The Good Doctor (2017) s03e15 Episode Script
Unsaid
1 I followed Gordon Ramsay's recipe for the perfect scrambled eggs.
Oh, thank you.
This looks amazing.
Except I cut the tomatoes in half.
The recipe says to saute them whole, but I once had a patient who almost choked to death on a Oh, my God.
These are perfect.
I'm glad you like your breakfast.
I read that if I made you feel loved and cared for, it could help us work out your insecurity.
Over my friendship with Lea.
Aww, Shaun.
You don't have to do any more research.
I am fine with you and Lea being friends.
But you can keep making me eggs anytime you want.
You're late.
I made Carly a special breakfast this morning.
And then she wanted to have sex.
So we did.
That's great, Shaun.
Next time, feel free just to say you missed the bus.
Women don't like it when you kiss and tell.
Even though they do it all the time.
Not at work.
Apparently, you've never been in the nurses' break room.
What were you doing in there? Delivering the donuts.
Best lesson I learned as a cop, better to feed down than kiss up.
Oh, it's my fault we haven't started our rounds.
I missed the bus.
It's all right.
I'm glad you're all here.
Because I want to apologize.
Dr.
Lim told me she received a complaint about me playing favorites.
She obviously didn't reveal any names, but I want to assure you all that I don't have any favorites.
And if I did anything to give that impression, it's my mistake.
It won't happen again.
We're a team.
And we need to be able to communicate and trust each other in order to be our best.
So in the future, if you have any concerns, you can come to me directly.
Absolutely.
She got blindsided, never saw it coming.
Thank God a woman driving by had pepper spray in her purse, or the dog would've killed her.
- Brave woman.
- Loosen the tourniquet.
Oh.
Okay.
We need an OR stat.
Page Dr.
Melendez.
Right away, Doctor.
And start empiric antibiotics.
I'm gonna guess this dog wasn't big on flossing.
On it.
Wasn't that funny.
Donuts.
Best 10 bucks you'll ever spend.
Cory's upper trachea never fully developed in the womb.
His upper airway is totally blocked, and he has no larynx at all.
The trach tube he needs to breathe continues to cause reoccurring infections and pneumonias.
He says it tickles when you touch his neck.
Sorry.
Not much I can do about that, but I'll try to make it quick.
Why are you signing? He's mute, but he's not deaf.
It helps us stay mindful of what he's going through.
What did he say? He says when we get mad, we don't sign We yell.
And when we play soccer together.
So keep your room clean and pass your dad the ball every once in a while, and then they won't have to yell.
The good news is his lungs are clear and I don't see any sign of infection.
Thank God.
The better news is he's a good candidate for the surgery we discussed.
Yes, it seems a bit experimental.
It's shown great results.
If we can excise the scar tissue and open up the airway, he still won't be able to talk, but he'll finally be able to breathe normally.
It's a complicated procedure, but given the severity of the infections he's been dealing with, I think it's definitely the best option.
He says he'll do anything to get rid of the tube sticking out of his neck.
And you two? Okay, now you're the one yelling.
We hear you.
What do you think? Let's do it.
Fran? Fran, I'm Dr.
Melendez.
This is Doctors Park and Browne.
You were attacked by a dog, almost bled to death.
You remember? Yes.
We had to repair a severed artery in your arm.
So, am I okay now? The surgery went well.
Dr.
Park.
We were able to stop the bleeding, which had caused you to go into shock.
But we still need to go back in, stabilize the shattered bone, repair nerve damage, and do skin and tissue grafts.
But after that? I'm a firefighter.
I need my full strength.
With plenty of physical therapy, we should be able to get you pretty close.
It must be hard for him to communicate.
My friend's 12-year-old daughter took a signing class at summer camp.
She picked it up pretty fast.
Non-verbal communication is definitely more confusing.
That's why Carly and I always talk out our problems.
Sorry to break it to you, Murphy, but it doesn't matter how explicitly Carly speaks.
She's saying a lot more silently.
And it's often the opposite of what she said out loud.
Why would Carly lie? It's not lying.
It's communicating indirectly.
Everyone does it, but women way more than men.
Most of the time, we don't realize it.
That sounds sexist.
You gonna report me to HR or listen and learn? Has she ever told you that she didn't want to have sex because she had a headache? No.
And I thought you didn't want to hear about my sex life.
Fine.
But if you ever get the feeling she's upset about something and she insists nothing's wrong, something's wrong.
Humerus isn't broken.
It's pulverized.
Who do you think complained to Lim? No idea.
And we're gonna need internal fixation with locked intramedullary nailing to stabilize the fractured pieces.
It must be Morgan.
She's always looking for a competitive advantage.
Let's focus on the patient.
You can start your whistleblower investigation as soon as we're done.
How does she expect us to trust her if whenever something doesn't go her way, she just goes to the boss It wasn't Morgan.
It was me.
Why? You're the least competitive of all of us.
That's not true, and I didn't do it to help me, I did it to help you.
If people see you're getting special treatment, even if it's not your fault, they'll resent you.
I'm not getting special treatment.
And I don't need your protection.
Fine.
My mistake.
So you can yell at me or we can get back to work.
Just what the doctor ordered.
- W-W-What? - You.
I need a double dose of Shaunie, stat.
Glassy is driving me crazy.
What is it with old people and technology? Hmm.
Don't worry.
I just need to vent for a minute.
And I'll scram if Carly comes.
It's okay.
I think Carly's not insecure about you anymore.
Really? That's awesome.
I added the "I think" because Morgan thinks women sometimes say the opposite of what they think.
But I don't think Carly would hide what she thinks.
What do you think? Nobody always says what they think.
So Morgan's right? Except for the sexist part? No.
I think Carly is very in tune to how you communicate.
If she was unhappy, I'm sure she wouldn't hide it.
Yes.
I agree.
Lunch is over.
We have a surgery to do.
Hey, Morgan.
Love your boots.
Thanks.
Love your sweater.
Thanks.
DR.
- Nice work.
Look at that.
On the bone.
Teeth marks.
Must've been a huge dog.
During "no knock" searches, I was more afraid of dogs than guns.
Gangsters have horrible aim, but their dogs never miss the target Which was our crotches.
Damn.
How many times they get ahold of you? Never.
Another benefit of martial arts training.
You kicked the dogs? Like I needed a 60-yard field goal to win the Super Bowl.
That's awful.
It's self-defense.
Totally.
I need 9-oh nylon microsutures.
Next step is to suture in the interposition graft.
Dr.
Park's doing great.
Might as well continue.
I I wouldn't mind getting my hands dirty.
Let's see how Park does with this first.
Make sure your stay sutures are at six and twelve o'clock.
You are very efficient.
And you're very clever, introing your insult with a compliment.
Your "helping me out" appears to have conveniently helped you out.
Eh, I was expecting worse.
Melendez is bending over backwards to avoid anything that might convey the slightest bit of appreciation for my work.
Because it couldn't possibly be that I was actually doing a better job than you.
Right.
You're probably buying him donuts, too.
I did what I thought needed to be done, and you're accomplishing nothing by continuing to badger me about it.
Thanks, Dad.
You're welcome, child.
The boy's obstructed cricotracheal segment looks bigger than what we saw on imaging.
I chose to be aggressive with resection.
Murphy, flex the neck to mobilize the ends and reduce tension on the anastomosis.
Are you sure we're gonna be able to cinch it closed? Not "we.
" You.
Step on up.
Four-oh vicryl sutures on a needle driver.
Place lateral traction sutures at the proximal and distal airway.
- You all right? - Yeah, it's just, I I hit my finger with a hammer last night.
I was trying to hang a painting.
Murphy, take over.
It's all right.
I can Move.
You're a surgeon, not a hockey player.
We don't play through our injuries.
Next time, hire a handyman.
Those fingers are your livelihood.
Got it.
I know Carly says she's not jealous anymore, but based on what I saw at lunch, I'm thinking maybe she should be.
I think Murphy's old enough to handle his own girlfriend trouble.
I don't have any girlfriend trouble.
That "eating off the plate" move is the oldest trick in the book.
Lea was hungry.
It looked more like she was claiming territory than satisfying hunger.
She might as well have peed on your leg.
You, shut up.
And you, keep a smaller gap between the sutures.
We're gonna need a solid anchor to get the anastomosis airtight.
That's better.
Good job.
- Good work today.
- Thanks.
See you tomorrow at the track.
I, uh I I wanted to talk to you about that.
We can't do this anymore.
It's just a run on a public track.
It's not like we're meeting at a hotel.
I just shouldn't be socializing with residents outside of work.
Any of you.
Neil.
I've been going through a tough time.
Our friendship, having someone I can talk to, it helps.
I'm not abandoning you.
I'll be there to support you at work.
You've got your therapist.
You're gonna be fine.
This is exactly why women have such a hard time finding mentors.
No one questions when guys hang out, but anytime a woman wants to build a totally appropriate relationship with a male colleague, the stupid rumors start.
I agree.
But the rumors have started.
I'm gonna plug the trach tube, and I want you to try to take a breath.
Nice and easy.
He says it hurts, but it's the best feeling he's ever had.
What's wrong? You don't like it? It's delicious.
I hear delicious, but I see disappointed.
It's not the chicken.
It's my patient.
We fixed his airway, and he can breathe without the trach now.
That's fantastic.
But he still can't talk.
He can talk.
He just does it with his hands.
Mm, but only with people who can also sign, and they have to be looking at him, and Well, could you do a cadaveric larynx transplant? No.
I've heard that's worked for some throat cancer patients.
No, Dr.
Lim ruled that out years ago.
The risk of tissue rejection is too great in a child his age.
Well, could you wait till he's older? No! If he doesn't learn to speak soon, he'll never be able to.
Okay.
I need to do some reading.
Oh, come on, Shaun.
You should at least eat something first.
No.
I'm hungry, but I will do the reading first.
You're in early.
What's the haps? Are you serious? I didn't even know Michelle Obama was in SEAL Team Six.
Have you ever noticed how Glassy grinds his teeth when he's listening to someone talk? It's like a cow chewing on You never used to do that.
Do what? Eat food off my plate.
I used to work full time at a place with private chefs.
Now I work part time in a place with hard-boiled eggs in a vending machine.
She said it's like you're peeing on my leg.
You're gonna have to expand on that.
Morgan thinks your body language says you're trying to assert your dominance over Carly.
Morgan is one twisted biatch.
Is she right? No.
Not even close.
I promise you my voice and body language are communicating the same thing, which is pure, non-threatening, platonic friendship.
Shaun? He also snores.
Really loud.
- Glassman? - Oh! I have to go! Okay.
Incision sites look good.
And skin and tissue grafts appear to be taking hold nicely.
We were able to reattach your bicep muscle and tendon.
That's good to hear.
Can you lift your arm? No.
I I can't.
Because it hurts too much? It doesn't hurt at all.
I figured that was because of the pain meds.
You feel that? No.
Vocal cords aren't the only way a person can create sounds with their mouth.
You want the kid to learn to burp his way through his conversation? Mm, I don't think it would be possible to sustain enough air output to It was a joke, Murphy.
Oh.
Snoring is a better model anyway.
Soft palate tissue is what vibrates, making the sound when people snore, but it's not stiff enough to replace the vocal cords.
But we could use his own costal cartilage to act as vocal cords.
The larynx is a complicated piece of anatomy.
Basically, a tiny musical instrument.
We can remove two of his ribs to create the anterior and posterior larynx frame and then stretch the cartilage across it.
And then cut open a trachea we worked so hard to close? We could destroy everything we just fixed.
Yes.
I think it's worth the risk.
Because you're thinking the kid's like you, that he needs to speak out loud to be understood.
She's right.
The larynx is like a musical instrument.
But if Bo Diddley can make a guitar out of a cigar box, I'm pretty sure I can make a larynx from bone and cartilage.
Absolutely not.
He's finally healthy.
There's no need to take any more risks.
You're right.
There are definitely risks.
But I wouldn't present the option if I didn't think we could manage them.
Couldn't we just wait until he's a few years older? I assume the stronger he is, the safer it is.
Most verbal language development happens within the first eight years of a child's life.
Cory's already 10.
It we wait any longer, he may not be able to learn to speak, even with a larynx.
He can communicate without speaking.
You're making a big mistake.
Murphy.
He'll always be Limited.
It'll be difficult to make friends, to interact with strangers.
Murphy.
That's enough.
They're aware of their options, and they've made their decision.
The suture repair looks fine.
Which makes me think the nerve here got compressed between the bone and the dog's teeth.
It's too wide a span to repair with a graft.
What if we built a nerve conduit out of silicone and polyglycolide? We could use it to guide the severed nerve ends to grow toward each other, create a pathway for them to connect and heal.
I'm not sure the nerves can grow across that distance.
It's definitely worth a try.
We can't just experiment on her, like a lab rat.
And we can't just sit back and do nothing.
I'm not saying we should do nothing.
I'm just saying we can't experiment on her blindly.
Maybe we could use donor tissue to bridge the gap.
Well, that means putting the patient on a transplant list.
Who knows how long it would take before she gets a viable donation? The firehouse won't hold her position until she heals.
She'd lose her job.
Well, first, you want to treat her like a guinea pig, and now you're deeply concerned about her life experience.
You just want to be right.
And you don't? Are you gonna step in at any point? I think Park's idea has the best chance of success.
Get her prepped.
Did you really think his idea is better, or do you just not want to look like you're biased toward me? I'm not happy about this situation either, but I think you're overreacting.
You better get it under control, or you're gonna find yourself watching from the gallery.
- Hi.
- Hey.
Do you have a problem with me staying friends with Shaun? I know you've told him you're fine with it, but are you? Yes.
Really? I mean, I'm totally glad you are.
It's great.
But I'm not sure I would be if I were in your shoes.
If it was any other guy, I probably wouldn't be.
But Shaun, he always tells the truth.
So when he told me that he's not interested in you, I believe him.
Okay.
You told the residents not to come to me? No.
That's not at all what I said.
You didn't tell them, "Next time you have a problem, come to me directly"? I was encouraging open communication and trust on my team.
What I have is a group of ambitious young residents who are struggling to figure out how to be cooperative as well as competitive.
You're not helping them figure it out by suggesting they resist taking complaints up the chain of command.
I'm sorry you've had to waste your time dealing with this, but there really isn't Neil, I am not wasting my time.
You do have an issue.
And you've got to stop pretending you don't.
The incision is healing nicely.
We should be able to discharge you today.
Are you happy to be going home? Do you have any questions for us? Are you sure? Because you don't really seem all that happy to be going home.
What is he saying? He said Dr.
Murphy was right.
He does have a hard time talking to kids at school.
And making friends.
He doesn't want people to ignore him or act like he's stupid anymore.
Honey, I'm so sorry.
Okay.
May the good Lord shine a light on you Make every song your favorite tune May the good Lord shine a light on you Warm like the evening sun That's two segments from the seventh rib.
Let's close his chest.
Angels beating all their wings in time Reznick, I need you to secure the posterior surface while I place PDS four-oh sutures.
Murphy, be ready to suture the graft into the anterior section.
Morgan realized our patient wasn't happy, even though he said he was.
If she hadn't been there, we wouldn't be doing this surgery.
It wouldn't have mattered what I was able to realize if you hadn't been so obsessed about finding a new surgery to help the patient.
Blood pressure's plummeting.
The field is filling with blood.
I can't see the source.
Murphy, expose the external carotid and find the superior thyroid.
BP still dropping.
Heart rate is up.
Place a temporary clamp on it, Reznick.
It's not working.
This is venous.
10 blade.
I see what happened.
Left and right jugular veins are connected by a venous arc we injured during retraction.
Dr.
Murphy, just double ligate with two-oh silk ties on both ends.
Silk ties.
He's stabilizing.
Good job.
Both of you.
Congratulations.
It's not every day you get to build a kid a brand-new larynx.
It was very exciting.
Was I on your mind? Was I on your mind? Those two are getting pregnant tonight.
Yeah.
They should get a room.
So they can make out in private.
Oh, my God.
It's Lea.
She's not getting pregnant.
She definitely uses protection.
Every time one of her boyfriends would come over, - she She would - That's okay.
I don't need the details.
Would you ever be comfortable making out in public like that? Hmm.
I don't know.
As a board-certified pathologist, I think we need to conduct an experiment.
Okay.
You were in my dream last night Creepin' in again When I least expect Shaunie! I can't believe you're here! Is this what 22 feels like? Do you feel 10 blade.
Transverse incision approach to the brachial plexus.
Adson forceps.
I can assist with ligating the traversing external jugular branches.
I could divide the omohyoid muscle.
It's all right.
Probably best for me to handle this.
Retracting to the side.
Sister, won't you listen? I don't wanna love the one who lies And I can hear him whisper 'Bout the things you did in days gone by I'm sorry.
I think we killed the mood.
No! Mm.
You did manage to wound it pretty bad.
It's bleeding out.
Yes.
It's a joke, Shaun.
See, what Carly did was I get it.
I get it.
She anthropomorphized the word "mood" to make it seem like you hurt it and it's now hemorrhaging.
It's very clever.
Can't you hear that boom, badoom, boom Boom, badoom, boom, bass? He got that super bass Boom, badoom, boom Boom, badoom, boom, bass Yeah, that's that super bass This one's for the boys in the polos All your Marcos and the moguls He could ball with the crew, he could solo But I think I like him better when he dolo And I think I like him better with the fitted cap on He ain't even gotta try to put the mack on He just gotta give me that look When he give me that look Then the panties comin' off, off, oh Excuse me, you're a hell of a guy I I Mean, sigh, sickening eyes I can tell you're in touch with your feminine side Oh, yes, I did, yes, I did Please, someone, who the heck I is I am Nicki Minaj, I mack dudes up Back coupes up and chuck the deuce up! Boy, you got my heartbeat running away Beating like a drum, and it's coming your way Can't you hear that boom, badoom, boom Boom, badoom, boom, bass? He got that super bass Boom, badoom, boom boom, badoom, boom, bass Yeah, that's that super bass Boom, badoom, boom, boom, badoom, boom, bass He got that super bass Boom, badoom, boom, boom, badoom, boom, bass Yeah, that's that super bass Boom, boom, boom, badoom, boom, boom, boom, boom Boom, boom, boom, badoom, boom, boom, boom, boom Boom, badoom, boom, boom, badoom, boom, bass He got that super bass Boom, badoom, boom, boom, badoom, boom, bass Yeah, that's that super bass TONIGHT.
It was fun last night.
I'm glad you and Lea are friends.
Yeah.
What was your favorite song? Mine was Whip It.
I have to go.
I have an early morning.
Okay.
I will see you at work.
You're at 60 meters per second.
Normal electrical signal velocity of the nerve is 50-65.
That's good? Very.
The surgery worked.
Your strength might go down a bit, but you definitely should get function back.
How can I thank you? Seriously.
Well, actually, uh, it's Dr.
Melendez you should thank.
He did the surgery.
We didn't really do anything.
Well, you obviously did something.
Okay.
You're welcome.
Get some rest.
How are you feeling? Any pain or discomfort? Good.
If you're feeling up to it, we'd like you to try to make a sound.
Now, start down here and just push the air up.
Be gentle.
We don't need you breaking any wine glasses just yet.
That's the most beautiful voice I've ever heard.
It's just a primitive sound.
With speech therapy, he'll be able to fully speak.
Cory says thank you, Dr.
Murphy, for pushing for the surgery.
This is the best day of his life.
You are very welcome.
This is not you.
And it's not right.
We can be friends and have it not be weird.
It's already weird.
I'm not gonna stay.
Well, you don't have to run away just because I'm here.
I'm not running.
I'm being professional.
You're overcompensating.
Trying to play it safe.
And it's It's hurting things.
It got Park and I in an argument.
That's not how I want to be mentored.
That's not who you are.
At least, it's not who I thought you were.
Enjoy your dinner.
I'm confused.
One day, you're filing a complaint about your boss.
The next, you're being incredibly nice and supportive to your fellow resident.
I told you, I just felt like Dr.
Melendez's treatment of Browne was starting to cause dissension on the team.
I have no doubt that's part of the truth.
I'm guessing the other part was Preemptive.
You thought it would inoculate you.
We'd never be able to fire someone who filed a formal complaint against their attending.
Which is why I'm so confused.
Why would you feel like your job could be in jeopardy? I don't.
I don't know what you're talking about.
Okay.
Just so you're clear I won't hesitate to let you or anyone else go if I feel it's deserved.
No matter whether they've filed a complaint or not.
Of course.
I understand that.
Good.
Have a good night.
Thanks.
Two menus.
I'm going to make you a surprise dinner tonight.
It's a special grilled cheese sandwich.
It's special because it uses four kinds of cheeses Gruyere, Parmesan, yellow I don't think that we should be together anymore.
Hmm? I can't be your girlfriend anymore.
Did Did I do something wrong? No, Shaun.
It's not Last night at karaoke, when you and Lea were singing together, there was something between you two.
You love her, not me.
No.
N-No.
No.
I don't.
It's obvious.
You're wrong.
You say that.
And maybe you even believe it.
But I saw what I saw, Shaun, and I am telling you, it doesn't matter what you say.
It's true.
And I think she loves you, too.
You should tell her how you feel.
Oh, thank you.
This looks amazing.
Except I cut the tomatoes in half.
The recipe says to saute them whole, but I once had a patient who almost choked to death on a Oh, my God.
These are perfect.
I'm glad you like your breakfast.
I read that if I made you feel loved and cared for, it could help us work out your insecurity.
Over my friendship with Lea.
Aww, Shaun.
You don't have to do any more research.
I am fine with you and Lea being friends.
But you can keep making me eggs anytime you want.
You're late.
I made Carly a special breakfast this morning.
And then she wanted to have sex.
So we did.
That's great, Shaun.
Next time, feel free just to say you missed the bus.
Women don't like it when you kiss and tell.
Even though they do it all the time.
Not at work.
Apparently, you've never been in the nurses' break room.
What were you doing in there? Delivering the donuts.
Best lesson I learned as a cop, better to feed down than kiss up.
Oh, it's my fault we haven't started our rounds.
I missed the bus.
It's all right.
I'm glad you're all here.
Because I want to apologize.
Dr.
Lim told me she received a complaint about me playing favorites.
She obviously didn't reveal any names, but I want to assure you all that I don't have any favorites.
And if I did anything to give that impression, it's my mistake.
It won't happen again.
We're a team.
And we need to be able to communicate and trust each other in order to be our best.
So in the future, if you have any concerns, you can come to me directly.
Absolutely.
She got blindsided, never saw it coming.
Thank God a woman driving by had pepper spray in her purse, or the dog would've killed her.
- Brave woman.
- Loosen the tourniquet.
Oh.
Okay.
We need an OR stat.
Page Dr.
Melendez.
Right away, Doctor.
And start empiric antibiotics.
I'm gonna guess this dog wasn't big on flossing.
On it.
Wasn't that funny.
Donuts.
Best 10 bucks you'll ever spend.
Cory's upper trachea never fully developed in the womb.
His upper airway is totally blocked, and he has no larynx at all.
The trach tube he needs to breathe continues to cause reoccurring infections and pneumonias.
He says it tickles when you touch his neck.
Sorry.
Not much I can do about that, but I'll try to make it quick.
Why are you signing? He's mute, but he's not deaf.
It helps us stay mindful of what he's going through.
What did he say? He says when we get mad, we don't sign We yell.
And when we play soccer together.
So keep your room clean and pass your dad the ball every once in a while, and then they won't have to yell.
The good news is his lungs are clear and I don't see any sign of infection.
Thank God.
The better news is he's a good candidate for the surgery we discussed.
Yes, it seems a bit experimental.
It's shown great results.
If we can excise the scar tissue and open up the airway, he still won't be able to talk, but he'll finally be able to breathe normally.
It's a complicated procedure, but given the severity of the infections he's been dealing with, I think it's definitely the best option.
He says he'll do anything to get rid of the tube sticking out of his neck.
And you two? Okay, now you're the one yelling.
We hear you.
What do you think? Let's do it.
Fran? Fran, I'm Dr.
Melendez.
This is Doctors Park and Browne.
You were attacked by a dog, almost bled to death.
You remember? Yes.
We had to repair a severed artery in your arm.
So, am I okay now? The surgery went well.
Dr.
Park.
We were able to stop the bleeding, which had caused you to go into shock.
But we still need to go back in, stabilize the shattered bone, repair nerve damage, and do skin and tissue grafts.
But after that? I'm a firefighter.
I need my full strength.
With plenty of physical therapy, we should be able to get you pretty close.
It must be hard for him to communicate.
My friend's 12-year-old daughter took a signing class at summer camp.
She picked it up pretty fast.
Non-verbal communication is definitely more confusing.
That's why Carly and I always talk out our problems.
Sorry to break it to you, Murphy, but it doesn't matter how explicitly Carly speaks.
She's saying a lot more silently.
And it's often the opposite of what she said out loud.
Why would Carly lie? It's not lying.
It's communicating indirectly.
Everyone does it, but women way more than men.
Most of the time, we don't realize it.
That sounds sexist.
You gonna report me to HR or listen and learn? Has she ever told you that she didn't want to have sex because she had a headache? No.
And I thought you didn't want to hear about my sex life.
Fine.
But if you ever get the feeling she's upset about something and she insists nothing's wrong, something's wrong.
Humerus isn't broken.
It's pulverized.
Who do you think complained to Lim? No idea.
And we're gonna need internal fixation with locked intramedullary nailing to stabilize the fractured pieces.
It must be Morgan.
She's always looking for a competitive advantage.
Let's focus on the patient.
You can start your whistleblower investigation as soon as we're done.
How does she expect us to trust her if whenever something doesn't go her way, she just goes to the boss It wasn't Morgan.
It was me.
Why? You're the least competitive of all of us.
That's not true, and I didn't do it to help me, I did it to help you.
If people see you're getting special treatment, even if it's not your fault, they'll resent you.
I'm not getting special treatment.
And I don't need your protection.
Fine.
My mistake.
So you can yell at me or we can get back to work.
Just what the doctor ordered.
- W-W-What? - You.
I need a double dose of Shaunie, stat.
Glassy is driving me crazy.
What is it with old people and technology? Hmm.
Don't worry.
I just need to vent for a minute.
And I'll scram if Carly comes.
It's okay.
I think Carly's not insecure about you anymore.
Really? That's awesome.
I added the "I think" because Morgan thinks women sometimes say the opposite of what they think.
But I don't think Carly would hide what she thinks.
What do you think? Nobody always says what they think.
So Morgan's right? Except for the sexist part? No.
I think Carly is very in tune to how you communicate.
If she was unhappy, I'm sure she wouldn't hide it.
Yes.
I agree.
Lunch is over.
We have a surgery to do.
Hey, Morgan.
Love your boots.
Thanks.
Love your sweater.
Thanks.
DR.
- Nice work.
Look at that.
On the bone.
Teeth marks.
Must've been a huge dog.
During "no knock" searches, I was more afraid of dogs than guns.
Gangsters have horrible aim, but their dogs never miss the target Which was our crotches.
Damn.
How many times they get ahold of you? Never.
Another benefit of martial arts training.
You kicked the dogs? Like I needed a 60-yard field goal to win the Super Bowl.
That's awful.
It's self-defense.
Totally.
I need 9-oh nylon microsutures.
Next step is to suture in the interposition graft.
Dr.
Park's doing great.
Might as well continue.
I I wouldn't mind getting my hands dirty.
Let's see how Park does with this first.
Make sure your stay sutures are at six and twelve o'clock.
You are very efficient.
And you're very clever, introing your insult with a compliment.
Your "helping me out" appears to have conveniently helped you out.
Eh, I was expecting worse.
Melendez is bending over backwards to avoid anything that might convey the slightest bit of appreciation for my work.
Because it couldn't possibly be that I was actually doing a better job than you.
Right.
You're probably buying him donuts, too.
I did what I thought needed to be done, and you're accomplishing nothing by continuing to badger me about it.
Thanks, Dad.
You're welcome, child.
The boy's obstructed cricotracheal segment looks bigger than what we saw on imaging.
I chose to be aggressive with resection.
Murphy, flex the neck to mobilize the ends and reduce tension on the anastomosis.
Are you sure we're gonna be able to cinch it closed? Not "we.
" You.
Step on up.
Four-oh vicryl sutures on a needle driver.
Place lateral traction sutures at the proximal and distal airway.
- You all right? - Yeah, it's just, I I hit my finger with a hammer last night.
I was trying to hang a painting.
Murphy, take over.
It's all right.
I can Move.
You're a surgeon, not a hockey player.
We don't play through our injuries.
Next time, hire a handyman.
Those fingers are your livelihood.
Got it.
I know Carly says she's not jealous anymore, but based on what I saw at lunch, I'm thinking maybe she should be.
I think Murphy's old enough to handle his own girlfriend trouble.
I don't have any girlfriend trouble.
That "eating off the plate" move is the oldest trick in the book.
Lea was hungry.
It looked more like she was claiming territory than satisfying hunger.
She might as well have peed on your leg.
You, shut up.
And you, keep a smaller gap between the sutures.
We're gonna need a solid anchor to get the anastomosis airtight.
That's better.
Good job.
- Good work today.
- Thanks.
See you tomorrow at the track.
I, uh I I wanted to talk to you about that.
We can't do this anymore.
It's just a run on a public track.
It's not like we're meeting at a hotel.
I just shouldn't be socializing with residents outside of work.
Any of you.
Neil.
I've been going through a tough time.
Our friendship, having someone I can talk to, it helps.
I'm not abandoning you.
I'll be there to support you at work.
You've got your therapist.
You're gonna be fine.
This is exactly why women have such a hard time finding mentors.
No one questions when guys hang out, but anytime a woman wants to build a totally appropriate relationship with a male colleague, the stupid rumors start.
I agree.
But the rumors have started.
I'm gonna plug the trach tube, and I want you to try to take a breath.
Nice and easy.
He says it hurts, but it's the best feeling he's ever had.
What's wrong? You don't like it? It's delicious.
I hear delicious, but I see disappointed.
It's not the chicken.
It's my patient.
We fixed his airway, and he can breathe without the trach now.
That's fantastic.
But he still can't talk.
He can talk.
He just does it with his hands.
Mm, but only with people who can also sign, and they have to be looking at him, and Well, could you do a cadaveric larynx transplant? No.
I've heard that's worked for some throat cancer patients.
No, Dr.
Lim ruled that out years ago.
The risk of tissue rejection is too great in a child his age.
Well, could you wait till he's older? No! If he doesn't learn to speak soon, he'll never be able to.
Okay.
I need to do some reading.
Oh, come on, Shaun.
You should at least eat something first.
No.
I'm hungry, but I will do the reading first.
You're in early.
What's the haps? Are you serious? I didn't even know Michelle Obama was in SEAL Team Six.
Have you ever noticed how Glassy grinds his teeth when he's listening to someone talk? It's like a cow chewing on You never used to do that.
Do what? Eat food off my plate.
I used to work full time at a place with private chefs.
Now I work part time in a place with hard-boiled eggs in a vending machine.
She said it's like you're peeing on my leg.
You're gonna have to expand on that.
Morgan thinks your body language says you're trying to assert your dominance over Carly.
Morgan is one twisted biatch.
Is she right? No.
Not even close.
I promise you my voice and body language are communicating the same thing, which is pure, non-threatening, platonic friendship.
Shaun? He also snores.
Really loud.
- Glassman? - Oh! I have to go! Okay.
Incision sites look good.
And skin and tissue grafts appear to be taking hold nicely.
We were able to reattach your bicep muscle and tendon.
That's good to hear.
Can you lift your arm? No.
I I can't.
Because it hurts too much? It doesn't hurt at all.
I figured that was because of the pain meds.
You feel that? No.
Vocal cords aren't the only way a person can create sounds with their mouth.
You want the kid to learn to burp his way through his conversation? Mm, I don't think it would be possible to sustain enough air output to It was a joke, Murphy.
Oh.
Snoring is a better model anyway.
Soft palate tissue is what vibrates, making the sound when people snore, but it's not stiff enough to replace the vocal cords.
But we could use his own costal cartilage to act as vocal cords.
The larynx is a complicated piece of anatomy.
Basically, a tiny musical instrument.
We can remove two of his ribs to create the anterior and posterior larynx frame and then stretch the cartilage across it.
And then cut open a trachea we worked so hard to close? We could destroy everything we just fixed.
Yes.
I think it's worth the risk.
Because you're thinking the kid's like you, that he needs to speak out loud to be understood.
She's right.
The larynx is like a musical instrument.
But if Bo Diddley can make a guitar out of a cigar box, I'm pretty sure I can make a larynx from bone and cartilage.
Absolutely not.
He's finally healthy.
There's no need to take any more risks.
You're right.
There are definitely risks.
But I wouldn't present the option if I didn't think we could manage them.
Couldn't we just wait until he's a few years older? I assume the stronger he is, the safer it is.
Most verbal language development happens within the first eight years of a child's life.
Cory's already 10.
It we wait any longer, he may not be able to learn to speak, even with a larynx.
He can communicate without speaking.
You're making a big mistake.
Murphy.
He'll always be Limited.
It'll be difficult to make friends, to interact with strangers.
Murphy.
That's enough.
They're aware of their options, and they've made their decision.
The suture repair looks fine.
Which makes me think the nerve here got compressed between the bone and the dog's teeth.
It's too wide a span to repair with a graft.
What if we built a nerve conduit out of silicone and polyglycolide? We could use it to guide the severed nerve ends to grow toward each other, create a pathway for them to connect and heal.
I'm not sure the nerves can grow across that distance.
It's definitely worth a try.
We can't just experiment on her, like a lab rat.
And we can't just sit back and do nothing.
I'm not saying we should do nothing.
I'm just saying we can't experiment on her blindly.
Maybe we could use donor tissue to bridge the gap.
Well, that means putting the patient on a transplant list.
Who knows how long it would take before she gets a viable donation? The firehouse won't hold her position until she heals.
She'd lose her job.
Well, first, you want to treat her like a guinea pig, and now you're deeply concerned about her life experience.
You just want to be right.
And you don't? Are you gonna step in at any point? I think Park's idea has the best chance of success.
Get her prepped.
Did you really think his idea is better, or do you just not want to look like you're biased toward me? I'm not happy about this situation either, but I think you're overreacting.
You better get it under control, or you're gonna find yourself watching from the gallery.
- Hi.
- Hey.
Do you have a problem with me staying friends with Shaun? I know you've told him you're fine with it, but are you? Yes.
Really? I mean, I'm totally glad you are.
It's great.
But I'm not sure I would be if I were in your shoes.
If it was any other guy, I probably wouldn't be.
But Shaun, he always tells the truth.
So when he told me that he's not interested in you, I believe him.
Okay.
You told the residents not to come to me? No.
That's not at all what I said.
You didn't tell them, "Next time you have a problem, come to me directly"? I was encouraging open communication and trust on my team.
What I have is a group of ambitious young residents who are struggling to figure out how to be cooperative as well as competitive.
You're not helping them figure it out by suggesting they resist taking complaints up the chain of command.
I'm sorry you've had to waste your time dealing with this, but there really isn't Neil, I am not wasting my time.
You do have an issue.
And you've got to stop pretending you don't.
The incision is healing nicely.
We should be able to discharge you today.
Are you happy to be going home? Do you have any questions for us? Are you sure? Because you don't really seem all that happy to be going home.
What is he saying? He said Dr.
Murphy was right.
He does have a hard time talking to kids at school.
And making friends.
He doesn't want people to ignore him or act like he's stupid anymore.
Honey, I'm so sorry.
Okay.
May the good Lord shine a light on you Make every song your favorite tune May the good Lord shine a light on you Warm like the evening sun That's two segments from the seventh rib.
Let's close his chest.
Angels beating all their wings in time Reznick, I need you to secure the posterior surface while I place PDS four-oh sutures.
Murphy, be ready to suture the graft into the anterior section.
Morgan realized our patient wasn't happy, even though he said he was.
If she hadn't been there, we wouldn't be doing this surgery.
It wouldn't have mattered what I was able to realize if you hadn't been so obsessed about finding a new surgery to help the patient.
Blood pressure's plummeting.
The field is filling with blood.
I can't see the source.
Murphy, expose the external carotid and find the superior thyroid.
BP still dropping.
Heart rate is up.
Place a temporary clamp on it, Reznick.
It's not working.
This is venous.
10 blade.
I see what happened.
Left and right jugular veins are connected by a venous arc we injured during retraction.
Dr.
Murphy, just double ligate with two-oh silk ties on both ends.
Silk ties.
He's stabilizing.
Good job.
Both of you.
Congratulations.
It's not every day you get to build a kid a brand-new larynx.
It was very exciting.
Was I on your mind? Was I on your mind? Those two are getting pregnant tonight.
Yeah.
They should get a room.
So they can make out in private.
Oh, my God.
It's Lea.
She's not getting pregnant.
She definitely uses protection.
Every time one of her boyfriends would come over, - she She would - That's okay.
I don't need the details.
Would you ever be comfortable making out in public like that? Hmm.
I don't know.
As a board-certified pathologist, I think we need to conduct an experiment.
Okay.
You were in my dream last night Creepin' in again When I least expect Shaunie! I can't believe you're here! Is this what 22 feels like? Do you feel 10 blade.
Transverse incision approach to the brachial plexus.
Adson forceps.
I can assist with ligating the traversing external jugular branches.
I could divide the omohyoid muscle.
It's all right.
Probably best for me to handle this.
Retracting to the side.
Sister, won't you listen? I don't wanna love the one who lies And I can hear him whisper 'Bout the things you did in days gone by I'm sorry.
I think we killed the mood.
No! Mm.
You did manage to wound it pretty bad.
It's bleeding out.
Yes.
It's a joke, Shaun.
See, what Carly did was I get it.
I get it.
She anthropomorphized the word "mood" to make it seem like you hurt it and it's now hemorrhaging.
It's very clever.
Can't you hear that boom, badoom, boom Boom, badoom, boom, bass? He got that super bass Boom, badoom, boom Boom, badoom, boom, bass Yeah, that's that super bass This one's for the boys in the polos All your Marcos and the moguls He could ball with the crew, he could solo But I think I like him better when he dolo And I think I like him better with the fitted cap on He ain't even gotta try to put the mack on He just gotta give me that look When he give me that look Then the panties comin' off, off, oh Excuse me, you're a hell of a guy I I Mean, sigh, sickening eyes I can tell you're in touch with your feminine side Oh, yes, I did, yes, I did Please, someone, who the heck I is I am Nicki Minaj, I mack dudes up Back coupes up and chuck the deuce up! Boy, you got my heartbeat running away Beating like a drum, and it's coming your way Can't you hear that boom, badoom, boom Boom, badoom, boom, bass? He got that super bass Boom, badoom, boom boom, badoom, boom, bass Yeah, that's that super bass Boom, badoom, boom, boom, badoom, boom, bass He got that super bass Boom, badoom, boom, boom, badoom, boom, bass Yeah, that's that super bass Boom, boom, boom, badoom, boom, boom, boom, boom Boom, boom, boom, badoom, boom, boom, boom, boom Boom, badoom, boom, boom, badoom, boom, bass He got that super bass Boom, badoom, boom, boom, badoom, boom, bass Yeah, that's that super bass TONIGHT.
It was fun last night.
I'm glad you and Lea are friends.
Yeah.
What was your favorite song? Mine was Whip It.
I have to go.
I have an early morning.
Okay.
I will see you at work.
You're at 60 meters per second.
Normal electrical signal velocity of the nerve is 50-65.
That's good? Very.
The surgery worked.
Your strength might go down a bit, but you definitely should get function back.
How can I thank you? Seriously.
Well, actually, uh, it's Dr.
Melendez you should thank.
He did the surgery.
We didn't really do anything.
Well, you obviously did something.
Okay.
You're welcome.
Get some rest.
How are you feeling? Any pain or discomfort? Good.
If you're feeling up to it, we'd like you to try to make a sound.
Now, start down here and just push the air up.
Be gentle.
We don't need you breaking any wine glasses just yet.
That's the most beautiful voice I've ever heard.
It's just a primitive sound.
With speech therapy, he'll be able to fully speak.
Cory says thank you, Dr.
Murphy, for pushing for the surgery.
This is the best day of his life.
You are very welcome.
This is not you.
And it's not right.
We can be friends and have it not be weird.
It's already weird.
I'm not gonna stay.
Well, you don't have to run away just because I'm here.
I'm not running.
I'm being professional.
You're overcompensating.
Trying to play it safe.
And it's It's hurting things.
It got Park and I in an argument.
That's not how I want to be mentored.
That's not who you are.
At least, it's not who I thought you were.
Enjoy your dinner.
I'm confused.
One day, you're filing a complaint about your boss.
The next, you're being incredibly nice and supportive to your fellow resident.
I told you, I just felt like Dr.
Melendez's treatment of Browne was starting to cause dissension on the team.
I have no doubt that's part of the truth.
I'm guessing the other part was Preemptive.
You thought it would inoculate you.
We'd never be able to fire someone who filed a formal complaint against their attending.
Which is why I'm so confused.
Why would you feel like your job could be in jeopardy? I don't.
I don't know what you're talking about.
Okay.
Just so you're clear I won't hesitate to let you or anyone else go if I feel it's deserved.
No matter whether they've filed a complaint or not.
Of course.
I understand that.
Good.
Have a good night.
Thanks.
Two menus.
I'm going to make you a surprise dinner tonight.
It's a special grilled cheese sandwich.
It's special because it uses four kinds of cheeses Gruyere, Parmesan, yellow I don't think that we should be together anymore.
Hmm? I can't be your girlfriend anymore.
Did Did I do something wrong? No, Shaun.
It's not Last night at karaoke, when you and Lea were singing together, there was something between you two.
You love her, not me.
No.
N-No.
No.
I don't.
It's obvious.
You're wrong.
You say that.
And maybe you even believe it.
But I saw what I saw, Shaun, and I am telling you, it doesn't matter what you say.
It's true.
And I think she loves you, too.
You should tell her how you feel.