The Good Doctor (2017) s02e17 Episode Script


1 Previously on "The Good Doctor" HAN: Dr.
Murphy, you shouldn't be in contact with patients.
Or their families.
Do you understand? Don't be stupid.
What? There's no cameras in here.
Lim, Dr.
I do not want to be a pathologist.
Han, you need to make me a surgical resident again.
What are you doing up so early? I'm not up early.
I never went to bed.
Oh, my God.
Didn't you get my text? I told you I was spending the night with Jake.
I don't want to be a pathologist.
It's that still.
Shaun no one's life goes exactly like they dreamed as a kid.
You're still a doctor.
Still saving lives.
Just in a lab instead of an operating room.
Where are you going? I'm going to walk to work.
The hospital's four miles away.
Studies have shown that walking boosts creative inspiration.
- Shaun, I just think - You don't understand.
You don't understand.
Neither does Dr.
I need to change his mind.
I don't know how.
Mm, we're gonna be late.
So stop.
- Mm.
And don't be smiling at me when you see me in the hall.
I smile at everyone.
I'm a friendly guy.
You'd be a horrible poker player.
- What're you doing? - Murphy's on the corner.
Move it.
That's not where his bus drops off.
Do you think he saw us? He's not looking over here.
Well, that doesn't mean anything with him.
We got to get out of here before the light turns.
AOKI: Through the generous support of St.
Bonaventure Foundation, we've been able to transport Kenny and his mother from their home in Mississippi.
And we'll be covering the costs of surgery and post-op recovery.
And all I have to do is buy one CD a month for the next 100 years.
No repayment necessary.
We appreciate you allowing us to share your case as an educational opportunity for our staff.
You know what they say those who can't teach.
And as you can see, I can't do much of anything.
Actually, y'all haven't really seen anything yet.
How about we get this party started? The neurofibroma started as a small bump near the base of the spine.
In less than six months, it encircled his abdomen and grew to over 100 pounds, the blood supply becoming so intertwined with the patient's, it was deemed inoperable.
But we've been able to come up with an innovative surgical plan that will allow us to slowly peel the tumor off the front and back of his torso in one piece and give Kenny his life back.
We didn't expect to see you.
This is just about logistics, witness lists, scheduling.
The hospital's attorney could've handled this on his own, Dr.
I understand, but I wanted to be here.
Three reasons really.
If my doctors are gonna be judged in this room, I wanted to see the place, see all of you, and see the mood Well, we try to make it very casual.
I know.
But have you ever been judged? I have.
It's scary.
Someone has gone to the trouble of checking out every aspect of your actions, every decision you've made.
You don't know what they know, what they're gonna ask, what could be misunderstood, misinterpreted.
Also, and this is kind of embarrassing, but our lawyer - probably not the best.
- [SIGHS.]
I decided to save a few dollars on him.
So I could hire a private investigator check all of you out.
We're not the ones on trial here.
See? You say you make it casual, and then you call it a trial.
Now, I'm sure she won't find anything.
I mean, nothing too crazy, right? Maybe just something embarrassing.
Maybe a lapse of judgment here or there.
I mean, like I was saying, you parse every choice anyone has made, gonna be a few things they'd rather not revisit.
Am I right? And the third reason? I thought maybe you'd want to work out a compromise.
The surgery went well.
- We were able to fully evacuate the subdural hematoma without any complications.
It's a good thing you didn't hesitate to bring her in.
One advantage of being an insecure, first-time mom who panics every time her child has a slight fever.
Did I just hear you admit that you're insecure? The girl who double-majored in Physics and Chemistry because the Dean told her they were the two toughest? Mom guilt ruins us all.
You'll see.
Whenever you decide to give up the motorcycle and settle down.
No way.
My kid's going to kindergarten on the back of a Ducati.
I'm sorry.
I need to go check on another patient.
Oh, how long will she need to stay here? I'm still not sure what caused the bleeding.
I didn't see any signs of an aneurysm or AVM, so that's good.
I'll have a better idea when I get the post-op test results back from Pathology.
Thank you.
CARLY: This is why I love Pathology.
We don't just fix stuff.
We figure out how it got broken - [DOOR OPENS.]
- and why.
- LIM: Good morning.
Just checking to make sure you got my clot specimen - and blood draws.
- Just logged them in.
And if there's any way to expedite, I'd appreciate it.
The mom's a friend of mine and stressed to the max.
I'm pretty sure the bleed was caused Stop.
I'm sorry.
I meant please stop.
I'd rather not know what you think.
It causes confirmation bias.
Copy that.
Um Did I see you on Hanover Street this morning? I don't know.
Were you on Hanover Street this morning? Yes.
I walked to work.
Did you see anything interesting on the walk? Hmm S-Shaun? We can't both expedite your results and reminisce about our morning walks.
Carry on.
You're totally freaking out, aren't you? No, I'm not freaking out.
All my patients freak out waiting for their final test results.
For 48 hours, you don't know if you've won the lottery or if you're gonna be dead in a few months.
Hell, I freak out, too.
It's the only time I feel helpless.
The treatment's over.
There's nothing left to do but wait.
I'm a little stressed.
That speech not helpful.
My advice.
Embrace it.
You're experiencing emotions only a few people on Earth will ever understand.
The kind Hemingway wrote about.
- I'm more of a Faulkner guy.
- You would be.
- You don't like Faulkner? - No, I don't like Faulkner.
Nobody really likes Faulkner.
I like Faulkner.
Anyway if there's anything you need from me, even if it's just to talk, you have my direct number.
Do not hesitate to use it.
I appreciate that.
And I would like to show my gratitude.
I know I haven't been the easiest patient to deal with.
That's not necessary.
I mean, if you want, you can make a donation to cancer research.
I already donate.
I wanted to thank you, not society at large.
How about Have you ever tried Macallan's Sherry Oak 25? I don't drink.
And I just said it's not necessary.
How about a weekend in Ojai? I hear the spa is amazing.
- No means no.
- I'm not trying to molest you.
- I just want to thank you.
And you have, and you are very welcome.
Why do you have to control every little thing? I have pepper spray in my purse.
Don't make me use it.
Carly, I am gonna need 60 units of type B-positive packed red blood cells held for O.
- 60? - Mm-hmm.
You operating on a hemophiliac elephant? Our patient has a 200-pound neurofibroma.
There's more blood in the tumor than the patient, so we're gonna have to follow Massive Transfusion Protocol.
You You might need antifibrinolytic agents to control the bleeding.
That's a good idea.
I could do some research on cell salvage techniques.
Cancer is a risk, but if we were I'm sorry, Shaun.
Melendez has put together a pretty big team, so we have everything we need.
I talked to Murphy.
He definitely saw us.
What'd he say? It's not what he said.
It's how he acted.
He was clearly uncomfortable talking to me.
He's uncomfortable talking to everyone.
We need to get out in front of this.
Tell Andrews before someone else does.
We need to figure out exactly what Murphy saw.
How? We can't just ask him if he saw us making bread.
We're not gonna get anywhere with indirect questions.
I'll talk to him.
You think you can read him better than I can? No, but if at first you don't succeed Let the man try? Dr.
Han wants to see you two.
- Both of us? - Yep.
Have a seat.
Actually, we've been meaning to talk to you.
- The issue is - Dr.
Han met with the medical board.
We're not going to be suspended or reprimanded.
The hospital will pay fines on your behalf, and you'll need to complete a few continuing education classes.
But overall, not bad.
Thank you.
Yeah, thanks.
Does this mean I'm back on the surgical team? No.
It does not.
You convinced the Board that he's competent.
You're welcome.
We got a big problem.
With our tiny patient.
I did a repeat assessment of the pre-op CT's and found a trace subarachnoid bleed.
But there was no bruise on her scalp.
I know.
The only way she could get this injury is if someone shook her, and they would have to shake her hard.
S-Someone abused her.
I've known Laura since high school.
She's the most composed, even-tempered person I've ever met.
And she's totally devoted to that baby.
What about the father? She conceived via a donor.
A nanny, a relative, a-a boyfriend who's been helping out? She waited so long for this wanted to do everything herself.
Then it has to be her.
We need to call Child Protective Services.
Not yet.
I'm gonna do an MRI to rule out benign enlargement of the extra-axial space.
- Before we ruin her life - Good idea.
Except for the part about you doing the test.
She's your friend.
You think I'd try to help someone cover up child abuse? I don't know you well enough to know what you would or wouldn't do to protect a friend.
I could do the MRI.
I'm not the mother's friend.
But you are a pathologist.
Giving MRI's is not your job.
Page Farmer.
Have him do it.
On it.
We need to talk.
I don't have a girlfriend.
Is that consistent with what you've deduced and seen regarding my life? Yesss? Good.
Enjoy your apple.
CLAIRE: It's not fair.
Shaun is being punished for mistakes that Han thinks he might make in the future.
He's not punishing him.
He just saved his ass.
Okay, Kenny.
The MRA's gonna help us map the blood supply to the tumor.
If you could just lie still.
No talking until we're done.
Sure, no problem.
We should take a stand.
- Meaning what? - Stage a walkout? How much does one of these bad boys cost, anyway? About $3 million.
But it's worthless unless you stop talking.
My bad.
Us getting fired is not gonna do anything to help Shaun.
And I'm not even sure we should be helping him.
Did you ever stop to think that maybe Han knows what he's doing? Shaun has made mistakes, but he has three more years of residency.
That is plenty of time to improve.
Yes, you can build a winning team through supportive training, but you can also do it by recruiting the best and pushing them.
No feelings.
No charity.
No loyalty.
Those who thrive and get better than they ever thought they could, you keep - [COMPUTER BEEPS.]
- and those who don't, you cut.
That's not good.
It works for Jeff Bezos and Bill Belichick.
I'm not talking about your leadership lecture.
I'm talking about this.
We need to page Melendez.
What are you talking about? You know me! How could you possibly believe I could hurt my baby? I don't.
Which is why I ordered the additional tests.
But did you never leave her with anyone else? Even for just a few minutes so that you could take a nap? Or a bath? Taking care of a newborn.
It's It's exhausting.
It isn't.
After waiting for so long, every single moment, no matter how hard It's not exhausting.
It's a joy.
Laura, I know you love her but you're still human.
You must get tired sometimes.
I don't! Really.
You don't understand because you because you haven't experienced it.
But when you love someone so much The tests.
They have to be wrong.
We expected the tumor to grow since the last scans, but not to this extent.
Blood vessels that I thought we'd be able to quickly cauterize are now thicker than my thumb.
It's impossible to remove the tumor without causing you to bleed to death.
I don't care how risky it is.
I'd rather die in surgery than continue to live with this huge, damn tick sucking the life out of me.
Kenny, as long as your heart remains healthy, you basically will be, too.
And we can do a better job treating the pain.
I don't want to be treated.
I want to be cured.
I want my life back.
I always thought all all I had to do was get enough money, or find the right doctors But if you're telling me there's no hope [SHUDDERING BREATH.]
I appreciate everything y'all done.
Or at least tried to do.
The injuries from shaking a baby are much different than from blunt force trauma.
Oh, that's awful but also interesting.
It's like you're a detective in a murder mystery.
Only, thank God, the baby's not dead.
That's exactly what Carly said.
She likes solving medical mysteries.
She's very smart.
And aggressive.
Well, how do she treat you? Is she nice? Yes, she's very nice.
She wants me to stay in her department.
She thinks we make a good team.
So it sounds like you have a case you're interested in and a coworker you like who's nice to you.
Maybe Pathology won't be that bad after all.
I have work to do.
Since it seems we're gonna be working together for a while longer maybe it is time we came out of the closet.
Maybe? Are you saying you want to? Do you want to? - [GLASS TAPS LIGHTLY.]
- Maybe.
You're afraid it would make things awkward? People seeing us as a couple? Yes, obviously.
But at the moment, I'm more afraid that we wouldn't be having this conversation if Murphy hadn't almost busted us.
Which makes me think we're not ready to have this conversation.
It's understandable if we aren't.
We've both been in relationships we thought were gonna last Yeah.
Understandable, but why should we even care what people at work think? [BREATHES DEEPLY.]
So, should we talk to Andrews? Maybe.
What do you think? Maybe.
MAN: Uh, Sawchuck? - Sorry for the wait.
- Oh.
Thank you.
Excuse me, duck curry and rice? 40 minutes? Really? Sorry, the kitchen fell a bit behind.
- It shouldn't be much longer.
- You're not just behind.
People have come in after me, they've gotten their food, gone home, eaten.
They're in their PJs, watching a movie.
I'm so sorry.
I'll check right now.
- Duck curry.
- Here you go, sir.
Duck curry, brown rice.
- White rice.
- Um, excuse me.
- Duck curry with brown rice? - Yes.
- Connelly? - That's me.
Thank you.
What are you guys doing back there? I'm so sorry, Sir.
You know what? I'm tired of sorry.
I just I want my food! I'm sorry.
It should just be another minute.
I don't want to wait any longer! [EXHALES DEEPLY.]
I'm sorry.
I'm sorry.
I didn't I didn't mean to yell.
I'm so sorry.
Carry on.
Carry on.
She's always trying to one-up us.
She's not staying late because she wants to do research.
She's staying late so that Han can see she's staying late.
It's just who she is.
Don't take it personal.
My dad's a Taekwondo grandmaster.
Coached me growing up.
He always used to say, "Only you can beat you.
" Well, my mom's a lounge singer, and she used to say, "Upstage me and I'll beat your ass.
" You'd think if you're selling boba, you'd have straws wide enough to get the balls through the damn thing.
I can't believe you drink that stuff.
It's like putting gummy bears in a drink.
You give up? Want a soda instead? I see you.
Which is, I assume, your primary objective.
I didn't even know you were still here.
I've been reading the latest journal articles - on neurofibroma - Go home.
There's nothing you can do for Kenny Grimm.
And you're gonna have other patients tomorrow.
I got an idea.
If we embolize the larger blood vessels to the tumor before surgery, we can use your body's clotting factor to help clog them.
This should reduce hemorrhaging during surgery and allow us to excise the tumor without you bleeding out.
We'll steer a catheter through an artery in your thigh - Yes.
- Kenny maybe you should let them finish.
No, I shouldn't.
And, yes, you should.
Yes, yes, yes.
As soon as possible.
Thank you.
The tests came back.
They confirm the previous results.
Well, they're wrong.
There must be some other There has to be another test! Please.
Ma'am, you're gonna need to come with us.
- You need help.
- From you! You're my friend, and you called the police?! Well, someone hurt your baby.
If it wasn't you No one hurt my baby! You're wrong! How can you not believe me?! Just need to get a few more branches off the aorta and we're done.
Well done, Dr.
What's the fluid status? CVP is 14 and rising.
Get diuretics on deck.
40 milligrams I.
If his pressure goes too low, his kidneys won't perfuse.
I need you to keep his CVP between 8 and 12.
He can't tolerate much more of this.
We need to get him to an O.
Embolizing his vessels caused third spacing of fluids to the body and lungs.
We saved the operation, but now we only have half the time do it.
Any word? No, not yet.
Well, I-isn't there someone from Radiology who can expedite, someone who owes you a favor? Even if there was, I would not waste it on you because you do not need it.
You are one of the most willful patients I've ever had, and the finish line is in sight.
All you need to do is just run through the tape.
Look, if it helps, as soon as I'm done with this patient, we can talk some more.
I can write you a script for something to help you with the anxiety, but I don't think you need it.
You got this.
- More suction.
- Me, too.
More sponges.
That's it.
What's his estimated blood loss? About 8 1/2 liters.
The entire human body typically only has 5 1/2 liters of blood.
Yeah, I know.
Let's get 30 more units on deck of PRBC.
Add cryo, fresh frozen plasma, and platelets to that.
We should have checked for blood breakdown products.
If you don't mind, I'm trying to pay attention to this.
I wasn't talking to you.
Or about this patient.
We need to reexamine the subdural blood clot specimens.
If there's hemosiderin deposition and chronic membranes including fibrous wall, it could prove it was not abuse.
What else could it be? The tests proved non-accidental trauma.
The tests were right.
PARK: Resected portion is secure.
's and central line? - Secure.
- Secure.
Okay, everybody, get in position.
Let's flip this pancake.
On three.
One, two, three.
- Wait.
His heart rate spiked.
Lay him back down.
- We okay? Yeah.
Just a blip.
Once more with feeling.
Ready? One, two, three.
- How are we doing? - Good.
He's stable.
All right, swab the posterior incision site.
Okay, scalpel and sponge on a stick.
- He's crashing.
He's ventilating fine.
We've got no immediate blood loss or hemorrhaging.
It looks like distributive shock.
I need stat labs and initiate shock resuscitation.
He's got a high white count and what looks to be a systemic pro-inflammatory cytokine release.
Cutting off the blood supply to the tumor is causing post embolization syndrome.
I need intra-arterial lidocaine, 130 milligrams of methylprednisolone, and start antibiotics.
Should we be trying to reverse the embolization? Restore blood flow to the tumor? Well, then, we'd risk him bleeding out even faster.
We need to abort.
Cut off what we already excised and leave the rest.
- No.
We can't give up.
- HAN: We're not giving up.
We're stopping a futile procedure to save the patient.
We need to get Murphy in here.
It's a blood flow problem.
Murphy has a special talent for visualizing complex anatomy.
We don't have time.
We need to stop the P.
- Page Dr.
- No.
Do not page Dr.
I get it.
You like him.
But we don't have time for an audition.
I'm trying to save my patient's life.
My patient.
Which means it's my call.
I am also trying to save your patient's life, so I'm urging you to stop wasting time.
Now we've cut away almost half.
That's all we can do right now.
So let's remove it and give him a chance to live and fight another day.
The breakdown products show the injury that caused the hematoma happened at least seven weeks ago.
When was she born? A little over seven weeks ago.
But the vacuum delivery must've caused a subdural bleed which re-bled two days ago.
The baby wasn't abused.
Shaun, we need you in the O.
Any thoughts, Dr.
Murphy? You don't have enough time.
You can't fully map the circulatory system and remove the tumor without killing the patient.
It's too complex.
Well, at least he was brief and to the point.
Now, can we do what I But you don't have to do it quickly.
We slow down, he bleeds out.
If you clamp the aorta, it could lower the blood flow to the tumor enough to slow the release of the cytokines.
Clamping the aorta will kill the intestines, kidneys, and legs.
Not if we release the clamp every 10 minutes.
Give it just enough blood to stop the cytokines but not so much that he bleeds to death.
Let's do it.
Thank you for the consult, Dr.
MELENDEZ: Reposition him to lateral.
Secure I.
and central line.
- Secure.
- 10 blade.
Starting midline laparotomy.
Opening up the lesser sac.
Vessel loops.
Get a Rumel ready.
I need umbilical tape.
MRI exams show chronic changes of surgery and radiation, but no sign of residual tumor detected.
No signs.
We'll do another MRI in six months just to be sure, but you are in the clear.
This is exactly what we hoped for.
Tuh, tuh, tuh.
- Knock on wood.
- Thank you.
- Oh, you son of a bitch.
I told you.
You told me no.
It's too heavy for diamonds.
- Is it a Magic 8 Ball? Will you just open it? [CHUCKLES.]
I don't like baseball.
I do.
So you got me something you like? I caught that foul ball down the third base line on my 13th birthday.
My dad was amazed that I snagged it.
After the game, we went outside the stadium.
And I was a shy kid, but my father pushed me to ask my favorite players to sign it, and they all did.
Bert Campaneris, Rollie Fingers, Reggie Jackson, Catfish Hunter.
If it happened today, it'd all be on video.
But all I have to remember that awesome day is that ball.
I wanted you to have something that mattered to me.
- Aaron, I can't.
- Oh, yes, you can.
Cancer changes people.
I've had patients tell me it was a blessing.
That their lives were better after.
They're idiots.
Would you have thought of such a wonderful gift 11 months ago? [DOOR CLOSES.]
Care to do the honors? Let's take it up.
- [SIGHS.]
- [SIGHS.]
I'm so sorry.
I should've trusted you.
Please talk to me, Laura.
Yell at me if you want.
I deserve it.
- It's not your fault.
- Yes, it is.
I should have done more research, looked harder for an alternative diagnosis.
I mean it's not your fault you are the way you are.
You don't understand the love a mother feels.
I understand that a lot of mothers abuse their children.
You don't understand love.
Because you've never allowed yourself to be vulnerable.
Even when you were married to Kashal, you never really committed.
You always expect the worst in people.
Because that's all you see in yourself.
I've never been in so much pain but felt so good.
We'll up your pain meds.
You're still gonna need some skin and soft tissue grafts, but the hard part's done.
Your prognosis is excellent.
Thank y'all so much.
What am I taking this thing home in? A glass bottle? Y'all got something that big? [LAUGHS.]
He's just being a smart ass.
Are you sure you want to do this? Shut up.
I saved the patient.
I deserve to be a surgeon.
Murphy Dr.
Han, I want my old job back.
You're making a mistake.
Am I, Shaun? Yes.
Because it seems like you're doing really well in Pathology.
You made a great save on an earlier case and a great save today.
You keep doing well, and, over time, we can build to you having more responsibility.
I'm a surgeon.
I am not leaving your office until you reinstate me.
What are you doing, Shaun? Do you think ordering me to do something will change my mind? Do you really think it's a good idea to try and bully me? I am a surgeon.
I am a surgeon.
Do you realize that you're proving my point? That you're acting immature? Showing that you don't know how to communicate and you can't control your emotions? I am a surgeon! But you do have a talent that I value.
So I'm gonna give you one last chance to maintain your dignity and leave my office now.
Because if I have to call Security, you understand that I'm also gonna have to fire you.
I am a surgeon! I am a surgeon! I am I am a surgeon!! I am a surgeon, Dr.
I am a surgeon! [BREATHING SHAKILY.]
Holding back the flood In this skyscraper town [BREATHING HEAVILY.]
You gave all that sweat and blood Now you think you're gonna drown You can't tell that you're bigger Than the sea that you're sinking in [BREATHING QUICKLY.]
And you don't know what you got But you got it at your fingertips [BREATHING SHARPLY.]
Ooh You got it in you [BREATHING QUICKLY.]
Ooh You got it in you When the lights go out And leave you standing in the dark No one ever told you this would be so hard I know you think your fire is burning out But I still see you shining through You got it in you [BREATHING HEAVILY.]
When the lights go out And leave you standing in the dark No one ever told you this would be so hard I know you think your fire is burning out But I still see you shining through You got it in you You got it in you You got it in you You got it in you You got it in you
Previous EpisodeNext Episode