The Good Doctor (2017) s01e01 Episode Script

Burnt Food

1 Boy: Mister? Mister? Woman: Ladies and gentlemen, welcome to San Jose International Airport.
[Indistinct talking] [Beeping] [Carriage rattling] [Beeping] [Drill whirs] - [Glass shatters] - Look out! Watch out! Help! - Adam?! - Oh, my God! Adam?! Somebody call 911! Oh, my God! I'm a doctor, let me take a look.
Let me take a look.
His jugular vein's been cut.
Does anyone have a clean cloth? Please.
Someone! I have a fresh change of clothes in my bag.
That's great.
You're killing him.
I'm saving his life.
He was bleeding out.
N You have it in the wrong place.
I think I remember enough of Anatomy 101 to know where the jugular vein is.
You would be in the right place if he were an adult.
He's not an adult.
He is a boy.
Which means you're also putting pressure on his trachea.
Which means he's not currently breathing.
You have to put the pressure higher up.
- There.
- [Gasps] [Gasping] Some glass.
He'll be fine.
Who are you? Hello.
I'm Dr.
Shaun Murphy.
I'm a surgical resident at San Jose St.
Bonaventure Hospital.
Autism a mental condition characterized by difficulty in communicating and using language and abstract concepts.
That's the definition.
Does it sound like I'm describing a surgeon? He's not Rain Man.
He's high functioning, he's capable of living on his own, capable of managing his own affairs.
"High functioning"? Is that our new hiring standard? If it were, you wouldn't be here.
I'm sorry.
Is this really necessary? Really? A special meeting of the Board of Directors as much as I love you all questioning one of my hiring decisions? Did you bother to look up the definition of "President" while you were skimming the dictionary? You're hiring him to be a surgical resident my department over my objections.
Marcus, stop making everything so personal.
I made it personal? You've wanted his job since day one.
Everyone in this room knows that.
And, Aaron, yes, this is your hospital.
But the money it takes to run it comes from the Foundation I control.
So let's all play nice, shall we? Stop acting like you're stunned that you're standing there.
You tried to slip one past us.
I vetted him like I would any other candidate.
And you genuinely thought that this Board wouldn't reasonably have any doubts about hiring a surgeon who's been diagnosed with autism? So justify your decision.
[Sighs] I met Shaun Murphy when he was 14 years old.
I was living in Wyoming at the time.
He was, and he still is, an extraordinary young man.
Yes, he has autism, but he also has savant syndrome genius-level skills in several areas.
He has almost perfect recall.
He has spatial intelligence.
And he sees things and analyzes things in ways that that are just remarkable.
In ways that we can't even begin to understand.
Those are assets.
Undeniable assets for any doctor, particularly a surgeon.
You've known him since he was 14? You care about him.
He's like a son to you.
Dr.
Andrews, your wife is gonna be very upset with you.
If you're trying to turn this into a nepotism case, we're gonna have to fire her idiot nephew from bookkeeping.
[Laughter] [Woman speaking indistinctly on P.
A.
] Hey! Sorry.
You seen Claire? Would you turn off the light? Sure.
You seen Claire? Why? Would you turn off the light? Melendez wants to operate on 104, but Claire hasn't gotten informed consent.
And she's ignoring her page.
You seen her? No.
Now go away and turn off the light.
Sure.
[Scoffs] [Woman giggling] They need you to, um [Laughs] I heard.
Oh, she's such a bitch.
[Laughs] No.
She just doesn't like you.
Hmm.
It's kind of silly, isn't it? Um, maybe.
To say for sure, I'd need to know what it is you're talking about.
Us.
- Ah.
Not silly at all.
- Hmm.
Quite a bit of fun, actually.
I meant that we're hiding it.
Our relationship.
Hmm.
Well Jared, we don't have a relationship.
We have sex.
But, if you want to tell people that you're screwing me, go for it.
[Woman speaking indistinctly on P.
A.
] The veins in the boy's left arm are popping.
- Is that bad? - I-I don't see.
Intrathoracic pressure.
No, his chest is rising.
He's breathing.
No, the the chest is moving paradoxically.
The left lung is in distress.
Yes.
Who here has a sharp knife, blade five inches or longer? Nobody? You should start artificial respiration.
He's going to stop breathing very soon.
- I feel fine.
- Dr.
Melendez would like to do the surgery today.
You need bypass surgery quite urgently.
Would you please sign the consent? No.
You're scared.
- I-I'm not scared.
- Well, you should be.
We're gonna cut your chest open, we're gonna stop your heart, repair it and restart it.
Are you seriously telling me that that doesn't scare you? I just want a second opinion.
Callum, yesterday, your life was perfect.
You were playing tennis, you had a big anniversary.
Today, you're lying in a hospital bed trying to figure out the best way to say goodbye, maybe forever, to your teenage children.
Why are you doing this? Because I can't deal with lies.
If you lie to me, my answers won't help you.
But, if you're scared, I can help you.
I'm scared.
Okay.
[Man speaking indistinctly on P.
A.
] - You can't be back here.
- Oh, I need a knife.
Where do you keep the knives people forget they're traveling with? A knife? Sure.
Anything else? I do also need a narrow six-foot tube and high-proof alcohol and gloves and baggage-handling tape, but I am going to get the alcohol from the duty-free store and the tube from the back of a soda machine.
Well, I wish you all the luck with that.
But I'm not gonna give you a knife.
No, I need a knife.
It-It's It's very There is a medical emergency.
There's a medical emergency.
That one.
That one, right near the top, looks very sharp.
Would you get it for me? No, I'm not gonna give you a knife.
- I'll ask - There's not the time.
Weapon! Weapon! Move! Get out of the way! [Grunts] Drop it.
You idiot! You're lucky we didn't just shoot.
No! He's trying to save my son's life.
You get that consent on 104? Well, I made him a deal.
He's got a meeting with Dr.
Max from psychiatry at 6:00, we'll get the consent by 8:00, we can operate first thing in the morning.
You did pass anatomy, right, Dr.
Browne? His problem's in his heart, not his head.
He's not psychologically ready for surgery.
He will be.
Soon.
Well, he is physically ready.
So, get the consent.
We're prepping O.
R.
6 now.
Do I need to cite you the 17 studies that show a correlation between attitude and outcome in surgical patients? Do I need to remind you that I am your superior? You do know what the opposite of superior is, right? - Subordinate.
Doesn't - Sure.
Subordinate.
Or inferior.
- Either way.
- It doesn't mean I'm wrong.
[Scoffs] I suppose not.
But it does mean you have to act like you're wrong.
He's panic stricken.
Yesterday, he was young and healthy.
Today, he's mortal.
Just give him a chance to wrap his head around that.
Dr.
Kalu? Do you think you can get me a signed informed consent on 104? - Of course.
- Thank you.
You think he's right? I think he's my boss.
And if I have to choose between my boss and the woman I'm screwing, not much of a choice, am I right? Shaun: Excuse me.
Excuse me, please? The incision should take place two ribs down.
Okay, well, why the bottle? The air will continue to leak and accumulate until the damage can be properly repaired.
The tube allows the air to get out.
The water in the bottle stops the air from coming back in.
A homemade one-way valve.
[Gasps] He's breathing.
[Cries] You saved his life.
He saved his life! [Applause] Shaun, where are you? I-I [Clears throat] Call me as soon as you can, please.
- That was a mistake.
- I agree, 'cause it's not about the new doctor, this is about you.
They're baiting you.
And you're letting them.
- Maybe.
- Maybe what? What mistake are you talking about? - Your shot at Andrews' nephew.
- Oh, come on.
It was funny.
- It was very funny.
- It was also disrespectful.
Well, you don't show him respect.
I assume it's because you don't respect him.
You show someone respect because you respect them, or because you're afraid of them.
I don't fit into either category.
Well, neither do I.
You should.
You're only in that room because your grandfather founded this hospital.
I'm gonna pretend that this conversation didn't take this tangent, and instead focus on something relevant the debate you are losing.
Here's how you win this.
You don't make it personal.
You do not make it about you.
That is what they want, and if you give it to them, you will lose.
[Siren wails] I need to get to San Jose St.
Bonaventure Hospital.
That's where we're going.
Good.
[Monitor beeping] Ethan: How hard can it be to just act like a normal human being?! - He doesn't know how.
- Bull! What are we supposed to do now? Huh? This is the third school he's been thrown out of.
We'll find another school.
No, we won't, 'cause nothing's gonna change.
They can't handle him, and I don't blame them, 'cause obviously, we can't handle him, either.
What the hell happened this time? What happened?! You're hurting him.
[Grunting] What did you do?! - Shaun! - No! Will you stop petting that stupid rabbit?! [Thud] It changed.
The boy's ECG changed.
It's the same 86 BPM.
No.
It used to be higher.
No, it used to be 86.
It's still 86.
It used to come up to here.
Lower amplitude means lower voltage.
Lower amplitude means lower voltage.
What's going on? What does it mean? It means he's trying to read 20-year-old equipment while traveling in a vehicle going 40 miles an hour.
[Beeping] How did you get him to sign? I simply told him it was either consenting or going home, then I gave him two forms and told him to pick one.
Melendez: And you highlighted the Release Against Medical Advice form that mentions the "possibility of death or permanent disability"? Well done.
Hand me the Metz and a pick-up.
I'm isolating the descending aorta.
Sarah: Vascular clamp.
What is that? Under the left atrium something white.
Is that part of the lung? Melendez: It's pus.
Did he have TB? No, he doesn't have any No, not currently.
Does he have a history When he was younger, he was exposed to This is an abscess.
It's gonna bur - [Monitor beeping rapidly] - [Gasps] Suction and a lap sponge.
His BP's crashing.
Two liters saline wide open.
Set up the level one.
Two units packed cells now.
Get Levophed on board and keep that MAP at 60.
Get in there with the suction.
I can't see a damn thing.
Suction.
I hope it isn't too upsetting to him when he hears he would have died in his room if we'd waited until tomorrow.
Dr.
Melendez, we've got an incoming 8-year-old male, pneumothorax stabilized, but undetermined internal injuries.
Who do you want to catch? Claire, I don't think we need you.
This patient is gonna be fine now.
8-year-old healthy boy, status post encounter with a shattered glass sign.
Numerous lacerations.
- Echo - Get him set up in Trauma 3 with an EKG, full blood work and a pan-scan.
We need an echo echocardiogram.
- Who is this guy? - He helped with first-aid at the airport.
I'm the doctor.
He needs an echocardiogram.
- Where are you taking him? - To surgery.
All cardiac vital signs are within normal range.
- Do you have any I.
D.
? - No.
His His heart.
It's his heart.
His heart is fine.
Now stay here.
Adam needs an echocardiogram.
No.
Behave yourself.
Or you'll be removed from the building.
[Grunts] [Breathing heavily] Echo.
Echo.
Melendez: What's that? Claire: A one-way valve.
And he reports the boy suffered a pneumothorax.
That is cool.
Do you think we should do an echocardiogram? Based on the presenting symptoms, which give no indication that an echocardiogram is necessary, I'm going to answer no.
Am I missing something? No, sir.
Knife.
Glassman: We don't normally treat rabbits, especially This was the closest doctor place, and it was an emergency.
No, I can see that.
But even if I was a vet, the rabbit is dead.
[Cries softly] I'm sorry, guys.
Everything smells different when it rains.
What do we do now? Well, you should bury him, I guess.
I don't know, give him a a nice funeral.
Has he gone to heaven? Yeah, sure.
Uh, sure sure, he has.
Um No, I don't want him to go to heaven! I want him to be here! [Sobs] This won't happen again.
It can't happen again.
He's dead.
I know that.
I mean, nothing like this is ever going to happen to us, ever again.
Because we're not going home.
We're never going home again.
We have each other, and that's all we need.
Andrews: A surgeon needs to communicate not just information, but sympathy, empathy.
Can Dr.
Murphy do that? He can't even reliably show up for a job interview.
Are you gonna sit here and tell us that there were no other equally-qualified young surgeons surgeons without this one's issues? No.
Which is why exactly why we should hire Shaun.
We should hire him because he is qualified and because he is different.
How long ago was it that we wouldn't hire black doctors in this hospital? How m How long ago was it that we wouldn't hire female doctors at this hospital? So, you're comparing being African-American or a woman with being autistic.
Please, go on Okay.
[Chuckles] The rationalization is exactly the same.
Words like "temperament" and, "Oh, no! Ohh! How are the patients going to react?" Aren't we judged by how we treat people? I don't mean as doctors.
I mean as people.
Especially those who who don't have the same advantages that we have.
We hire Shaun, and we give hope to those people with limitations that those limitations are not what they think they are, that they do have a shot! [Sighs] We hire Shaun, and we make this hospital better for it.
We hire Shaun, and we are better people for it.
We'd be "better people," spending a lot more on malpractice insurance.
- How old is this kid again? - 8.
Spong stick.
[Monitor beeping] What was his heart rate five minutes ago? - Uh, 86.
- You sure? Certain.
He's been a rock.
It's barely changed.
No, something's changed.
Something's different.
You asked earlier about an echo.
You had no medical reason, but you asked anyway.
Why? There was this weird guy, the one that did the one-way valve, he kept insisting that the boy needed an echocardiogram.
- He didn't say why? - H-He was really weird.
[Monitor beeping rapidly] His blood pressure's dropping.
That makes no sense.
He's not bleeding anymore.
Everything's under control.
Do an echo.
Sir, the boy is wide open.
It's gonna take awhile.
Good.
That'll give me time to figure out why the hell we're doing an echo.
Dr.
Browne, you're with me.
We're gonna go find your weird guy.
Keep him stable.
Why the echo? Uh, okay.
He, uh He Okay.
Uh, he Uh, I, uh He Okay.
I understand you think he needs an echocardiogram.
We just don't know why.
Well, I-I noticed that there was a slight reduction in the intensity of the electrocardiogram.
The electrical flow I noticed that, too.
The heart rate was the same, but the amplitude dropped.
Pericardial effusion.
Reduced cardiac output.
Would stress other organs.
Causing them to shut down.
Yes.
[Cellphone rings] Hold on.
Yeah, we're coming right back up Thank you.
They did the echo.
It's normal.
No pericardial effusion.
No.
It has to be.
There There is no other explanation.
The echo is normal, which means we just wasted our time.
N-No.
[Mumbling indistinctly] Okay, um, hey, come with me.
Come on.
Show them.
Again.
Again.
Again.
There.
Looks normal to me.
[Chuckles] It's not normal.
There's a concave deformity in the right atrium.
Um, no, there's not.
Yeah.
Yes, there is.
It's very subtle.
Even if you are right, that's not where a pericardial effusion manifests.
Not usually.
But it it could.
This kid was sprayed with glass shards cut his jugular.
What if a piece of glass entered his blood stream? It could have traveled down the jugular vein, into the brachiocephalic vein and on to the superior vena cava.
If it punctured the SVC, blood could be leaking behind the heart, restricting the heart's ability to expand and fill during diastole, reducing the heart's efficiency.
[Smacks lips] Lot of ifs there.
Dr.
Chen, pair of 14-gauge on a syringe.
All in favor of ratifying Dr.
Glassman's decision in hiring Dr.
Shaun Murphy? All against.
[Knocks] Excuse me.
Is this a medical emergency? No.
No medical emergency Then you weren't supposed to interrupt Yes, I know, but you need to go online.
- What? What site? - Pretty much any of them Twitter, YouTube, any local news site.
He saved his life! [ Applause] The YouTube clip already has over 200,000 views.
Apparently, he's one of our doctors.
Dr.
Shaun Murphy saved this boy? The boy is in O.
R.
2.
Dr.
Melendez isn't sure if he's going to make it.
Your fiancé sure can handle a knife.
Why did you warn me about respecting Dr.
Andrews? [Smacks lips] What's going on? I'm not gonna always be here to protect you.
You think you're gonna lose? Everybody loses eventually.
Is that your guy? Can we get a TV? No.
Why not? Because we're poor, dude.
We live in a bus.
Do you think Mom is looking for us? Nope.
She loves us, but she knows it's better this way.
I got you a present.
It's not my birthday.
I got you a present anyway.
Here.
[Clattering] Kelly.
Dr.
Browne You were right.
[Chuckles softly] - I don't like pickles.
- I know.
- I don't want pickles.
- And I checked.
You saved that boy's life.
Oh, good.
His name is Adam.
Traumatic pneumothorax.
I'm hungry.
Board reconvenes in 45 minutes.
Can you stay here until I get back? Okay.
Okay.
[Clears throat] He's got a serious deficit.
A child is alive today because of that deficit.
And tomorrow, one may be dead because of it.
I seem to remember that when I hired you, you weren't exactly making the most adult decisions.
You haven't killed anyone yet.
Have you? Well, thankfully, there's a cure for youth and stupidity time and experience.
[Laughs] There's a cure for stupidity? Okay.
That would be a windfall.
All Shaun has is a diagnosis.
I'd like your help.
I take it I'm not gonna get it.
Okay.
[Door opens] Wait.
What's the story with this kid? Why is it so important to you? [Sighs] Why not? Because letting things get personal is a sure formula for screwing things up.
I don't know.
Letting things get personal is how we [sighs]how we make it matter.
[Sighs] So, are you proud or disappointed? Do I have to pick just one? Hey.
You're new to town, right? Yes.
Well, I'm sure you have a lot of questions.
No.
Uh You got to be curious about the place, about the people.
Dr.
Glassman gave me a map of the hospital, and I got a map of San Jose online.
[Chuckles] Okay.
Great.
I do have one question.
Yeah? Why were you rude to me when we first met, then nicer to me the second time we met, and now you want to be my friend? Which time was it that you were pretending? Shaun.
We're ready.
The vote was clear.
Why are we reopening this? Is it really because of a piece of publicity? It's because the man just saved somebody's life.
And thank God for that, but it doesn't change a single thing we discussed.
Glassman: Give him six months.
If he proves anything less than excellent Someone "less than excellent" means someone else dies.
Well, I-I would love to make you happy, Doctor.
I would love to hire someone who never, ever makes a mistake.
Unfortunately, God already has a job.
I can accept that he will have insights that none of the rest of us will have.
Can you accept that he will make mistakes none of the rest of us will make? You won't be the one who pays the price.
If Shaun doesn't live up to everything I know he can do, he will be immediately released.
And I will resign my position as President of this hospital.
We haven't heard from Dr.
Murphy yet.
Perhaps we should hear from him before we decide his fate.
Shaun Dr.
Murphy I'd like you to tell us why you want to become a surgeon.
Why do I want them to be my friends? Everybody needs friends, Shaun.
It's gonna be cool, okay? Play hide and seek maybe? - Okay.
- Tag in the warehouse? Hey, stop following me.
- Told ya it was fun, right? - Shh! Hey, you know what? [Gasps, screams] [Thud] The day that the rain smelled like ice cream, my bunny went to heaven in front of my eyes.
The day that the copper pipes in the old building smelled like burnt food, my brother went to heaven in front of my eyes.
I couldn't save them.
It's sad.
Neither one had the chance to become an adult.
They should have become adults.
They should have had children of their own and loved those children.
And I want to make that possible for other people.
And I want to make a lot of money so that I can have a television.
Dr.
Murphy I want to be the first to welcome you to San Jose St.
Bonaventure Hospital.
We're very proud to have you.
[Applause] Shaun, Dr.
Melendez's team is going into surgery.
I mean, if you're interested.
Got a messy field here.
Murphy.
Shaun: Suction.
Never forget, you're the smart one.
You can do anything.
And I'm proud of you, Shaun.
Bet you've seen many of these.
I remember my first.
Kept thinking, "It doesn't get any better than this.
" And for you, I'm afraid, that's literally true.
You're a nice kid, and you're obviously very smart, but you don't belong here.
So, as long as you're part of my team, this is all you're ever going to be doing suction.
I saw a lot of surgeons in medical school.
You're much better than them.
I have a lot to learn from you.
You're very arrogant.
Do you think that helps you be a good surgeon? Does it hurt you as a person? Is it worth it?