The Good Doctor (2017) s03e19 Episode Script


1 CLAIRE: Previously on The Good Doctor You ready to tell me what's on your mind? I think I'm in love with my boss.
REZNICK: I have rheumatoid arthritis.
I wanted you to know and no one else.
I've been thinking about synovectomy surgery.
That'll resolve the pain temporarily.
Then what? It'll give me at least ten years.
And then you're gonna be bone on bone.
What's your plan then? I understand you're leaving surgery.
That's tough.
But it's the right call.
No, I don't think it is.
I'm doing the surgery.
You don't tell me anything about your life.
That's because you don't want to know anything.
That's not true! KELLAN: You don't want to feel guilty about being a thousand miles away.
You just want to know that I'm okay.
I love you, Lea.
I want to be your boyfriend.
(VOICE BREAKING) I'm a challenge for anyone.
I just know it would be too hard for you.
You have to give me a chance.
You need to let me try.
- No.
- I will fix it! Shaun, you're autistic.
You can't fix that.
You acted like you cared about me, but you don't even respect me.
You're going to end up alone, and you deserve it! Because you're a superficial, selfish, and prejudiced person! (SPRINGTIME CARNIVORE'S NAME ON A MATCHBOOK PLAYS) (INDISTINCT CONVERSATIONS) Uh, two lychee Kolsch, please.
Lea? - Hey! - Hey.
Until you prove me wrong I saw the invite at the clinic.
And I assumed you wouldn't be here.
You with a friend? Uh, it's been a rough couple of weeks.
Hey! They're here! The guys who made this all possible! I don't know about all that.
Yeah, well, you try opening a brewery or fundraising when you're dead.
Oh, honey, uh, you remember Dr.
Melendez Hi.
And Dr.
This is my wife, Noreen.
This is Lea.
Your flavor profiles are epic.
Well, how about a tour? Uh, yes.
Okay, great.
Come on.
(CHUCKLES) - (GASPS) Carl! - Marta.
It's good to see you! She is in host mode.
We could be here forever.
I'll show you around.
The, uh, hops in the Kolsch, is that the Citra? In combination with the Noble German.
Lady knows her stuff.
(RUMBLING, WALLS CREAKING) Do you feel that? (RUMBLING INTENSIFIES) It's an earthquake.
Are you okay? Um, I'm fine, I think.
The ceiling caved in.
Were you hit? Are you bleeding? Not as far as I can tell.
Just (EXHALES SHARPLY) Just some bruises.
The brewing tanks fell over.
One went right through the floor.
And Glassman? Wasn't he with you? I was! I am! (BREATHING HEAVILY) (GRUNTS) Your shoulder.
It's dislocated.
We're okay here.
I'm about to assemble a HURT team and head out.
Any idea how many wounded? No.
Let me check.
The hospital is on mass casualty incident protocol.
Cancel all elective surgeries.
Transfer non-critical patients to urgent- or chronic-care facilities.
No family members or visitors are allowed in the ER.
We're gonna need every inch of space we've got.
Use the waiting room for patient overflow.
Our HURT Team, which I'll be running, has been assigned to the Bold Statement Brewery, which collapsed during a charity event.
Melendez and Glassman went to that.
I spoke with Melendez.
They're both fine.
(SIREN WAILING IN DISTANCE) That's two out of approximately a hundred.
Park, Shaun, Claire, you're with me.
Get the equipment packed up.
I want to be on the road in three minutes.
(INDISTINCT TALKING) I need you to cover surgery.
I'll get another attending on the ER.
I'll do both.
I used to run the whole hospital.
(PEOPLE MURMURING) It's just a cut.
You'll be fine.
I need to focus on medical emergencies.
Cuts and scrapes do not qualify.
My colleague and I will be com Lea? The door to the Brew Hall is totally blocked.
Melendez! Noreen? Marta.
What hurts? (STRAINED) My back.
Okay, I'm gonna need a towel and some tape, and Glassman and I need every first aid kit you've got.
Hold still.
You're gonna be okay.
I'm gonna stabilize that leg, sir.
(GROANS) Hold on a second.
Sir, please put that light on your leg.
(CLACK) What was that? Just hold still.
What if there's an aftershock? The whole place could come down.
Just hold still, please, sir.
Just hold still! - (BONE CRACKS) - Aah! (GROANS) Just please sit down! (SIREN WAILING IN DISTANCE) (INDISTINCT TALKING) - (INDISTINCT TALKING) - RADIO CHATTER) Hey, you guys can head across the street, and you'll be okay over there.
(EXHALES SHARPLY) There mi Might be about 40 people inside in need of treatment or so Some kind of onsite evaluation.
Where do you need me? Back at the hospital.
We're short on surgeons.
Uh Lea was here.
Where is she now? I don't know.
She was inside when the tanks fell down.
But the first responders are gonna find her.
Let's lift it.
All right, she's clear.
CLAIRE: Melendez.
50-year-old woman, medical history includes spinal tumor resection, C1-through-3 fusion, complaining of severe back pain.
Hey, where were you hit? - Are you dizzy? You okay? - I'm fine.
A beam fell, hit me on my side, knocked me down.
Let me see.
I'm fine.
(PEN LIGHT CLICKS) Let me see.
I'll lay off working my obliques at the gym for a bit.
How much does that hurt? No more than it should.
You're gonna need a full evaluation.
I'll go with Marta back to the hospital, get checked out.
(SIREN CHIRPS) Where was Lea? In the Brew Hall, and it's completely blocked in.
Glassman and I already tried.
The danger of spinal fracture Let's get a real cervical collar on her and get her onto the board.
(INHALES SHARPLY) Stop! Don't touch her.
You winced when they touched your neck.
Did your right hand hurt? Yeah.
Like it was on fire.
It's not just a fracture.
Something is pressing on her spinal cord.
Even the move to the board could shift the object, leading to permanent paralysis.
I need to find Lea.
Get the battery-powered X-ray.
Lucky there weren't more books on that shelf.
Bay one.
500 milligrams IV acetaminophen, and page Calderon in pedes.
Reznick, no.
You had surgery on your hands 48 hours ago.
I don't need them to triage.
We need a surgeon over here.
Construction worker.
Through and through impalement.
Point of entry's his pelvis.
BP 111 over 84.
Pulse 107 BPMs.
- Pupils? - Ignore her.
Normal and reactive.
Right now she's a patient, not a doctor.
Motor exam? - Normal.
- All right.
I'm concerned about the iliac artery.
You should check his femoral pulse.
- I was planning to.
- (GRUNTS) Okay, okay, okay.
Right leg is strong.
Left is thready.
Ultrasound his leg to confirm.
His abdomen, too.
Look for additional damaged vessels.
Then take him to OR 2 and page Cohen.
There could be a lot of vascular injuries.
You should do his surgery while I help with triage.
Reznick, I don't need or want your help.
You have a habit of withholding key details from your attendings as it benefits you.
Go to bed.
Lea? Lea, can you hear me? MAN: (STRAINED) Help.
Think I'm stuck.
Shaun, we need you on triage.
Let the professionals Sh Okay.
MAN: Help.
Under here.
Someone is down there.
Someone's down there, but it's not Lea.
We need fire and rescue over here! MAN: Coming now! Shaun! It's right up against the spinal canal.
It's the C2 screws we used to fuse the vertebrae once the tumor was out.
That doctor was right? I could end up paralyzed? I'm afraid so.
So, what are we gonna do about that? We could remove the screw here.
You can't operate on my wife's spine in the middle of all this.
MELENDEZ: It would have its risks, significantly more than most surgeries, but Dr.
Browne's right.
If we don't remove the screw here, it's very likely that you'll be paralyzed from the neck down.
Take it out.
Lea? Lea? Are you there? - Can you hear me? - (METAL CLANKING) - Lea? - LEA: Please help! Lea, it's me! Lea, it's Shaun! It's (HELMET CLATTERS) Lea? Shaun, help! Okay.
DAN: Hey! This area needs to be stabilized - before any medical personnel - Lea! (HELICOPTER BLADES WHIRRING) (COUGHS) (COUGHS) I think I'm stuck.
I'm coming.
(GRUNTS) Okay.
I am not afraid.
I'm not afraid.
Of course you are.
You know why? Because this is stupid scary.
Dispatch rerouted us to Good Sam for some reason.
Put us on diversion.
Too many trauma patients, too few surgeons.
Now you got two more patients and one more surgeon.
Which procedure do you want? Pelvic fracture can wait.
Bay 7.
I'm overseeing the ER.
Someone has to.
Doesn't have to be you.
Morgan texted me.
She's offered to help.
I'll handle the ER.
You two go cut.
Who's gonna actually treat the patients? Siri? The nurses.
I'll tell them what to do and then oversee every move.
(SIGHS) Running this place isn't a job for a third-year, even on days without an earthquake.
Well, we've had an earthquake.
There are no options.
You be careful with those hands.
You could screw them up for good.
Petringa! OR 3.
What were you doing in a brewery, anyway? I was just sitting at the bar, having a beer.
Now I'm trapped under it.
You're not 21.
I'd show you my ID, but my pockets are kind of underground right now.
(SIGHS) We should let your parents know where you are.
I'm fine.
It doesn't even hurt.
I think you should have someone here Mom, Dad.
My mom's dead.
And my dad's on a plane.
Do you know the flight number? We can get word to him.
If my son was in your situation, I'd want to be there, no matter what else was going on or how he got there.
My dad already thinks I'm a screw-up.
And this doesn't exactly disprove that.
Just get this thing off me.
(SIGHS) Call me a bitch.
Call me a bitch.
We are gonna clear this ER and get the hospital off trauma diversion.
With a patient in every bed and one doctor with zero hands? Actually, I've got eight.
You guys are gonna do exactly what I tell you.
I ask you to probe 2 inches to the left, I don't mean 1.
5 inches or 1.
I have you debride a wound, that's three Betadine swabs, not two.
I don't care what shortcuts you've picked up.
I will not say please.
It is a wasted word.
I will not say thank you.
I will be moving on.
I will be a bitch, so you may as well call me one now.
- You're a bitch.
- Bitch.
As a feminist, I'm really not com - Say it.
- Bitch.
Let's get to work.
You should be up there doing your job, not down here.
Lea needs me.
No, she doesn't.
You think rescuing her will make her fall in love with you.
It won't.
You're being You always said I could do Because I believed in you.
Right now, I don't.
She doesn't love you.
She told you.
She thinks you're limited.
You are.
You're not her hero.
LEA: Please help! We need a central line, endotracheal tube, bag mask, portable oxygen, anesthesia We've got midazolam.
That combined with a morphine drip should work.
Noreen? Don't do this surgery.
I-I can't lose her.
Not this soon.
M-Marta was with her husband.
She was miserable.
She didn't know We're not the ones you need to persuade.
I will push your wheelchair.
I'll wipe your mouth, whatever you need.
And be glad for every minute of it because You will still be alive.
And we'll still be on our adventure.
(VOICE BREAKING) Five years.
That's That's just not enough.
So greedy.
Marta, please.
(INHALES DEEPLY) Thank you for being willing to take care of me Again.
Five years isn't enough.
However long I have with you will never be enough.
I only found you once I stopped listening to my fear Fear of hurting my husband Being thrown out of the church, of dying alone.
Pushing all that aside made room for you, and you are my life.
Melendez saved me once.
He's gonna do it again.
Be brave with me.
Shaun Murphy.
I'm here to help you.
What's your name? Vera.
Where does it hurt, Vera? Everywhere.
But mostly the shoulder.
(SIGHS) Take a deep breath, please.
(BREATHES DEEPLY) Your lungs are fine.
Can you feel your hands? Yes.
That means you have no nerve damage.
It missed your vital organs.
I can remove it without risking permanent injury.
That's good news.
(BREATHING SHAKILY) When I cut, brace this.
Her neck cannot move at all.
Making initial midline incision to posterior neck.
KELLY: It's gonna take some time before we can move that bar.
That's fine.
We need to get a sense of the kid's injuries before you do anything.
I need to get under there and take a look.
Follow me.
Asthma and dust inhalation.
- Bad combination.
- (COUGHS) Take deep breaths.
- Higher.
- (COUGHS) Where her lungs are.
- You're the one that can hear them.
- There.
Just (COUGHS) can't.
(COUGHS) That's probably because your lungs are hyperinflated.
Start nebulizer albuterol and oxygen, eight liters per minute.
Why are you using plaster of Paris? You told me cast her arm.
You didn't tell me To use fiberglass, which takes half the time and is twice as effective? I wasn't aware that I had to instruct you on common sense.
Lim, please? Shaun, where are you? I found a woman with shoulder and leg impalements.
I'm going to extract the shoulder, but freeing the leg could sever the posterior tibial artery.
That sounds bad.
You would die.
LIM: What's the leg impaled on? Mm, it appears to be steel rebar.
We'll send down a firefighter.
Once they've sawed through the rebar, they'll transport her up.
And keep this channel open so I can hear you.
Have they found Lea? No.
They're still searching.
(MONITOR BEEPING) Hey, Aaron, can you head back to the ER when you finish here? Not unless you can take the transected aorta being prepped in OR 3.
I got a myocardial contusion and tamponade in 2.
Ceiling fan fell on this guy's chest.
See you on the other side.
- Clamp.
The hardware tore a muscular branch of her right vertebral artery.
I can't find the bleed without suction.
I see it.
- (CLAMP CLICKS) - (SIGHS) Her vitals are stable, but she's lost too much blood.
We can't keep cutting till we give her a transfusion.
Check all local hospitals and blood banks.
See who can get us O-negative, stat.
There might be another way to transfuse her.
PARK: So, I'm 16, in my dad's car, a dime bag in my pocket, and a cop approaching.
Did you get arrested? Hey, let me tell the story.
It's got a beginning, middle, and end.
- I want the end.
- It's better with the middle.
(SCOFFS) We, uh, roll down the window, and the cop is hit with a cloud of smoke.
(LAUGHS) She makes us get out, pats us both down, searches the whole car Uh, I'll be right back.
Oh, wait.
Come on, come on.
Don't leave me hanging.
Come on.
She didn't find anything.
All right.
Our bodies can do amazing things, even hide dime bags.
Holy crap! No way! Did you still smoke it? I'll be right back.
(LAUGHING) Oh, man, you did! Euggh! How bad is it? His spine's been severed.
He's lost a lot of blood.
No femoral pulses.
His legs are ice cold.
The bar's basically cross-clamping his abdominal aorta.
He's gonna bleed out when we lift the bar.
No, there's gotta be something we can do.
We can get his dad here before it's too late.
Inject five CCs bupivacaine, wait 20 minutes, then pull it out.
You here for me to discharge our asthmatic? No, she's gotten worse.
And she's complaining about back pain.
She said she fell during the earthquake.
Symptom explained.
Those sutures need to be closer together.
Add budesonide to her nebulizer.
That should help her breathing.
I think she might be pregnant.
Shortness of breath plus back pain could be UTI, kidney stones, or pregnancy.
Urine dip ruled out UTI and kidney stones.
So her symptoms have nothing to do with the earthquake? It's possible.
How can you be both slow and sloppy? This is my first time doing sutures.
Finish up so I can discharge him.
Stop with the zebra hunting.
Put her on budesonide and clear the bed.
I asked you to be my hands, not my brain.
I'm over the bitch plan, after three years of it.
We're in crisis.
That you are using to rehabilitate your reputation with Andrews, which is fine.
But stop biting the hands that are your hands.
(SIGHS) What are you doing? Sterilizing the instrument.
Do you know someone with cancer? Um I'm curious why you were at a fundraiser for cancer research.
I was there for a man.
One without cancer or any interest in being with me.
My ex-boyfriend is on the board of the charity.
Why did you want to see your ex-boyfriend? I guess I hoped he'd realize he was still in love with me and beg me to take him back.
Clever, huh? I understand.
I still want Lea to be my girlfriend.
But she doesn't feel the same way? I have autism.
Oh Shaun, that shouldn't (SCREAMS) (BREATHING HEAVILY) - (GRUNTING) - (SIZZLING) (BREATHING HEAVILY) Why didn't you warn me? Studies have shown that anticipation only heightens pain.
(GROANS) I used small talk to distract you.
I'm not a member anymore.
(GRUNTS) Place that in the surgical cavity.
You made a cell saver out of a Beer engine.
I ran alcohol through it to sterilize it.
Attach this to an IV.
(GRUNTS) We are gonna pump her own blood back into her.
Hey, we got somebody down here! Can you hear us? We're coming! Lea.
Are you okay? I-I think so.
How long before you guys get this thing off of me? We're working on it.
(SIGHS) (GRUNTS) You said your dad thinks you're a screw-up? Has he actually said that? No.
The reason I told you that story is everyone does dumb stuff when they're a teenager.
I bet your dad doesn't judge you nearly as harshly as you think he does.
My dad doesn't know me.
Neither do you.
Can you stay with him? That's incredible.
Thank you.
Spend enough time around Dr.
Browne, you get used to incredible.
Thank you.
There'll be a cruiser waiting to pick Casey's dad up when he lands in three hours.
What if we compress Casey's aorta against his spine and create a higher cross-clamp? You didn't tell him yet, did you? No.
We could buy time to repair his aorta after we lift the bar.
Casey's about Kellan's age.
This has nothing to do with Kellan.
Yes, it's It's a 1% chance of success if we do this, against a 100% chance of death if we don't.
Prep him.
When will we know if she's gonna be okay? When she wakes up.
And there's still a risk of infection.
Let's get her stabilized and out of here.
(ULTRASOUND WHOOSHING) I'm administering the budesonide and checking to see if she's pregnant.
I told her I'm on the pill.
Ever miss a day? Look at that.
An unoccupied uterus.
Prep her for discharge.
Can you give me something for my back pain? It's bruised from when you fell in the earthquake.
Take some Tylenol.
Uh, it's been bad all week.
Muscle relaxers usually help.
Check her tubes.
The fetus is developing inside your fallopian tube.
It's called an ectopic pregnancy.
It's not viable.
(SIGHS) That's a relief.
But if your fallopian tube ruptures, it can cause a serious, possibly fatal, bleed.
So we'll get you into surgery as soon as possible to make sure that doesn't happen.
It's gonna be fine.
If we get out of this alive, let's promise to move on.
You can do better than Lea.
Not that I have any business suggesting that.
I might die because I'm still hung up on Paul.
I don't want to move on.
If she doesn't feel like I always knew I could be a good doctor.
But until I met Lea, I never knew I could drive a car.
Or enjoy music.
Or sing karaoke.
Or take tequila shots.
(CHUCKLES SOFTLY) Or fall in love.
I don't want to stop being the person I am with her.
Lea makes me more.
(ON RADIO) But I don't make her more.
If I did, then Lea would want to be my girlfriend.
She's tachycardic and hypotensive.
Abdomen? Rigid.
Her fallopian tube ruptured.
(COUGHS) Any chance he can wait an hour? Rapidly expanding subdermal hematoma.
It still doesn't hurt.
Can't this wait? We need to fix something right away.
Whatever you gotta do, I guess.
Hey, um, about my dad The minute he lands, we'll get him here.
Thank you.
(SIGHS) She needs a surgeon Stat.
(MONITOR BEEPING) I'm a surgeon.
Harmonic scalpel, DeBakey forceps, two Yankauer suctions, and vasopressin.
(INHALES SHARPLY) (BREATHING SHAKILY) (INHALES SHARPLY) Marta? Can you squeeze Noreen's hand? Let's get you to the hospital.
(CRYING) (WEAKLY) You two, free beer for life.
- Watch it! - Aftershock! (CLATTER) SHAUN: We need to immobilize your leg.
Cover your head.
(RUMBLING CONTINUES) (RUMBLING FADES) All right, get her out of here.
(BREATHING HEAVILY) That was a big one.
Oh! Are you okay? (COUGHS) Yeah.
(CHUCKLES) Just a little A little motion Oh! I need oxygen here now! (COUGHING) You okay? (BREATHING HEAVILY) What about our patient? Vitals stable.
Shaun, you okay down there? - (WATER RUSHING) - I am okay.
Except for the water.
Please hurry.
Please hurry!
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