- Nah.

My new profile pic.

You will stand out.

I'm sorry I offended you.

I grew up very... sheltered.

I'm still trying to figure
things out and play catch-up

and get past my limited
sense of imagination...

which is just a long
way of saying that yes,

I was being ignorant and judgy and...

I hope you can forgive me.

I, tore my ACL.

growing up, my dream was
to play Division 1 soccer,

and I was pretty good.

Junior year of high school, I
had a dozen offers for a full ride.

That's impressive.

The first game of senior year, I tore my
ACL trying to slide tackle a midfielder.

And just like that, every
D-1 school rescinded.

The only place that still wanted
me was the Naval Academy.

I never really had much
interest in the military,

but, hey, the tuition was free.

I was promised a roster spot.

I played all four years on varsity,

and we even won the Patriot
League championship my senior year.

Nine months later, I was
deployed to Afghanistan.

That sounds horrible.

Not at all.

Joining the Navy was the
best decision I ever made.

I enjoyed our field trip.

I had a good time, too.

Being away from the
hospital and all that. Yeah.

It's definitely nice out here.

I might even have to
come back for a swim.

You could bring a date.

Not a bad idea.

Just need to find the right person.

The bet.

Yes. The bet.

I'm sorry. I just...

I can't.

Need some help?

Although, it's after 5:00, so I'd
have to charge you time and a half.

Sweet of you to offer,
but I think I got this.

You sure?

It'd be a shame if this...

$70 bottle of olive oil hit the ground.

Well, I had a good
day. I splurged a bit.

Good idea.

I'm sure you deserve it.

You do, too.

For saving me twice.

Can I offer you a taste?

I got a baguette at
Listo's, a Brie, a Gouda.

It's a deal.

Thanks.

This is nice.

Talking to someone I don't have
to supervise or be serious with.

I agree.

I just realized I don't
know what you do.

I'm a professional hockey player.

Okay, I know that's a joke.

Now I just have to decide if that
means you love hockey or hate it.

Now I'm curious what you'll decide.

Let's see.

You grew up in Michigan.

You appear to have all your teeth.

But they're also perfect,

which means they could be veneers.

I'm gonna say you're a
Pistons fan that hates hockey.

It's like you can see right through me.

And my job?

Clearly, you're the
parking garage attendant.

Or you're just stalking me.

I'm a marketing exec at Greenzy.

I have no idea what you guys
do, but I know your building.

There's an amazing Chilean
restaurant right across the street.

- Valeska's.
- I love that place.

I've been craving their sopapillas.

We should take care of that craving.

Dinner at Valeska's sometime?

Definitely.

Yeah.

- You okay?
- Yes.

Thinking about work.

I saved my patient's arm today.

I should be happy.

So why aren't you?

If this is about your
fight with Glassman...

I'm thinking about
my patient's shoulder.

I have to go.

- Dr. Glassman!
- Okay! Okay!

Okay! Okay. What?

- Are you okay?
- Yes.

I know how to fix it.

I know how to fix everything.

There's a surgery that
will cure Lim's paralysis.

Okay.

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