The Good Doctor (2017) s01e03 Episode Script

Oliver

1 Previously on "The Good Doctor" ETHAN: How hard can it be to just act like a normal human being? No! Would you stop petting that stupid rabbit?! [THUD] We're never going home again.
We have each other, and that's all we need.
Aah! Your fiancé sure can handle a knife.
He's got a serious deficit.
So, are you proud or disappointed? Marcus, stop making everything so personal.
You've wanted his job since day one.
Everyone in this room knows that.
How did you It's my department.
It's my job to know everything.
Since I work for you, doesn't that make all this - actually your fault? - Oh, I'm sorry.
I stopped listening after "I work for you".
A surgeon needs to communicate.
Can Dr.
Murphy do that? Can he do that under stress? Can he do that knowing that a human life literally hangs in the balance? [MAN WHISTLES] [GIGGLING] [ENGINE STARTS] [TIRES SQUEAL] [CRASHING] [MEOWS] [KNOCK ON DOOR] [MEOWS] [KNOCKING CONTINUES] So, I'm in the middle of "Uncharted", and I'm dead.
Can I borrow some triples A's? I'm your neighbor.
Hello.
34? I moved in last week.
33.
Yeah, I know.
I work at a hospital.
That's cool.
Yes.
Triple A's, por favor? Batteries.
Right.
Do you have any? [CAT MEOWS] Triple A batteries.
Thank you.
Piece of advice don't feed the cat.
Which cat? Feed it once, and it'll never leave you alone.
Thank you for the batteries, neighbor.
You're welcome! [TELEPHONE RINGING] WOMAN ON P.
A.
: Dr.
Forrest, dial 118, please.
Dr.
Forrest, please dial 1-1-8.
[RINGING CONTINUES] Surgical.
Well, you're in luck because I'm not a nurse, I'm a surgical resident.
How can I help you? We got a liver for Chuck! - Where? - SF Municipal Hospital! And how long do we have body-to-body on the liver transplant? - Eight hours.
- Eight hours.
You don't know the longevity of a liver? This is a teaching hospital, and I'm the teacher.
You and Murphy, you're on organ pick-up.
Check the health and bring the liver back from SFM.
I was at Chuck's intake.
I'd really like to be Now you're gonna be at the intake for his new liver.
Jared, get Chuck down here and get him prepped.
We got eight hours on this thing, and the clock starts ticking now.
[BEEP] WOMAN ON P.
A.
: Dr.
Bender to the mental ward, please.
Dr.
Bender.
I'm not interrupting your pre-game, am I? I think this is my 400th breast reconstruction.
The board should give me a plaque.
What's up? Your 4:00 P.
M.
The V.
I.
P Wannamaker.
Yes! The Free-Flap.
He's checked into the penthouse suite, resting comfortably I'm sure.
I've been working on him for awhile now, and he's close.
He's real close to making the Foundation his tax relief.
That's good to hear.
I want aces on this.
Everything perfect.
That's good to know.
I was gonna phone it in.
[BEEP] WOMAN ON P.
A.
: Dr.
Bender to the mental ward, please.
Dr.
Bender.
Is this the chairman's version of a pep talk? I'm looking for a fail-safe outcome on the procedure.
I want you to use Dr.
Melendez as your second.
That's your fail-safe? Melendez? I'm your Chief of Surgery.
It's just a precaution to guarantee a perfect outcome.
Are you doubting my abilities? Wannamaker is important.
Everything has to be perfect.
You said that already.
I'm your fail-safe.
The V.
I.
P.
will be fine.
[HELICOPTER BLADES WHIRRING] How you doing? I know these sounds and everything might be a lot for you.
It's it's hard for anyone.
I like helicopters.
I, uh, didn't know you'd been on a helicopter.
I haven't.
15 minutes to San Francisco Municipal Hospital.
Should be a smooth ride.
You do know what this is, right? Well, I'll tell you what it is.
It's scut work.
Jared gets the golden ticket, and we get pizza delivery.
The rotors just go round and round, Shaun.
They don't change.
How do I talk to you? So, Chuck, any chest pains, shortness of breath? No.
Any alcohol in the last six months? No.
- Here comes a quick pinch.
- Any swelling in your limbs? It's Walmart on Black Friday in here.
Things speed way up when you're having a transplant.
I like it.
It's good energy.
So, that's a "no" on the swelling? No.
I feel lousy all the time, pretty much.
But I've got a second chance, you know, with this liver.
Sure.
[CELLPHONE RINGS] Oh! Excuse me.
It's my daughter.
I already spoke to Mom.
A-And Uncle Tommy, too.
Yeah, I need to see your face.
All right.
I love you.
Bye.
She just graduated from law school at Cal.
I told you that.
Uh, no.
Congratulations.
I must've told Dr.
Browne, then.
Where is Dr.
Browne? [WOMAN SPEAKING INDISTINCTLY OVER P.
A.
] Here's your liver.
I'm going to need you to sign for it.
Standard operating procedure is the leave the liver in the safety of the body cavity.
I'm aware of the procedure.
We had a John Doe at the top of the registry, but that John Doe died before we could plant.
How long ago did you take it out? Three hours.
We just lost three hours.
Technically three hours and five minutes.
True clock is on the cooler.
SHAUN: Can't go below 39 degrees or above 47 degrees.
You want to sign for it? Tissue looks healthy.
What are you doing? What are you looking for? - What's he doing? - I'm not sure.
Shaun, what are you looking for? Masses? Cysts? They're clean.
You think we'd miss a tumor? There's nothing there.
I know.
There's nothing there.
Okay, the liver needs to go back into cold storage, and we got to go.
then I'll release the vascular clamp and let your blood perfuse in your donor liver.
- That's it? - Connect the bile ducts, sew you up, and then we wait.
[SIGHS] Does the new one always take? Over 70% of the time.
Oh, I can live with those odds.
[LAUGHTER] You get some rest.
See you later.
He looks at something.
I don't know what he's looking at.
Is he, you know, is is he curious? Is he concerned? He won't answer me.
GLASSMAN: You're having trouble communicating with him.
It's a weekday.
It's Shaun.
Hm, let's see.
That seems about right.
He seemed different at the hospital.
I could kind of talk to him.
Well, he knows what to expect in the hospital.
Outside, everything's different.
Everything's new.
New stimuli.
So, what do I do? I-I I don't know what he's thinking.
Claire, you're not gonna figure out what he's thinking, so don't even try.
In fact, if he's thinking about something in his own mind, just let him be.
I'd appreciate it if people gave me the same courtesy.
I thought with your history Claire, if you want to connect with him, you're gonna have to figure out your own way in.
How's Chuck? Chuck? Chuck's fine.
He's waiting for a liver.
So come home, please.
Okay.
KATT: Doctor.
What's up? I just wanted to thank you.
I haven't done anything yet.
You have.
You've given my dad hope.
[HELICOPTER BLADES WHIRRING] You know, Chuck was my first patient.
Six months ago, first day at St.
Bonaventure, I get a liver failure.
And the nicest guy in the world.
I wanted to be the one to give him the good news.
SHAUN: We're not leaving.
You said you liked helicopters.
We are not leaving.
We We made it here safe.
Yes, we are not leaving.
We're not leaving.
Fog's rolling in too quick.
Does that mean it rolls out quick? Could be an hour.
Could be three.
Don't know.
Okay, uh We're gonna need a new ride.
CLAIRE: Excuse me! I need an ambulance to St.
Bonaventure.
Sorry.
I just don't have the EMS.
I've got a pile-up on I-80 and four other vehicles out on call.
Not one ambulance? Let me be clear this is emergent.
It's time sensitive.
Honey, this ain't Hertz.
What about a police escort? That can be arranged.
[LAUGHTER] Of course.
ANDREWS: Don't want to ruin the festivities.
But if I could just get a few minutes with my patient, alone.
Mr.
Wannamaker.
Dr.
Andrews.
How we doing today? Incomplete.
Let's see what we can do about that.
Look here.
Well, looking not too bad considering we cut out a tumor less than two weeks ago.
Yeah, I've been walking around with a hole in my mouth.
Ever drink Scotch with a hole in your mouth? Waste of good Scotch.
[LAUGHS] We needed to give it time to heal.
Yeah, yeah.
You told me.
Have you continued to smoke? It constricts the vessels, slows the healing.
I'm not a quitter.
We are going to graft some skin from your leg and fix that cheek up better than new.
I'm a real estate guy.
There's an old saying "You can have it fast.
You can have it good.
You can have it cheap.
Pick two.
" It's not gonna be cheap.
[LAUGHS] I like doctors like you.
You're good, and you know it.
CLAIRE: Yes.
It was harvested before we got there.
We're waiting for transportation.
The itinerary and the life clock have changed.
Yeah, uh Four hours and 14 minutes.
Excuse me! Are you talking to the hospital? Have someone tell Dr.
Glassman that I might be late for our lunch, please.
Yeah.
Okay.
So, how did you know about the weather? Is it some kind of gift? [LAUGHS] Come on, I got to know.
What, Shaun Murphy is Zeus? I watch The Weather Channel.
[SIREN WAILING] You my doctors? Shaun? Shaun, we got to go! You're home.
Your dad and mom have had a tough night with your brother and all.
Come on.
Let's go.
No! No! He He promised me! He He promised me! He promised! He promised me! He promised me! He promised me! [PANTING] I think we'll get there much quicker if we drive, Shaun.
C-Could you turn off the flashers, please? What's the patient's name? I told you.
It's Chuck.
- No.
- No? No.
The The donor? What's his name? What? The liver? I "Oliver"? Oliver.
[KNOCK ON DOOR] Hey, you got a second? What's up? Just waiting on a liver.
Transplant.
Everyone wants in.
They'd trade their liver to do the liver.
[CHUCKLES] Hey, look, uh, you want some help on this Free-Flap? What's his name? - Wannamaker.
- Right.
You got the transplant.
That should keep any attending busy.
Well, I can make time.
Aoki come to you about this? Look, I get it.
You're the Chief.
That's right.
Look, this this isn't a coup.
What is it? It's about making sure this hospital is first on Wannamaker's donation list.
I'm aware of the stakes.
Thanks for coming by.
You know, it doesn't make you any less of a surgeon, having me in there as your second.
I'm the Chief.
You're my attending.
Can't argue with that.
And we both know what your presence in my O.
R.
will say.
That's not my intention.
It's the impact.
Intention doesn't matter.
Thanks but I'm good.
[DOOR OPENS] [DOOR CLOSES] These can't be right.
Whatever it is, it's right.
Chuck's labs.
It's got to be a false flag or a bad reading.
For what? Medications? Foods? I don't know.
Look, if this is right, we lose our transplant.
I'm sorry.
That doesn't change the results.
There's alcohol in his system.
He drank.
The blood doesn't lie.
Run the lab again.
E.
T.
A.
to St.
Bonaventure? 70 minutes.
What are you looking for? What do you see? I have a girl neighbor.
Okay.
Is she nice? What does she do? Does she have a boyfriend? Do you know her name? What the hell are you looking for on the scans? [BEEPING] What the The temperature is going up! Officer, we need to find a place with ice, like, now! JARED: I tested it, Chuck.
And re-tested it.
Talk to me.
You know the six-month rule.
- Was it a craving? - It was three days ago.
My daughter's graduation.
Nobody in my family had ever gone to college.
There she was.
My little girl wearing the robes.
And for just that day, I I wanted to be normal.
So, I I had a glass of champagne.
[SIGHS] [BELL DINGS] You're out of ice? It's broken.
Supermarket's about three miles down.
We don't have time.
Okay.
Okay.
The temperature's already at 47 degrees.
We can't let it go any higher.
Are you gonna help me? It's sweet.
You'll like it.
What should I do with him? DEPUTY: Child Services is down in Cheyenne.
That's 150 miles, and they'll just turn me around and send me back to the parents.
The parents don't want him? I don't know.
He doesn't seem to want the parents, that's for sure.
You can take him to do the hospital.
Social worker there.
[SLURPS] That won't work.
How do you know? Shaun? You're right.
It's not working! Why? Shaun! Are you even listening to me?! Just one drink? That's what he said.
Should I inform the registry? How long ago did Chuck have that drink? Three days ago.
Give me your marker.
That's Estimated blood-alcohol content.
What type of alcohol? Uh, champagne.
What percentage of alcohol is that? I don't know.
What's the difference? Take out your phone and look it up.
I don't know why it's not working! It needs to be submerged to cool.
CASHIER: Hey! Every five seconds is an XL.
Why did you answer me the last time, but not before? Was it because I was angry? Was it random? Why can't you answer my questions? This better work.
It will work.
You answer when I don't ask.
You don't like questions.
I don't.
I didn't do well in calculus.
This is algebra.
With his severe cirrhosis, his alcohol-clearance rate is one milligram per deciliter per hour.
One drink, say eight ounces If it's champagne, six ounces, tops.
Play it conservative.
Eight ounces results in a blood alcohol level of 39 milligrams per deciliter.
One standard drink.
Now, the purpose of abstinence, at least according to the transplant registry is Patients who kill their livers due to excessive drinking prove they can be sober.
Let me see that report.
0.
02.
Chuck was telling the truth.
He did have just the one drink.
He didn't fall off the wagon.
Corporate loves its data.
I'm not sure it'll actually make a difference, but it does give us an argument.
You are genius.
[WOMAN SPEAKING INDISTINCTLY OVER THE P.
A.
] You don't like the cafeteria food? They only make one thing well.
What does it say when the staff sees the President of the hospital not eating their cafeteria food? Well, it says the President of the hospital isn't allowed in the kitchen.
You sat down.
What can I do for you? I'd like your advice.
Really? Where's Aoki? Did she die? This was a mistake.
That's insulting.
Sit down.
At least hear what I have to say, and then decide it's bad advice.
Sit.
Aoki is pushing Melendez on me for the VIP.
Ah.
You didn't get the e-mail blast.
Rich people aren't allowed to die in this hospital.
You're not the young star anymore.
Melendez is.
I know that.
And you're upset about the "why"? Why does Aoki think that? You should be asking "who".
"Who"? I know who.
Melendez.
Who are you? Are you a Chief who wants to be surgeon, or are you a Chief who wants to be president? 'Cause if it's the latter, take your ego, shove it in a cupboard somewhere, and start acting presidential.
[WOMAN SPEAKING INDISTINCTLY OVER P.
A.
] Dr.
Melendez is going to argue to the board that you get this liver.
And I think it's a pretty good argument.
Do I deserve it? I'm not sure that's relevant.
You know when you're dying, and I've been dying for a long time, you start to think about your life.
I haven't led a great one.
I could've been a better dad.
A better man.
News flash I drank too much.
You know, I also have a son.
Yeah.
First marriage.
I haven't seen him in three years.
Getting a liver is not a second chance, and it's not a reward for being perfect.
It's just what we can do.
Maybe.
But on the registry, all of us wait in line together.
And I see these [COUGHS] these people here, waiting.
I know their faces.
Even their names.
They all have stories.
We're in it together.
And I I broke the [COUGH] [MONITOR BEEPING] Chuck? Chuck! Chuck? Code blue! Chuck, can you hear me? [MONITOR BEEPING RAPIDLY] All right.
He's got blood in his esophagus.
He's got a variceal bleed.
All right.
Saline wide open.
Type and cross four units.
I'm going to band the vein.
Pressure's coming up.
[EXHALES DEEPLY] [MONITOR BEEPING NORMALLY] Chuck had a variceal bleed.
I was in there.
Portal hypertension, decompensated Are you finished? He's got three months to live, maybe.
You have to be six-months alcohol free before you're registry eligible.
And you said you weren't good at math.
He gets this one or he dies.
[SIGHS] You know what this thing looks like at 8:00 A.
M.
? I need a police escort to work every morning.
280 South.
Where are all roads meet.
[LAUGHS] No, they don't! - What's wrong with him? - He's autistic, officer.
OFFICER: What's that mean? Does he need to be in a hospital? The last place he should be is a hospital.
What are you doing? Shaun? What are you thinking? Okay, this isn't a question.
I just I don't know what you're looking for, Shaun.
Yes, I can feel it.
It's firmer.
And? I don't know what that means.
There must be a clot, but there isn't a clot.
The scan showed no clot.
That's because the scans were taken before they harvested the liver.
Prior to the liver being flushed with UW solution! It's dying! To preserve the liver, they replace all its blood with a solution to protect it from the cold storage, but they must've left some blood behind, which clotted.
How long to St.
Bonaventure? - Less than 30 minutes.
- Can't wait! We have to immediately remove the clot and flush the left lobe to protect it from the ice bath.
We need to stop the car.
- Here? - Yes.
Yes.
We need to operate right here, right now.
[HORNS HONKING] Flush this from the right.
So, the left lobe, starting at the middle hepatic vein.
Less intrusive cut would be along the falciform ligament to allow access to Segment III.
When you locate the blockage, I'm gonna have to remove it.
[HORNS HONKING] Okay.
I need a straw to cannulate the vein, please.
There's a straw in my cup.
[HORNS HONKING] UW solution will stabilize the cell walls.
Preserve the integrity of the organ.
This is better than having a baby in my car.
How are you feeling? Like I'm writing a blank check.
You're gonna be fine.
You're the best.
This bleed, these varices this isn't good news.
Tells us that your liver failure has progressed considerably.
How much? You have two to three months.
We're getting the liver today, in an hour.
I don't get it.
You didn't tell them.
What? Your father had a drink.
[SIGHS] He had one glass.
Transplant registry doesn't quantify things like that.
So he doesn't get the liver? I'm gonna try and get it for him.
What are you, a car salesman? What, you're gonna try? The final decision is out of my hands.
[WOMAN SPEAKING INDISTINCTLY OVER P.
A.
] And if you fail? I'm gonna do everything that I can.
I am meeting with the committee in 10 minutes.
Excuse me.
I handed my dad the drink.
Doesn't matter how it happened.
He didn't want it.
He just wanted to make me happy.
If you let him die, I will have killed my father.
It was a glass.
A glass of champagne at his daughter's graduation.
I have the labs to prove it.
Chuck didn't fall off the wagon.
He had one drink and never went back.
The transplant registry guidelines don't play in the gray for a reason.
Those guidelines are so arbitrary.
Have one drink and you die.
A couple pills of ecstasy, no problem.
Hepatitis B from careless sexual practice, nope.
Nothing at all about that.
So, what do you want us to do? Throw out the rules? I want us not to hide behind them.
We do have a responsibility.
Without the rules, we're playing God.
We need the rules.
Does that help you sleep better at night? Yes, it does.
We have one liver today, and 800 people in this state need it.
I don't want to be haunted by the other 799.
Your guy hasn't earned it.
He knew the rules, and this it's a technicality.
No, the drink is a technicality.
Jessica, what's the legal burden here? Significant.
If we move forward with this transplant, we could lose privileges from the registry.
- If it were discovered.
- If it were discovered? How narrow can you be about this? Dr.
Glassman, where are you on this? I can make a good argument either way.
Go ahead, please.
Better to remove the arguments all together.
What the hell is he talking about? All I'm talking about is that we have a patient in this hospital who needs a liver.
We also just happen to have a liver that needs a patient.
It's not that simple.
It is that simple if you consider the patient.
Rules are secondary.
But is saving this patient worth the risk of not being able to save hundreds of others? I don't have hundreds of patients right now.
I have one, and his name is Chuck.
Blood pressure's steady.
Donor vessel to the facial artery, and we're ready to close him up.
10-0 polypropylene and vascular forceps.
Nice work, Dr.
Andrews.
What do we have here? Uh hematoma? I can see that.
Let's find its source.
Sponge, stick, and probe.
It's not my recipient artery.
- [MONITOR BEEPING RAPIDLY] - Heart rate is dropping.
Whatever it is, it's compressing his carotid.
I can't get deep enough here.
I need better access.
We move through zone three from the outside.
Zone three's a minefield.
I'm aware, but we need to do this.
Whatever you're gonna do, do it quick.
It's strangling him from the inside.
Get me Melendez.
CLAIRE: We made it! Yeah, we're here.
Downstairs, coming up.
No, no, no.
Jared, you're not gonna believe wh Yeah? Got it.
Um Chuck's been moved to the bottom of the list.
San Jose Presbyterian are coming to get the liver.
- Oxygen sats tanking.
- Up him to 100 % O2.
You have to go through the mandible from the inside to probe for the source.
It's the only way.
Loops.
We have to be careful in there, or he'll get a stroke.
We'll just have to be careful then.
Give Dr.
Melendez the mandibular channel retractor and number five bone cutter.
Number five bone cutter.
[SIREN WAILING] 29 minutes.
That's a lifetime.
Thank you.
This is amazing.
Got to go.
The whole team is waiting.
His name is Oliver.
[SIREN WAILS] It was a good day.
We saved a life just not Chuck's.
You can still see where the water was In a line at the top of the chimney bricks It's not your fault.
I want to believe that.
Can never be fixed So, we saved a few things that were spared And brought it to the ground 'Cause you always build it better the second time around Ooh, ooh, ooh, ooh, ooh Hi! Hello.
Are you a lab guy or something? - I'm a surgeon.
- That's insane.
May I have my batteries back? The ones you borrowed.
Yeah.
You can still see where the water was There you go.
In a line at the top of the chimney bricks What's your name? I'm Lea.
I'm Dr.
Shaun Murphy.
Nice to meet you.
Can never be fixed So, we saved a few things that were spared And brought it to the ground 'Cause you always build it better the second time around Ooh, ooh, ooh, ooh, ooh Ooh, ooh, ooh, ooh, ooh I drove past the place where we used to live Where you said you never wanted kids Sometimes, something so broken can never be fixed You'll stay with me tonight.
And tomorrow, we'll figure out the rest.
You always build it better You always build it better You always build it better the second time around You always build it better the second time around You always build it better You always build it better the second time around