Season 4 Rewatch: 4×20 Vamos

The Good Doctor Argentina on Twitter (@TheGoodDoctorAr) is currently running a ’20 Days Countdown to The Good Doctor Season 5’, and on our last countdown day, it’s time to take a closer look at episode 4×20 Vamos.

Season 5 premiere is tomorrow. Are you excited?!?

The Getaway

Things are getting real, today is Day 1 of their twelve surgeries. There’s three operations going on in parallel, but they hit their first snag pretty soon. The power goes out, and the backup generator isn’t working. There’s little light, and no electronic support. All three surgeries grind to a sudden halt.

After a quick regrouping and some creative problem solving, they continue with the surgeries as best as they can, moving the patients near the windows. Shaun and Marcus’s surgery is the trickiest, since they were using guided ultrasound, which is now no longer available. They consider postponing the surgery, but that also means the patients down the list can’t get their operation and would likely die. It’s not a good solution.

It’s Shaun’s time to shine. His photographic memory has never been more useful. He visualises the images they saw on the ultrasound previously, and he guides the team to locate the tumour without having to resect a large part of the organ. Shaun, you’re a genius, and the team is lucky to have you!

All things considered, Day 1 goes pretty well. Day 2 continues with more surgeries. During one of Andrews’ ones, they run into a complication and they need supplies that the clinic doesn’t have. Nurse Morales suggests going to see a dental surgeon who might be able to help.

Ana and Marcus drive out there, but the surgeon refuses to give them the supplies for the amount of money previously agreed — mostly because Marcus is there and the dental surgeon thinks he can get more money out of the deal with an American doctor in the mix. Ana doesn’t have more to offer, but Marcus ends up giving up his wedding ring as payment, which gets them the needed supplies.

During Claire’s operation on Edna on Day 3, they find out she has cancerous growths in her gallbladder, and the surgery time would be tripled. Claire is not senior enough to lead that surgery, but neither Andrews nor Lim can take over. They decide to let Claire keep going. At least it would give Edna a fighting chance.

In the middle of the surgery, Edna’s blood pressure drops, and they can’t say why. Claire goes to get Shaun to hear his opinion. He’s the best diagnostician they have. They debate the options, but Shaun can’t really help. There’s no good indicator which of the two most likely causes is more probable to have caused the bleed. Claire is ready to rush back off to finish the surgery, and Shaun passes on the lesson he just learned from Dr. Glassman. He calls out to Claire and tells her, “Claire? Neither of us knows for sure, but… you are good at this. Better than you think.” Aw, Shaun. You’re adorable and sweet and we don’t deserve you. And Edna makes it through the surgery.

After a week in Guatemala, it’s time to say goodbye to the clinic and their patients. There’s many hugs exchanged, and a number of miracles performed. It’s been an amazing and rewarding time.

Patient Stories

We see a lot of the surgeries being done, but we also see some of the follow-up for the patients. Bastion gets his face fixed, and finally the huge mass covering the whole right side of his face is gone. He looks beautiful. Small gripe here, because this has got to be only a day or two after the surgery, right? And there are no stitches visible and it looks like the wounds have all healed up. Timeline-wise, that seems really off.

León, the patient with the hernia, checked himself out of the clinic after his surgery, but he’s back with complications. He went back to work in construction and reherniated. He’s now facing ischemic bowel syndrome. He’d be dead in days unless they operate on him, but they don’t have enough surgeons available.

Morgan says she’ll operate on him. She’s been doing physiotherapy, her hands are good. Except they aren’t. She’d definitely feeling the pain. Alex comes and takes over, and Morgan reluctantly steps away.

Miguel, the patient with the blood clot whose surgery had to be cancelled in the last episode, gets a happy ending, too. Claire decides to say in Guatemala (more on that below), so now they have a capable surgeon to do more hands-on work. Who better to save another life there than her?

Shaun & Lea

The morning after Lea talked to Shaun about wanting to stay with her parents for a while, they are in the hotel, packing up their things for the day. Lea asks Shaun how he’s feeling. Shaun is a champ and being super understanding. “I want you to feel better. So if going home might make you feel better, it’s a good thing.”

During the day, Lea spends more time with Sofía. Baby Isabela isn’t doing so well. Her oxygen saturation is getting dangerously low. Her husband had to go home to take care of his sick mother, and Sofía asks Lea to stay with her. Lea gladly does.

As they stay to monitor Isabela, her oxygen keeps dropping. It gets so bad that she has to be intubated and go on a ventilator.

Shaun, in the meantime, seeks advice from Dr. Glassman via Zoom. He just finished his second surgery, which went well, but Shaun isn’t doing so well himself. He’s still trying to come to terms with what Lea told him. He’s still in fixing-mode, wanting to make Lea “less sad”.

Glassman isn’t sure he’s the right person to talk to. His second marriage just failed, which Shaun doesn’t actually know about, and via Zoom is not the place to discuss it. “I’ve always love that you’ve asked me for advice, and I always will, but I’ve noticed the last while you’ve needed me less and less,” he tells Shaun. “It got me to thinking about what Steve told you that you’re the smart one. You can do anything. You’re good at this. Better than you think.” It’s beautiful, but I’m not sure it really helps Shaun all that much with Lea right now.

When Lea next goes to see Sofía and Isabela, Sofía is manually bagging the baby. They had to take the ventilator away for the surgeries. Lea says she’ll stay, however long it takes. She and Sofía take turns manually bagging the baby, and Lea insists that she’s fine doing her share, Sofía needs to get some rest.

While Sofía takes a nap, Lea keeps repirating the baby. Shaun comes to see how Lea is doing and takes over, just silently taking the ambu bag while he and Lea share a long, expressive look.

They’ve been playing so beautifully with these silent moments in the second half of the season. It’s all happening between the lines. When Shaun comes into the neonatal room, he is still wearing scrubs and his scrub cap, which means he came right after his surgery, likely not taking any break. He must be tired and has been on his feet for hours, but he goes straight to see Lea and Sofía and the baby, and then he takes over oxygenating Isabela without a single word or complaint. There’s no dialogue in this scene, just subtle but expressive communication that happens silently. He takes one look at Lea and he knows exactly what to do, how to offer his support.

“You’re good at this. Better than you think,” Glassman had said. And he is. I’ve said it before, and I’ll say it again. Shaun has come so far, and he and Lea are so in tune with each other. It’s amazing.

The next day, baby Isabela is doing better. The steroids seem to have helped, and she can finally breathe on her own again. Everyone is elated, but Shaun and Lea need to get some sleep and say goodbye. Sofía insists that they don’t leave before Lea has at least held Isabela in her arms once. Maybe she did read between the lines.

At first Lea doesn’t want to, but she reluctantly agrees and takes Isabela into her arms. Lea and Shaun share a look. It’s definitely a healing moment right here.

While they’re waiting at the airport, Lea has her head on Shaun’s shoulder. She sighs and looks at him. “I’m not going to Hershey,” she tells him. “Are you done being sad?” is Shaun’s question. No, not exactly. But she knows she won’t be sad forever, and that’s because she has Shaun by her side. She has a realisation right there. “I want to spend the rest of my life with you.” And so does he.

She takes his hand. “Will you marry me?” Of course he does. He loves her. And they kiss.

Shaun, of course, has to announce it to everyone right away. “We are getting married!” Everyone is excited! I’m cheering, too! Yay!! Bring on all the wedding shenanigans in season 5! I’m so happy for them!

The Others

Audrey is still radiant with the afterglow of spending the night with Mateo, and Claire sees it right away. She approves highly.

Audrey and Mateo spend the night together again after their first surgery day. She asks him how he speaks English so well. He’s actually American. He was born in Mexico, but his mother is an LA Mexican-American. He went to high school in Santa Monica. He’s getting uncomfortable with the personal questions, seeing how this is just a fling, right? But he does divulge that he hasn’t been to the US in ten years. He likes his job in Guatemala because it means he gets to help people and make a difference.

Mateo tries to turn the tables on Audrey and starts asking her personal questions, which she also dodges. Why does she have an excessive need to exercise? Why does she have all these phone alarms? Why is she having nightmares every night? She’s hiding something.

She finally shares her PTSD diagnosis with him while they operate together the next day. Audrey is doing her own healing in this episode, too. “In the future, I’m hoping to do more running toward things than running away from them.”

On the way to the airport, Mateo bares his own soul to Audrey. He committed a crime when he was in the US. He was arrested for pot possession during his first year of residency. He argued with the cops and it got physical, and then he skipped the country and now there’s an active warrant for him. Which is why he hasn’t been back.

But now, he’s reconsidering his options. What if he was going to start running toward things? What if he got a lawyer and got this cleared up? And here we have our very lovely cue of getting Mateo to come back to the show – or rather stay on the show. Which he will, because we’ll be seeing a whole lot more of him in season 5, and I’m really looking forward to it!

Marcus and Ana keep hitting it off, but she’s a bit confused. Was he flirting with her? But if he was, why is he still wearing a wedding ring? It turns out that things between him and wife aren’t going well, and she’s actually moving out because she’s seeing someone. So Marcus was definitely flirting. His reason for coming to Guatemala was partly to figure out whether he wanted to invest in trying to patch up the marriage, but we’ll guess that the answer is no.

Nurse Carla comes to talk to Claire in between surgery breaks. She talks about the different kinds of doctors who come to their clinic to help. Some care too much, some care too little, some manage to distance themselves just enough to do their job well. Claire hopes she’s in the last group, but Carla says she’s in her own group. “You care so deeply, but that only gives you more strength.”

Just as everyone is getting ready to say goodbye to Guatemala, Carla approaches Claire. She makes her an offer to stay, which Audrey fully endorses. It would be good for Claire. She’d be in exactly the right place. They all know it, and so the decision is made.

It’s a heartfelt adios with many hugs and many tears. Claire’s farewell to Shaun is really sweet. “I’m never quite sure what you’re thinking,” she says to him. “Many things. That I’m sad. That this airport is the only one I’ve been to without a Cinnabon. That people need to move forward. That… I hope you’re moving forward.” She thinks she does. He briefly meets her eyes. “I’ve never hugged you, Claire.” They share a long embrace that’s honestly overdue. Claire’s been such a strong supporter of his over the years.

After Morgan has to walk out on the surgery on León and Alex had to take over, she sits alone outside with a mug of tea or coffee. Alex comes to see her afterwards to tell her the surgery went well and León is in recovery. As Alex is about to go, she tells him, “I need a friend.”

She hadn’t really given up on being a surgeon. PT had been going so well, so she had hung onto the hope of going back to surgery eventually. But failing at the operation on León, she’s now realising that that chapter will have to be closed forever. “It’s all dumb, because I like being an internist, I just… hate failing.”

Alex watches her cry, and then chuckles. She’s incredulous. “Seriously? This is funny?” It is. A little. “I’ve never seen you vulnerable. Your face gets kind of ugly.” That, in turn, makes her smile. Alex tells her she never fails, and she’s not failing now. She kicks ass at everything. “You inspire me. And annoy me. Small price to pay.”

On the bus ride to the airport, Morgan apologises to Alex. “I’m sorry I’ve been weird. For a year. I really do care about you. I wish you and Heather the best.” Well. Alex broke up with Heather last night. “Because you think you love me?” Morgan asks. “I do,” he tells her. “I think I love you, too.” They hold hands and intertwine fingers. Oh man, it was high time!

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