The Good Doctor (2017) s05e06 Episode Script

One Heart

1 (CHEERS AND APPLAUSE) (INDISTINCT CHATTER) WOMAN: Home run! (CHEERING) (CHEERING CONTINUES) (CHUCKLES) JERRY: Open wide, Glass-wipe! This one's comin' at ya! Hey, Jerry! You haven't driven anyone home since junior prom! Ha-ha! Whoo! You tell him, Glassy! (BASEBALL BAT CRACKS) (CHEERS AND APPLAUSE) Whoo! Whoo! (CHEERING) (ALL WHOOPING, HOLLERING) GLASSMAN: Lea, what are you doing here? Is Shaun all right? He's fine.
"Basically"? Well, he's been trying to reach you.
You missed your tux fitting.
Are you here to take my measurements? Shaun is really struggling right now.
He's been calling you.
Struggling? Really? You came all the way out here to Montana because he's struggling? Wasn't he struggling over the the billboard thing, right? Turns out, he didn't need me at all, did he? So you figure he's never going to need you? What are you gonna do? Run away? Stay here? I'm not running away.
I'm hitting .
394, batting cleanup for the Devil Dogs.
Why? JERRY: Yo, Doc! We're just headed to the Stick & Steak.
You and your friend coming with? My friend was just leaving, but I'll be right there.
Shaun's fine.
You're fine.
I am fine.
I'll call him tonight.
Go home.
SHAUN: Lea is on a business trip.
She's gone until Sunday, which means I can spend the weekend reviewing the latest case reports.
I can't allow that.
Morgan's on call this weekend.
You and I are going out pizza and a movie.
Two de facto bachelors looking for trouble.
I don't like loud movies.
Or trouble.
We'll pick a quiet one.
Or olives, mushrooms, or anchovies.
But other than that, that sounds like a lot of fun.
Unstable level one trauma.
25-year-old male, fell 30 feet - from scaffolding.
- open.
Massive head trauma, multiple fractures.
BP is 50 over palp.
- You go.
- Bilateral tib-fib injuries.
Femur fracture of the right thigh.
Belly is distended, tense, and bruised.
He has internal bleeding.
He's lost 40% of his blood volume.
Apply pressure to the open wound.
He's O-neg.
We need six units and a rapid infuser, stat.
There's too much blood in his abdomen to see.
We need a portable CT before - (MONITOR BEEPING) - He's in respiratory failure.
Crash intubation tray! (UKULELE STRUMS) Hi.
Playing helps with attention, working memory, and processing speed.
I can make the clinic profitable.
A woman in my barre-cardio class is the health insurance manager for a media company.
They're looking for another health provider.
Could mean 3,000 insured clients if we win the contract.
Give me her name and I'll get it done.
I'd like to close the deal.
And then, I would like full control of the clinic and its budget.
Holding onto your leverage.
Let's see what you can do.
(STRUMMING CONTINUES) Severe brain contusions.
Multiple rib fractures.
Blood in the right pleural space.
He has a massive hemoperitoneum.
Grade five liver lac.
Spleen is pulverized.
(MONITOR BEEPING) Lumbar spine fractured.
Right kidney's unsalvageable.
Pressure's falling, and he's maxed out on vasopressors.
Try T.
Is he an organ donor? I don't know, but it's not relevant, because I am not going to let him die.
) Attention on the concourse, this is your final boarding call.
Park? - PARK: Hi, Val.
We've got a patient in the ER who's severely injured, and he's O-negative.
And the heart? Seems to be healthy.
The patient is an adult, but not a big guy.
Do you think it'll fit Ollie? I think so.
But I need you to bring him in for another CT to be sure.
W-we're just about to leave for Ollie's Make-A-Wish trip.
We've got a cardiology team and a very accommodating paleontologist.
(SIGHS) And other hearts have fallen through.
This trip won't happen again.
Not with the amount of time he has left.
(SIGHS) Should we get on this plane, or not? Bring him in.
We managed to slow your son's bleeding, but Brandon has a lot of internal injuries, so we won't know the full extent until we look inside.
Do you have any questions? No.
- You've been very clear.
- (CELLPHONE BUZZES) We're ready to move him to the operating room, so I'll find you when I know more.
Can I talk to my son? Before the surgery.
I'm sorry, uh, he's been unconscious since his fall.
I-I promise, I will take you to see him as soon as he's out of surgery.
After vision and hearing exams, I'll do a full occupational health screen.
And I would do that for every one of your employees.
Rest your chin here, please.
Cucumber water is a nice touch, too.
Never had this test before.
You don't wear glasses.
Most places wouldn't bother with this test.
- Hmm.
- Do you see a dot anywhere? Yep, right in the middle.
Where's the dot now? Nowhere.
Nothing in the upper left corner? No.
How about now? Upper right? No.
It seems like you have deficits in your peripheral visual fields.
According to this test, you're going blind.
It's an optic nerve tumor.
A craniotomy could get rid of it all, but it'd stop the blood supply to the optic nerves, and she'd still go blind.
An endoscopic endonasal approach would avoid those blood vessels.
She'd keep around 60% of her vision.
I need to do better than 60%.
Is this about the client, or the big fat contract she might bring to your clinic? Glassman's basically gone.
I see a vacuum.
I want to fill it.
I thought you wanted to be a doctor.
Last week, you told me I shouldn't expect you to become more ambitious.
The reverse is also true.
This could clear the tumor proton beam radiotherapy with a synchrotron accelerator.
It's experimental.
Never been done on an optic nerve tumor.
(DOOR OPENS) That's the last piece of this kidney.
LIM: Hemoglobin's 6.
I don't like his BP, either.
I can't fix this liver lac without risking a major bleed.
We're almost out of O-neg.
Isolate the vascular pedicle.
You know, his dad's in the waiting room.
Think there might be some unresolved issues.
Well, if we can get Brandon through this, maybe they'll make amends.
My dad and I set aside a lot of our issues after his cancer diagnosis.
Maybe my dad will get cancer and we can bond.
You know, other than one letter, I haven't heard from him in five years.
What did it say? Don't know.
Never opened it.
Oh! We need more suction and laps.
- Where's it coming from? - There.
His vena cava ruptured.
Clamp it and pack all four quadrants.
SALEN: Crickets are high in protein.
(CRUNCHES) Marcus, my needs are simple.
- You gotta smell good.
- Oh.
You gotta know I love my work, and I'm not gonna apologize for it.
And you absolutely gotta be up for trying new things.
(LAUGHS) So, how is your newest thing coming along? Our hospital.
A few problems in radiology.
We're spending too much in the pharmacy.
And how well do you know John Colson? Head of Pediatrics? Good doctor, good administrator.
Why? He won't sign his Ethicure employment agreement.
Don't know if I can afford to lose him, and I don't know if I can afford to keep him for what he's asking.
You signed your Ethicure contract without any pushback.
What sold you? I'm up for trying new things.
How do I get one of those hats in my size? Dr.
Park! I knew you'd find me a new heart.
Uh, let's not get ahead of ourselves.
But first, how do we get ready for a dunk in the giant donut? With a little donut? (GASPS) Jelly? You rock.
(SIGHS) (CHEERS AND APPLAUSE) When are you gonna stop stalking me? When you agree to come back to San Jose.
(CHEERS AND APPLAUSE) It's his patient satisfaction scores.
How bad? Is his job at risk? Well, no.
Because I omitted some of his negative reviews to bring his scores up.
You did what? Sorry.
There's no way this was Shaun's idea.
He He didn't even want me to talk to Salen.
Did he agree to this? Does he even know about it? (SIGHS) No.
So, instead of telling him, you decided to come see me? When did you get so unethical and condescending? You're infantilizing him.
These scores, the way Salen runs the hospital, this could really hurt him.
Hurting him any more than you're hurting him right now? I kn I know.
I So, what do you want me to do? You want me to go back to San Jose and co-sign your crap? - This isn't about me.
- It is.
- It's about Shaun.
- It's about you.
It's your fiance.
Your responsibility.
Your mess.
Go home.
And clean this up.
The graft is holding and the bleeding is stopped.
LIM: We still have to deal with his brain edema.
How's his intracranial pressure? ASHER: 31.
It's even higher than it was before we started surgery.
Run an EEG.
Burst suppression pattern.
Minimal activity.
He's in a coma.
Brandon is in a coma.
We're trying to relieve the pressure on his skull to try to help his brain recover.
And how long will that take for it to recover? It's It's hard to say.
Um What's more likely, given the extent of his injuries is that it won't.
And he will progress to brain death.
I thought about calling him this week.
So we could work through some stuff.
Yeah, those are (EXHALES SHARPLY) tough calls to make.
We haven't talked in about two years.
Since he dropped out of Annapolis.
Instead, he was gonna be a drummer.
Your dad must be very proud of you.
Uh He wanted a rabbi.
A st-straight rabbi.
I failed at both, so he disowned me.
(SIGHS) I really need to talk to my son again.
We're trying everything we can to make that happen.
Knock, knock.
Did you see the proposal I sent you about Nira's treatment? Yes.
Very ambitious.
And also quite expensive.
If the proton beam radiotherapy is successful, we'd save 100% of Nira's vision.
We'd definitely win the company's contract.
(SIGHS) Reasonable medical decision.
Bad business decision.
The cost of the equipment and treatment is several hundred thousand dollars more than the value of that contract.
You have a perfectly acceptable treatment that's FDA approved, covered by her insurance, and saves her life while preserving 60% of her vision.
I'm fairly certain that's all you need to secure the contract.
Our client deserves to know all of her options.
You're her doctor.
Do what you think is right.
But our deal only stands if you make the clinic profitable.
It's gonna fit like a heart-shaped glove.
(LAUGHS) Let's see how much excess fluid you're lugging around, Ollie.
OLLIE: Well? No salt and no soda all week.
And did you know the brontosaurus had a 300-pound heart? Imagine what that sounds like.
Probably like "ka-boom, ka-boom!" (LAUGHS) Check this out.
It's my new lucky charm.
It's a triceratops toe.
(SIGHS) It's, uh, 65 million (GASPING) years old.
Is your chest hurting, Ollie? (EXHALES SHARPLY) (MONITOR BEEPING RAPIDLY) I need a nurse and the ECMO team, stat! Oh, this doctor in Boston used an external drain to lower pressure in the brain.
Never mind.
The patient died.
Well, maybe we can try to relax brain pressure with a hemicraniectomy.
He wouldn't survive that surgery either.
Made any progress with your patient? Not yet.
H-Have you discussed organ donation with his family? No.
In his fragile state, his organs won't last long.
Shaun, this is a tragedy no matter how it ends.
You are breaking the rules.
My patient is getting weaker by the minute.
An organ recipient's doctor is not allowed to communicate with a potential donor's doctor.
I am talking to you as a friend.
You can't save everyone.
If your patient is gone, let me save mine.
Go away, or I will report you to UNOS, and you'll lose your transplant privileges.
Hey, Shaun.
You're late.
(SIGHS) Yeah, the plane was late and cramped and devoid of refreshments, and I'm starving.
You ready to get some pancakes? I need to fix my neurophysiology test.
Okay, well, uh, great.
- Can we do it while we eat? - No.
I answered this one correctly.
- Check my work.
- I understand that it's not - Check my work.
- Not a perfect score, but Check my work, please.
Check it.
- Question 5.
- Okay, okay.
- (SIGHS) Yeah.
- (STAMMERS) It should be A, but, uh, it could also be C.
But the internal carotid arteries branch.
It is worded a little strangely.
I would have gotten it wrong, too.
Yes, Professor Fontaine is wrong.
You need to tell him that.
I'm not gonna tell a professor to rewrite his test question.
But he is wrong about how blood flows into the supratentorial brain! So what, Shaun? It's just a test, and I'm starving! You go eat.
I'm going to see my professor.
The internal carotid arteries.
I don't see any issues in that area.
You wouldn't, if there is a very small dissection hidden by all the swelling and other damage.
Stents could increase circulation to his supratentorial brain, which might wake him up! Nira? I found a surgery.
It's not only going to remove the tumor from behind your eyes, it will also be able to save 60% of your vision.
(WEEPING) Oh, thank you.
LIM: There it is a tiny tear in the carotid.
Good catch, Dr.
But there's a clot.
The stent could expand the clot, which could kill him.
SHAUN: Not if we break up the clot with therapeutic heparin.
We'd be risking major bleeds in all his organs.
If we don't give him heparin, he will end up brain dead.
During my residency, we had a woman die on the table.
Healthy organs, no contact info.
No one was saved that day because we didn't know if she was a donor.
ASHER: I thought we weren't supposed to consider organ recipients when treating patients.
We're not.
Right up until the point where what we're doing is futile.
SHAUN: It is not futile.
This has a 1% chance of helping Brandon.
Start the heparin drip.
I'm sorry, Val.
(SIGHS) My boy spent his entire life in hospitals.
Getting poked and tested and promised things that never came.
And all I wanted was to give him just one perfect day.
(WEEPING) WOMAN: Here's your hot mocha.
Glad I ran into you.
Let me get this.
I got a favor to ask you.
My usual.
In that case, I'm having a muffin.
(REGISTER BEEPS) You know, my friend Joanne, she flew in from Seattle.
You got a minute to chat with her, give her the lay of the land? She's sitting right over there.
She's interviewing for your job.
She's a great pediatrician.
I'm not sure what you heard, but I'm not going anywhere.
Wait Uh, thank you.
I Oh, I'm sorry.
I heard that you were moving on.
No, just renegotiating.
I thought I have to go.
Thanks for the muffin.
Excuse me.
Is this seat taken? Your patient is in multi-organ failure.
Yes, w-we are treating him with plasma and platelets to increase He has clots forming on his heart valves, which means his heart is no longer an option for my patient.
Okay, you are not supposed to look at my patient's medical records.
It is a violation of policy.
I wanted to see if his heart was still an option.
Your Hail Mary surgery didn't save your patient, and it just killed mine.
Professor Fontaine said my answer is wrong.
I'm sorry to hear that, Shaun.
I'm going to talk to the dean.
You need to come with me.
You're gonna go over the head of your professor? That might cost you more than two percentage points.
He is wrong.
Well, he might be.
Then, why I got you something, Shaun.
Pick one.
Mm, I don't care about these things.
Okay, I'll pick one for you.
I don't do embroidery.
You can learn.
It's good practice for your sutures.
Sometimes bad things happen, okay? Sometimes even unfair things happen.
You know that better than anyone.
And sometimes you gotta let them go and focus on the next thing, the next challenge.
Are you not coming with me to see the dean? No.
You said you would always be there for me, to help me.
I am.
Go if you need to go.
I'll still be right here.
(DOOR OPENS) We need to talk to Brandon's father! I think we can save Brandon's heart.
We can use an embroidery technique.
In the 1900s, Alexis Carrel perfected vascular suturing using embroidery.
If we treat his valves like blood vessels, we might be able to repair them.
You can save my son? N-N-No.
We can only save his heart.
For d-donation.
It's time to let go.
My son is not dead.
Only because of what we're doing to him, but he will be very soon.
It is futile.
I nee I-I need to talk to my son again.
I-I need to tell him s-so much.
I I understand.
It's too late.
No, it's not.
Not for that.
Talk to him.
Say goodbye.
If something needs to be said, it should be said.
MORGAN: Here you go.
Everything's so blurry.
That will improve.
But the tumor was more complicated than the imaging showed.
We were only able to preserve 50% of your vision.
I'm so sorry, Nira.
Don't apologize.
You saved my life.
I would be blind or dead if you hadn't found that tumor.
It's I should run some vision tests on you now.
I will go get those prepped.
(MONITOR BEEPING) (BREATHING SHAKILY) Remember when I bought you that ham radio? Whenever I was stationed overseas, we would send each other messages in Morse code.
You picked that up so quickly But (LAUGHS) Then, you sent me that message saying that you wanted to be a rock star.
And I, um I shot it down.
Everything you wanted changed.
I didn't understand it.
I I didn't know how to help you.
I had a path laid out, and you didn't want to follow it.
I thought you were rejecting me, s (CHUCKLES) And now I know, you were just becoming your own man.
(BREATHES SHAKILY) Goodbye, Brandon.
I love you, son.
There's a longing inside of my chest For what could have been (SOBBING) The weight is heavy, Tell the sender That I'm ready To see you I know I'll see you I know I'll see you on the other side I know I'll see you I know I'll see you on the other side The other side Holding on now to memories That won't let go of me Reminding me that you're gone And I'm the one that can't breathe I can't breathe I know I'll see you I know I'll see you on the other side I know I'll see you I know I'll see you on the other side The other side Can I? No, thank you.
People have always tried to accommodate for Shaun's differences.
Compensate, overcompensate I don't need another lecture.
- I was one of those people.
- Mm.
It took me forever to get to where you started.
Right, it's so easy for me.
It is.
You always treated Shaun like a person instead of a problem.
You always saw Shaun.
Why did you stop doing that? You left.
So, what? So you panicked? Yeah.
I don't I don't know.
It's We're getting married, and he's not always easy, and I'm pretty much always a screw-up.
And It's just It's too much.
No, it isn't.
B-But you've always been there to back me up.
You don't need me anymore.
You're kind and you're patient.
You're resilient as all get-out.
You're the right person for Shaun.
Shaun's the right person for you.
If you can just trust that, you will have the most perfect, imperfect marriage.
I kind of feel like hugging you right now.
You don't need me.
(LAUGHS) There's something I want you to hear.
(CHUCKLES) - Ka-boom! - (LAUGHTER) Sounds like a 300-pounder.
No, no, no.
This is your lucky charm.
Yes, yes, yes.
I don't need it anymore.
(HEART BEATING STEADILY) (SIGHS) You wanted to see me? Make yourself at home.
This is Dr.
Glassman's office.
You've earned it.
(SIGHS) I found a very interesting documentary about the science of storm clouds.
We should watch that tomorrow night.
I'd like that.
I'll bring the pizza.
(LOCKER DOOR CLATTERS) No olives, no mushrooms, no anchovies, right? Right.
Because they don't taste good.
Is this payback? No, a gift.
Worms have more protein than crickets.
(LAUGHS) (CLEARS THROAT) Then I'll take another.
I feel like celebrating.
Colson suddenly lost interest in playing hardball and signed his employment agreement.
I assume you had something to do with it? Glad I could help.
(SNIFFS) You smell good.
You coming? I came to give you this.
It's where Brandon's organs went.
A secretary who's a single mom of three got his kidney.
A truck driver with a vision problem got his corneas.
A teenager with a rare autoimmune disorder got his ligaments.
And a young boy got Brandon's heart.
He loves dinosaurs.
Brandon helped all these people? There are 63 people on that list.
(PAGES SHUFFLING) (BEN ABRAHAM'S SATELLITE PLAYS) Don't Don't lose faith I know it can be so hard some days Go Hide your face But when you're ready Come back to your place Here, right by me Take all the time you need And when you feel you can't be found Caught up in the mess-around When the walls are crashing down I'll be your solid ground When you think you've lost the light (DOOR CLOSES) Stuck in a starless night Lift your eyes and watch the sky I'll be your satellite Here you go.
It's perfect.
It was a good exercise for suturing.
Would you like to get some pancakes? Yes, I would like some pancakes now.
When the walls are crashing down I'll be your solid ground When you think you've Lost the light Stuck in a starless night Lift your eyes and watch the sky I'll be your satellite (BUTTONS CLICK) VOICE RECORDING: Hi, you haven't reached Aaron Glassman, so I'll call you back sometime.
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