1. How are you feeling?
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2. I want you to feel better.
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3. So if going home
might make you feel better…
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4. it's a good thing.
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5. So, like, "Come on."
How would you say that?
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6. Venga! Vamos!
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7. Venga! Vamos!
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8. That right?
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9. Okay.
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10. What?
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11. You're smiling.
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12. Oh, my God.
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13. Oh.
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14. Yes!
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15. I approve. Highly.
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16. Oh.
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17. Bienvenidos to Day 1.
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18. We are getting our feet wet
with the three easiest surgeries.
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19. In OR 1, Dr. Rendon and I
have Leon Castillo…
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20. - Antibiotic flush.
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21. The incision is open.
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22. Nurse Morales, I need a Kelly clamp.
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23. Here you go, Dr. Murphy.
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24. Okay, Dr. Murphy,
I'll guide you to the lesion.
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25. No, no, no, no.
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26. Everyone must get to work on this.
Yes, hold on.
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27. I'm so sorry. We get
blackouts in the mountains all the time.
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28. That's why we have a generator.
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29. - Great.
- Which failed.
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30. You got a guess
when it comes back?
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31. Mm, sorry, no.
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32. Minutes? Hours?
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33. We wait, we risk losing the whole day,
dropping three patients.
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34. If I move my patient by the window,
I can debride the ulcer.
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35. Go. Pray it stays clear out.
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36. I'll see what I can do
about a herniated bowel.
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37. Can you resect a tumor
without ultrasound?
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38. I will speak to Dr. Andrews
about a revised surgical plan.
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39. Okay. Go.
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40. Thank you so much.
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41. Good luck.
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42. Suction's out.
Same for the electrocautery.
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43. Want to use your fingers?
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44. It would minimize blood loss.
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45. We could remove the lower lobe
without ultrasound.
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46. Maybe we should close her up
and do this tomorrow.
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47. It would be fatal.
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48. Not to her.
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49. To a patient down the list
that we'll have to drop.
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50. Maybe you're right.
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51. We take the whole lower lobe.
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52. No, I was not right.
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53. I can locate the tumor
without ultrasound.
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54. Her oxygen is very low. Ox-Oxygen. Low.
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55. Her oxygen is low.
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56. Oh, I'm so sorry.
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57. Where is Oscar?
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58. He had to go home.
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59. His mom is old and very sick.
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60. He went home.
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61. To your house?
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62. - Yes.
- Hmm.
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63. Mm… Stay? Please?
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64. I can feel pulsations
of an underlying vessel.
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65. Must be the artery.
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66. Feel your way under and make
the dissection plane deeper.
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67. I can feel the bowel.
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68. Sac is free.
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69. You're probably
getting close to a fissure.
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70. I am. The tissue is
becoming less pliable.
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71. A laceration there
would be devastating.
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72. We could wait a few more minutes
to see if the lights come on.
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73. I don't think we should.
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74. I feel something gravel-like
at the tip of my pickups.
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75. I think that's the surface
of the tumor.
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76. I'm there.
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77. Nice work, Murphy. We have
a clean path to the tumor.
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78. Let's get it out.
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79. Oh.
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80. I guess we could have waited.
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81. How do you speak English so well?
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82. I'm American.
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83. Born in Mexico,
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84. but my mom is an L.A. Mexican-American.
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85. I went to high school in Santa Monica.
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86. I just fake the accent
for sexiness purposes.
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87. So when's the last time you were back?
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88. Are we getting to know each other?
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89. I thought this was just a fling.
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90. Mm. So we can chat about
what schools you went to
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91. and where you worked in Africa,
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92. but old vacations are a bridge too far?
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93. 10 years. Happy?
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94. Quite, in fact.
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95. I have to go for a run.
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96. Now?
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97. You're clearly not a runner.
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98. I promise to be very quick.
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99. Like, poof, and it's gone,
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100. a fleeting but joyous memory.
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101. Oh, I can feel that
accent-generated sexiness
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102. just vanishing by the second.
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103. Quick but perfectly paced.
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104. I'm gonna hold you to both of those.
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105. Well, the truth is,
I will not be very quick.
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106. Is it going to hurt a lot?
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107. He wants to know if it'll hurt.
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108. Oh, no, no, no, no.
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109. We'll be giving you some meds,
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110. and you'll have
very little pain after the operation.
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111. We're going to give you medication,
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112. so that you have very little pain
after the operation.
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113. And before the operation,
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114. we're going to give you
something to help you sleep.
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115. And when you wake up,
your mom will be right there.
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116. He didn't realize he was
gonna be asleep during the surgery.
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117. Nurse Morales, how would one say,
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118. "You, in addition
to being very efficient,
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119. turn out to be
very perceptive as well"?
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120. I feel like you may have
added a few adjectives.
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121. Well, the truth is,
I'm not always so perceptive.
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122. For example…
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123. I was almost sure you were flirting.
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124. Flirting with me.
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125. But if you were,
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126. I'm sure you would've
taken off your wedding ring.
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127. You know, it's okay to be nervous.
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128. I'm not.
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129. You should be proud.
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130. You did a remarkable thing,
convincing her to come here.
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131. You probably saved her life.
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132. I'm just gonna sit here for a little while
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133. in case there's something
that you want to tell me.
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134. Because of me, my mother will live,
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135. but someone else…
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136. I prayed that she would get the operation,
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137. but she only did because Miguel,
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138. the guy with the dog…
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139. Because he got sick.
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140. You're a good person.
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141. And sometimes that's hard because
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142. you feel things that you…
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143. You don't deserve to feel.
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144. But sometimes…
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145. being good is fun.
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146. Come on.
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147. I've freed the tumor
from the paranasal sinuses.
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148. Periosteal dissector.
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149. It's invading the orbital floor.
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150. Curved osteotome.
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151. And the ethmoid and sphenoid, too.
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152. We're gonna have to remove multiple bones.
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153. Does the hospital have
titanium miniplates and mesh?
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154. Nothing that would work here.
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155. Could we just cover the hard palate?
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156. No. We'd give him a few years
of constant pain,
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157. and he'd still wind up
with a fistula that kills him.
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158. Is there a-a private hospital,
specialist, something?
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159. I have a friend from nursing school.
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160. She works for a dental surgeon
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161. who fixes the rich people
in this area.
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162. I can be there and back in an hour.
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163. Uh, k-keep him stable. Okay?
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164. Thank you.
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165. I was not fair before
when I was teasing.
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166. You were very fair. I was flirting.
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167. And how would your wife feel?
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168. Well, she'd be fine with it.
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169. I've heard men say that to me before.
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170. Well, she told me a few days ago
that she's moving out.
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171. And, uh…
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172. Well…
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173. She's seeing someone.
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174. So I'm down here, clearing my head,
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175. deciding if I want to try
to make the marriage work.
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176. By flirting?
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177. I guess I just wanted to feel…wanted.
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178. To feel good.
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179. It was selfish.
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180. I'm sorry it made you
feel uncomfortable.
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181. It didn't.
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182. And I think you do want
to make your marriage work.
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183. That's why you still wear your ring.
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184. We settled on 20.
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185. - You said four.
- I said 20.
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186. No. It was four. We agreed on it.
Copy !req
187. A boy's life depends on this.
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188. I'm sorry. I think there was
a misunderstanding.
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189. He's telling us it costs us
20,000 Quetzales now.
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190. - And do we have that?
- No.
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191. I can go to an ATM.
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192. No, no, there's no automatic
cashier machine I can use.
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193. This is my fault.
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194. No.
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195. I shouldn't have come.
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196. He sees an American doctor,
knows he can ask for more.
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197. There's a hospital in Quetzaltenango
a few hours from here.
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198. - Offer him this, too.
- No. No, no, no, no, no, no.
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199. You don't have to do this.
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200. Ana, just a ring.
Copy !req
201. Her oxygen level is much too low.
Copy !req
202. - No.
- The doctor is coming to give her steroids
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203. to try to stop
the inflammation in her lungs.
Copy !req
204. We need a ventilator.
Copy !req
205. Ventilator?
She has to go on a ventilator?
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206. Hello.
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207. Hey, Shaun. How you doing?
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208. I just finished my second surgery
and it went well.
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209. And I am not doing well at all.
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210. Okay.
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211. Lea is sad.
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212. And I don't know
how to make her less sad.
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213. Do you?
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214. Well, I don't know if I'm the right person
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215. to talk about this right now.
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216. Why not?
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217. I just don't think that right now…
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218. I've always loved that
you've asked me for advice.
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219. And I always will.
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220. But I've noticed…
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221. the last while,
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222. you've needed me less and less.
Copy !req
223. I don't know if you've noticed,
but it got me to thinking
Copy !req
224. about what Steve told you,
that you're the smart one.
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225. You… You can do anything.
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226. You're good at this.
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227. Better than…
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228. Better than you think.
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229. Ready?
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230. Does it look good?
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231. Beautiful.
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232. Beautiful.
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233. How did you end up in Guatemala?
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234. Yikes, you're just not good
at flings, are you?
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235. You should be asking me
if I've read the Kama Sutra,
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236. my favorite whipped cream.
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237. It's a good job.
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238. I get to coordinate these missions,
help some people.
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239. So you're the workaholic,
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240. "dedicate your life to the downtrodden"
hero type?
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241. Is that what drives you?
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242. I also get to sometimes have sex
with American doctors.
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243. You're only here for a week.
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244. We don't need to bare our souls
to each other.
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245. On the other hand,
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246. I'm only here for a week, so why not?
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247. You first.
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248. What are you hiding?
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249. I'm not hiding anything.
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250. Okay.
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251. I prefer a fresh local product,
but if you have lactose issues…
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252. Wait, why did you ask me that?
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253. Seriously. Why are we
having this conversation?
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254. You think I'm being dishonest.
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255. What do you think I'm hiding?
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256. I don't know.
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257. But between your excessive
need to exercise,
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258. the alarms going off that you never answer
when you're around me,
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259. and the nightmares
that you have every night,
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260. you're hiding something.
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261. Let's get ready for the day.
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262. You ready to start?
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263. Almost.
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264. There's three kinds of foreign doctors
who come down here.
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265. The first, they care too much.
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266. All the people they can't save,
it, uh, overwhelms them.
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267. The second care too little,
and that has problems of its own.
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268. Hmm.
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269. And the third group,
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270. they find a way to distance themselves
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271. so they can do their job.
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272. I better be in that group.
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273. You're in your own group.
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274. You care so deeply.
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275. But that only gives you more strength.
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276. Thank you.
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277. Well, let's go.
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278. Entering the peritoneal cavity.
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279. I need a long retractor.
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280. Long retractor.
Copy !req
281. That's not just gallstones.
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282. There is an immobile,
irregularly shaped mass.
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283. She's got gallbladder cancer,
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284. and it's spread
to the surface of the liver.
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285. It will double the duration
of the surgery.
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286. Triple, 12 hours at least.
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287. I'll need to swap with one of you.
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288. That's not possible.
Neither of us are prepped.
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289. It would be endangering
two patients instead of one.
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290. We can't just close her up.
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291. Unfortunately, we can.
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292. I'm sorry,
but you've never led anything like this.
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293. I think we should let her keep going.
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294. What's the worst that can happen?
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295. - Beyond death?
- This patient was gonna die anyway.
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296. Claire at least gives her
a fighting chance.
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297. Okay.
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298. What happened to the ventilator?
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299. They took it away.
They needed it for the surgery.
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300. The doctors needed it.
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301. The doctors needed it?
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302. And where's the nurse?
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303. The nurse?
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304. Busy. Lots of work.
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305. Okay.
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306. I'll stay.
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307. Stay here no matter how long it takes.
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308. Is there a problem?
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309. Yeah. The patient returned.
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310. Leon, the guy
with the ventral hernia,
Copy !req
311. checked himself out last night
and went to work.
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312. In construction.
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313. He reherniated? How bad?
Copy !req
314. About an inch of bowel is incarcerated,
probably ischemic.
Copy !req
315. He'll be dead in days
unless we operate on him.
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316. Can you fit him in
after your skull reconstruction?
Copy !req
317. Not without big risks to both of them.
What about the other surgeons?
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318. You think I'd be here
if anyone else was free?
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319. Give him some morphine.
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320. Until when?
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321. It sucks but it's his own fault.
We told him he needed to rest.
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322. This isn't some tech bro in San Francisco
waltzing out to party.
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323. He needed to keep his job
and not watch his family starve.
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324. If we operate on him,
we don't operate on someone else.
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325. I'll operate on Leon.
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326. I've been doing P.T. the last year.
It's been going great.
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327. You really think
you can handle the surgery?
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328. I know I can.
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329. I think I can do it without any pain.
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330. We need to do a cross-clamp resection.
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331. - Have you ever done one?
- I've seen one.
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332. - When I was an intern.
Copy !req
333. Freeing up the vein.
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334. Freeing up the vein.
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335. Dividing the pedicles.
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336. Separating the pedicles.
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337. Transecting the segments.
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338. Transection of the segments.
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339. Okay. Step two.
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340. That doesn't look ideal.
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341. It's a midline ventral defect.
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342. Also, the tissue planes are friable.
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343. We're gonna need component separation.
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344. I'm gonna cut the posterior
rectus sheath,
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345. mobilizing soft tissue
off of the external oblique fascia
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346. and then incise it.
Copy !req
347. Common femoral artery's
almost completely occluded.
Copy !req
348. I'll prep the inflow anastomosis site.
Copy !req
349. I have PTSD.
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350. I have nightmares because of it.
Copy !req
351. I exercise to help me
manage my symptoms.
Copy !req
352. And the alarm on my phone
Copy !req
353. is to remind me to take
my daily cocktail
Copy !req
354. of Fluoxetine, Prazosin, and Quetiapine.
Copy !req
355. Can you tunnel the bypass graft
in the subcutaneous plane?
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356. I'll get a clamp through.
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357. I lost a good friend a year ago
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358. and then lost more to COVID
Copy !req
359. and then spent a lot of time
denying I had an issue.
Copy !req
360. Running from pain.
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361. In the future, I'm hoping to do
Copy !req
362. more running toward things
than away from them.
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363. I'm ready for the graft.
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364. Oh.
Oh, it's my turn.
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365. You're exhausted. You should lie down.
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366. No. No.
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367. 10 minutes.
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368. Ten minutes.
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369. I'm good. I'll rest next.
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370. Me next.
Copy !req
371. Ten minutes.
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372. Thank you.
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373. If you need a break…
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374. I'm fine. Just cramped a little.
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375. I'm done.
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376. I can take over.
Copy !req
377. This ventral wall defect is huge.
Copy !req
378. Yeah.
Copy !req
379. Two Kocher clamps.
Copy !req
380. Heart rate is spiking.
Copy !req
381. B.P.'s dropping. She's crashing.
Copy !req
382. Why? What happened?
Copy !req
383. I don't know.
Copy !req
384. Edna's bleeding out.
At this rate, she has minutes to live.
Copy !req
385. There is post-op blood around the liver,
nothing crazy.
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386. The surgical drain also has blood.
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387. No evidence of bile leak.
Copy !req
388. Okay, so the patient could have G.I. bleed
unrelated to surgery
Copy !req
389. or a leak into the liver
from the hepatectomy.
Copy !req
390. Yes. Which one?
Copy !req
391. Mm, what's the surgical drain output
Copy !req
392. over the last half-hour?
Copy !req
393. If it's over 200 cc, the answ…
Copy !req
394. It's 200 cc. Exactly.
Copy !req
395. - Oh.
- Yeah.
Copy !req
396. I think it's the stomach.
Copy !req
397. The clotted blood in the N.G. tube
could be holding back a flood.
Copy !req
398. An intrahepatic bleed
is statistically more likely.
Copy !req
399. I still think it's the stomach.
Copy !req
400. But I came to you for a reason.
Copy !req
401. Okay, thanks.
Copy !req
402. Claire.
Copy !req
403. Neither of us knows for sure, but…
Copy !req
404. you are good at this.
Copy !req
405. Better than you think.
Copy !req
406. B.P.'s almost bottomed out.
What do we do?
Copy !req
407. Stomach.
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408. You did good work.
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409. I just had to close and clean up.
Copy !req
410. The patient's in recovery, doing well.
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411. I need a friend.
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412. I hadn't really given up
on being a surgeon.
Copy !req
413. P.T. was going great.
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414. Uh… almost no pain at all.
Copy !req
415. And…
Copy !req
416. It's all dumb
because I like being an internist.
Copy !req
417. I just…
Copy !req
418. …hate…
Copy !req
419. …failing.
Copy !req
420. Seriously? This is funny?
Copy !req
421. A little.
Copy !req
422. Never seen you vulnerable.
Copy !req
423. Your face gets kind of ugly.
Copy !req
424. Shut up.
Copy !req
425. You didn't fail.
Copy !req
426. You never fail.
Copy !req
427. For three years I've watched you kick ass.
Copy !req
428. At everything.
Copy !req
429. You inspire me.
Copy !req
430. And annoy me.
Copy !req
431. Small price to pay.
Copy !req
432. Your mom's gonna be all better.
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433. Her lungs sound good,
Copy !req
434. without retractions.
Copy !req
435. But there's only one way
Copy !req
436. to be sure that the steroids have worked.
Copy !req
437. Stop bagging.
Copy !req
438. Hopefully she can breathe on her own now.
Copy !req
439. Goodbye.
Copy !req
440. No, no.
Copy !req
441. We need to go sleep a little.
And you do as well.
Copy !req
442. We need to sleep.
Copy !req
443. No, she doesn't finish yet.
Copy !req
444. She needs to say goodbye.
Copy !req
445. She already said goodbye.
Copy !req
446. It's one of the three phrases
she knows in Castilian Spanish.
Copy !req
447. Oh, I want… her to hold my baby.
Copy !req
448. She wants you to hold her baby.
Copy !req
449. Ooh. Ooh.
Copy !req
450. She is so beautiful.
Copy !req
451. Bastion.
Copy !req
452. I'm sorry I've been weird…
Copy !req
453. For a year.
Copy !req
454. I really do care about you.
Copy !req
455. I wish you and Heather the best.
Copy !req
456. Well, it's a bit late for that.
Copy !req
457. I broke up with Heather.
Copy !req
458. When?
Copy !req
459. Last night.
Copy !req
460. - No.
- Yeah.
Copy !req
461. Because…
Copy !req
462. You think you love me?
Copy !req
463. I do.
Copy !req
464. I think I love you, too.
Copy !req
465. I committed a crime.
Copy !req
466. My first year of my residency,
Copy !req
467. I… I was arrested for pot possession.
Copy !req
468. The cops were jerks,
Copy !req
469. I argued with them, and…
Copy !req
470. It got physical.
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471. When my court date came around, I skipped.
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472. And now there's an active warrant
out for me in the States.
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473. That's why I haven't been back.
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474. But what if I got a lawyer,
got this cleared up?
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475. What if I was to start
running toward things?
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476. Would you be interested
in a visitor in San Jose?
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477. There's something I want to ask you.
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478. I think you should take the job.
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479. Of course she wasn't gonna
poach you without asking me.
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480. I can't speak the language.
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481. I don't know anyone here.
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482. I just started a relationship
with my father.
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483. I-I'm not ready.
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484. All legit concerns.
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485. But what I didn't hear
was one single reason
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486. you don't want to do this.
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487. You've spent so many years thinking
your heart was a liability…
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488. It made you care too much,
it hurt too much.
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489. But maybe here…
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490. maybe here, caring too much
is exactly what's needed.
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491. Okay.
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492. Aww.
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493. This is about time.
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494. You were far too good for us, anyway.
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495. Aww.
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496. Proud of you, Dr. Browne.
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497. Mm.
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498. Love you.
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499. I'm never quite sure what you're thinking.
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500. Many things.
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501. That I'm sad.
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502. That this airport is the only one
I've been to without a Cinnabon.
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503. That people need to move forward.
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504. That…
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505. I hope you're moving forward.
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506. I think I am, Shaun.
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507. What do we do now?
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508. I don't know.
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509. I've never hugged you, Claire.
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510. I'm not going to Hershey.
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511. Are you done being sad?
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512. No.
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513. But right now,
I know I won't be sad forever.
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514. And I don't think I would've
gotten there without you.
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515. I want to spend
the rest of my life with you.
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516. I want to spend my life
with you, too, Lea.
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517. Will you marry me?
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518. Of course. I love you.
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519. I love you, too.
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520. We are getting married.
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521. Yeah.
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522. We are getting married.
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523. We are getting married!
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524. Congratulations.
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525. Thank you.
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526. Okay.
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527. I have to tell Claire.
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528. Okay.
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529. Ten, nine…
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530. Scalpel.
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531. Yes, Doctor.
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532. Welcome.
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533. Venga! Vamos!
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