The Good Doctor (2017) s05e13 Episode Script

Growing Pains

1 JORDAN: (CHUCKLES) '80s night should be banned.
LEA: You had a blast.
I didn't say it wasn't fun, but that decade was a crime against fashion.
Tonight's club is my pick, my vibe.
Ooh, which is? Sophisticated ladies.
I can work with that.
(BOTH LAUGH) - Shaun? - Hmm? Sure you don't feel left out? I use the time to study less invasive bowel resection techniques.
(CELL PHONE VIBRATES) Please be home by 11:30.
He's got you on a curfew? Sex schedule.
Our window ends at midnight.
(SIGHS) It's like I slept on gravel.
Well, that explains your snoring.
Your mattress should be burned.
It's time to end the sleepovers and for you to ditch the bachelor pad.
You asking me to move into your place? I'm asking you to move into a new place With me.
No neutral zone to run to after a fight.
Making up's the best part.
Well, it can't hurt to look.
This is Trent, his mother, Carrie.
Signs of severe infection on his left index finger.
I'm ordering a CT.
Sutures are inconsistent and crude.
It's a minor upgrade.
I installed a magnet in my finger.
Were you having trouble holding forks? It's body art.
Yeah, he's 17, immune to common sense.
SHAUN: Art seems like a poor descriptor given the ugliness of the infection.
The more appropriate term is "bio hacking.
" I put Neosporin on it and took ibuprofen for the swelling.
That's worked before.
Before? Show them.
(THEME MUSIC PLAYING) - (KNOCK ON DOOR) - You wanted to see me? Dr.
Glassman, this is Kayla Quinn.
She's been diagnosed with major depressive disorder as well as chronic neuropathic pain from a neck injury six years ago.
The pain and depression are besties, uninvited guests that travel together, make it so I can't work, can't get out of bed, can't even think.
That's why I'd like to do this before their next visit.
An anterior cingulotomy seems like the Excuse me.
She is a smart, charming, successful woman whose life Nice ambush.
She's had over a decade of therapy, five classes of anti-depressants, and non-invasive neuro-modulation, including C.
and full-on E.
She's desperate for real relief from her pain and depression, and she's well aware of the risks.
(SIGHS) Get me a complete medical and psychological history and a couple of residents.
We're just gonna talk about it.
ASHER: Not sure who's struggling more, the overwhelmed, super-critical mom or the sad, self-harming teen.
Trent called it an upgrade.
He's not trying to self-harm, he is trying to self-improve.
Well, whatever the terminology, he cut into his finger with an X-ACTO knife.
His technique was primitive, but considering he lacks formal training and used only one hand, I am impressed.
Don't be.
Bony marginal erosion.
If the infection spreads, he could lose that finger.
For starters.
It's the modern equivalent of a lobotomy.
"Modern" being the operative word.
We'd be burning lesions into a key brain center.
That could alter her personality, impair cognitive function Her depression and reoccurring acute pain are already doing that.
Cingulotomies are effective in 67% of patients with Kayla's symptoms.
With a 20% chance of adverse effects, like loss of creativity, it could be a big deal.
This is Kayla Quinn.
She launched her own company at the age of 18, made millions designing scrunchies and bangles.
I discussed this with her.
Her focus is quality of life.
Now, I'm sure she feels that way now, but once it's done, it can't be undone.
Are there any alternatives that Kayla hasn't tried or should try again? Okay.
Let's do the surgery.
Wait, possible amputation? The infection is in the bone beneath the magnet.
It would have been better to have brought him in sooner.
I'm a single mom.
Trent Trent's father isn't in the picture.
You made sure of that.
I got divorced last year.
Trent and I were adjusting.
But then he started hanging out with these idiot biohackers.
(SCOFFS) Thanks, Mom.
We should remove the infected implant and start Trent on IV antibiotics.
What about the other implants? Shouldn't you take them all out? No! The other implants aren't infected.
This is not a decision you get to make.
(CLEARS THROAT) Once a patient is 16, it is hospital policy not to perform a surgery that's been refused unless that surgery is medically necessary.
Leaving in the other implants means Trent's still at risk for sepsis and septic emboli.
Wolke is correct.
With your consent, we can physically compel the surgical removal of all your son's modifications.
(SCOFFS) Good luck.
I'm outta here.
Trent! This is much easier than chasing him.
PARK: Head frame is secure.
Stand by with the Gamma knife.
Glassman, please stop what you're doing.
This is Justin Quinn, Kayla's conservator.
I have full authority over my sister's medical treatment, and I won't allow this surgery.
Kayla sees her psychiatrist weekly, and I check in with her daily, but clearly, this is not a weekend getaway at a cabin in Tahoe.
A chance e-mail from our insurance tipped me off.
(SIGHS) She's never lied to me like this.
KAYLA: I was 12 when my parents died.
My memories of them don't seem real, just clips from a movie.
JUSTIN: It was our grief therapist who first diagnosed her depression.
I was 22 and so out of my depth.
KAYLA: Justin and I used to do everything together.
It was us against the world.
I called him Bro-dad.
JUSTIN: She was such a creative kid, so talented.
She just had a vision and wanted to run with it.
Who knew scrunchies and glitter bangles could be a business? Just took off.
Eighteen years old, all that money and no guardrails.
She was out of control.
Clubs every night, the booze, the drugs (SIGHS) I couldn't help her.
I couldn't stop her.
It was during a blackout that I fell and injured my neck.
Everything just got worse after that.
The arrests piled up, underage drinking, possession, DUI.
I thought she was going to prison.
The judge agreed to a diversion program She's nearly O.
'd twice.
called me a danger to myself.
The judge ruled she was incompetent.
Put my brother in charge of everything.
He took away my life.
The conservatorship saved her life.
LIM: All I needed to piss off my parents were fishnets and heavy eyeliner.
ASHER: Of course you were a goth.
How many times did you see The Cure? Four.
(CHUCKLES) Robert Smith was, like, leader of our tribe.
Every lonely teen needs a tribe.
I was lonely, but I was not a rebel.
ASHER: My rebellion was just being honest.
My family preferred the lie.
Meanwhile Trent is damaging his relationship with his mom and his body.
That is not his fault.
She is his mother.
Mothers should try to understand their children.
LIM: Nice thought, but teenagers are asses.
Scientifically proven.
Their prefrontal cortex is underdeveloped, leading to excessive risk-taking and lack of impulse control.
- (SIGHS) - Margins in the soft tissue look good, but keep an eye out for the infection.
Let's close.
Your sister's suffering.
It's a roller coaster with her, good days and bad days.
But your solution is to fry part of her brain.
She could lose her creativity, her personality.
Her pain, her depression.
Those other doctors ran me through the risks and the numbers.
What if I could show you how Kayla's issues are hard-wired in her brain? An fMRI could demonstrate how the part of Kayla's brain that handles emotional and pain response is functionally abnormal.
It'll assure you that "frying her brain" means only frying the part of her brain that isn't working.
And it'll get you both off of the roller coaster.
(SIGHS) The scan's harmless.
Okay, do it.
(LAUGHS) I've got it.
Oh, see? I can spin it around.
I need to do a post-op exam.
You have modifications.
I'm Dixie.
My right hand got messed up in a car accident.
I had RFID chips put in so I could unlock my front door, store my medical info, and do some pretty cool tricks.
Are you attracted to Dixie? Are you concerned you'll be less attractive to her without your implants? We're just friends.
I host a monthly bio hacker meet up, and Trent's become a regular.
The only people who get me.
You found your tribe.
(CHUCKLES) Incision sites look good.
Right wrist please.
It was not until I came to work here at St.
Bonaventure that I felt like I was part of a community.
I've read about implants that can operate prosthetics and an occipital lobe electrode that receives visual images for sightless people.
Oh, these technologies are very exciting.
It's so cool, right? I was thinking I should be an engineer and I can design tech for people like Dixie.
How's he recovering, Dr.
Murphy? Hmm, oh, hello.
The surgeries went well.
Finger looks free of infection and bacterial cultures remain negative.
We still need to do an MRI to assess his joints, but I'm optimistic.
Then once I'm 18, I can get all my mods back in by the pros who did Dixie's.
Meaning the tattoo artist at the strip mall.
Tattoo parlors require a public health permit.
Yes, that would be much safer than doing it himself.
Rain check for tonight.
Surgery? A new patient reminded me I need to spend more time on my business ideas, less time on the dance floor.
I see a sparkle in your eyes.
What is the product? (CHUCKLES) My ingestible sensor that monitors gut bacteria as it travels through the GI tract.
Gross yet cool.
How are you gonna collect the data? Ideally, real-time monitoring.
I'm looking at wireless open-source programs.
You could connect the sensor with a smart phone via Bluetooth.
That would be amazing.
(CHUCKLES) But that code would be pretty complicated to write.
Not for me.
You'd have time for that on top of your IT work? Says the second-year resident looking to disrupt the med-tech business.
I wouldn't be able to pay you, at least not up front.
We could divvy up the spoils.
75%, 25% final offer.
Hell yes, partner.
Welcome aboard.
(LAUGHS) Put this on your calendar May 2025, yacht shopping.
- Okay.
- Yes! Dr.
Murphy? Please stop encouraging Trent.
Your interest in his body modifications comes across as an endorsement.
Oh, I am interested.
Why would I pretend that I'm not? Not so long ago, we were talking about amputating fingers.
Someone has to talk some sense into my son before he does this again.
I'm happy to have a chat with him.
He seems to connect with Dr.
If you talk to him, he might listen.
I would not be very good at that.
(OVER INTERCOM) Kayla, next I'm gonna ask you a series of prompts to help us map your brain activity.
I'll do my best.
Think of a nice memory.
Something from a happy time.
(BEEP) You didn't like any of the apartments I sent you? As predicted, altered limbic activity in the connections to the cingulate cortex.
The apartments are okay.
I'm shocked you're so easy to please.
(SCOFFS) You're such a quibbler.
"Hate art deco.
" "Low ceilings equal doom.
" "Berber carpets hurt my feet.
" Well Kayla, now I need you to think of an unpleasant memory.
(BEEP) Take it as a compliment that I'm so picky.
Picky's fine, passive not so much.
Send me some links.
More abnormal connectivity.
We're getting motion artifacts.
She's moving around.
Kayla, can you try and hold still? (GROANS) I'm sorry.
Can we please stop? - Kayla? Where does it hurt? - (GROANING) Mm-hmm? Everywhere.
It's back.
(BREATHES HEAVILY) (SIGHS) You never came to bed.
We were supposed to have sex.
(SIGHS) Sorry.
Our sensor keeps running out of power halfway through the digestive tract.
It's not on the schedule, but we could have sex now.
I have to shower.
I shower first.
I will be flexible and make you coffee.
Thank you.
How's Kayla? In pain and on the edge of a full depressive episode.
I upped her gabapentin and started a low-dose Ketamine IV.
You know we'll have to get her off the Ketamine before we take another shot at finishing the fMRI.
(SIGHS) Do you not want to move in with me? I've been busy.
I have other patients.
Allow me to present multitasking.
Look at that.
Three-bedroom, two-bath, courtyard building with a pool.
We'd have a guest room for Kellan, a shared office, and it's 10 minutes from the hospital.
Well, looks like the master bedroom window's overlooking the courtyard.
I know.
Not nice.
Then show me one you do like.
(SIGHS) Oh, hell no.
I'm gonna update the brother.
You paged me? Good morning, Shaun.
Lea and I missed our sex night.
It is not a good morning.
Mine started with a distraught mother whose son you refused to advise against bio hacking? What he chooses to do when he is 18 is up to him.
True, but you could advise him against the dangers of further mods.
Trent enjoys the connections he has made in the bio hacking community.
You really think the emotional benefits of belonging outweigh the physical dangers for this kid? Teens do many dangerous things.
If he injured himself skateboarding, should I advise him never to skateboard again, which could alienate him from his skateboarder friends? Is there a potential for medical harm? Yes.
Then remind your patient of that.
You have no trouble being honest.
I'll do it, only because you're my boss.
Case in point.
Justin's refusing to let me finish Kayla's fMRI.
He thinks her being in the hospital is what triggered this latest episode.
He (SIGHS) He's totally dug in.
It's a judgment call.
Legally, it's his judgment.
I need you to talk to him, get him to change his mind.
- Because? - You're the surgeon.
If medicine could persuade him, we'd be in surgery right now.
So I should just give up? I don't know.
Do you want to? - No! - Okay, then don't.
Go find another tactic.
No, no, no.
I do the surgery, you do the selling.
Okay, fine.
Look at it this way.
The brother has been cleaning up after his sister for years, right? So instead of trying to change his feelings about the surgery, maybe change his feelings about his sister.
Future modifications could result in sepsis, severe arthritis, pseudo-tumor formation, nerve damage and paralysis.
(SCOFFS) Suddenly you're a guy in a drug commercial "Side effects include insomnia, rash, dry cough, and death.
" Sounds like my mom got to you.
She tried.
It didn't work, but then she went to my boss.
That did work.
I think that it is nice your mother cares about you.
Mine did not.
Mine used to.
My dad used to travel a lot for work.
He was always off pitching to investors, conferences in Vegas.
And me and my mom would hang out all the time.
Every weekend, she would take me to the Boardwalk.
Never said no, no matter how many times I wanted to ride the Cyclone.
The Cyclone made me nauseous.
Now she's just working all the time.
And whenever we're together, she's angry.
Never stops nagging me.
She doesn't like you bio hacking.
I don't think she'd like anything I do.
(WINCES) Ohh, aah.
Is it your finger? No, it's my wrist.
(INHALES SHARPLY) Kayla's biggest trigger isn't being in the hospital, it's your control over her life.
I reviewed her history in detail, and over the last five years, Kayla's major depressive episodes coincide with major life decisions that you've made on her behalf Changing meds and moving homes, making decisions for the business.
You're saying this is all my fault.
She's saying that being in charge of my own life would be better for me.
Until you get drunk or O.
That was years ago.
I'm not that person anymore.
Because I've been protecting you.
Because the conservatorship works.
That argument means I'll be in this forever.
If I'm doing well, it proves you right.
If I'm a mess, proves you right.
I'm tired of this, Justin.
I'm tired of living the life that you want me to.
You pick out my doctors, you search my cabinets, you test my urine for drugs.
We can talk about relaxing some of those things.
No! No.
I'm done negotiating over my own life, of having what you think is best rammed down my throat.
- Kayla - Think acting like this is gonna change my mind about the surgery? It shouldn't have to.
It's my life! It's my messed-up brain! This place is bad for you.
I need her discharge papers.
Stop telling her what to do! Stop telling everyone what to do! - Kayla, please - Shut up! I need 10 milligrams of Haloperidol.
Stop it.
Shut up.
The LED light you've installed in your right wrist has irreversibly damaged the joint.
You will never regain full function in your hand.
You'll need physical therapy until you can compensate with your non-dominant hand.
Damn it, Trent.
How many times did I tell you? Thousands, okay? But I'm such an idiot, and I never listened.
I never said you were an idiot.
I said to stop hurting yourself.
Maybe some family counseling could help? No, she's the only one who needs counseling.
She's the one who failed as a parent.
Your choices are not my fault.
But I'm stuck with yours.
Like how you tossed Dad out.
He walked out on us.
I didn't want you to hate him.
I hadn't realized that the alternative was hating me.
Your father was a schemer.
He kept flitting from one big idea to the next, chasing fantasies instead of taking care of responsibility.
That's a lie.
You're a liar.
He was a self-absorbed narcissist who cared more about himself than us.
- That's not true! - Trent Leave me alone! Get out! (SNIFFLES) Get out! DR.
REZNICK: Lidocaine to numb you.
I figured you'd want me to feel every stitch.
I'm used to being the bad guy.
Bad guys don't give up their lives to care for their little sisters.
Thanks for seeing that.
You feel that? People idealize what it's like being a kid, but, really, childhood blows.
Being told what to do, where to go, how to behave.
Spoken like someone who had a terrible childhood.
It wasn't my wheelhouse, or my parents'.
Kayla's first try at growing up, she flamed out.
Doesn't she deserve a second shot? Maybe.
Leave it to Kayla to choose elective brain surgery for a maiden voyage.
Scares the crap out of me.
Tell her that.
(SIGHS) Jerome's birthday is coming up.
I need to find him a great gift.
Please don't distract me.
I am looking for a surgical solution for Trent's wrist.
That's valiant, but he's about to be discharged.
I need a gift that says "I'm really into you," but, mm, without overdoing it.
We could attempt a partial wrist fusion.
Not for another year.
Trent's still growing.
Jordan mentioned you have some super cute race car pajamas.
I could get Jerome a pair.
They are classic cars, and I'd prefer not to discuss my sleepwear at work.
We could give Trent a course of Methotrexate to combat He'll adjust to the bad wrist.
The bigger problem is that mother and son act like they hate each other.
I have no idea how to fix that.
(SIGHS) He's managing his feelings by turning himself into a cyborg.
Trent is not becoming a cyborg But maybe he could! I can fix Trent's wrist.
This experimental surgery uses a customized implant to replace his wrist joint.
He will have full use of his wrist.
Also, he will be very happy, because he'll have a one-of-a-kind body modification.
E-Experimental? Would it be covered by our insurance? Mm, n-no.
I-It is quite expensive.
Which means I'm getting a second mortgage to pay for it.
If Trent keeps getting other modifications, could that cause problems with this device? Yes, his body could reject the implant.
Okay, but Thank you Trent should be able to follow the post-op regimen, including no further modifications.
Or he'll keep seeing it as a cool hobby which allows him to stick it to his terrible and controlling mother.
I can fix your son's wrist with your consent.
(COMPUTER BEEPING) (LEA SIGHS) Looks like our sensor's gonna poop out before it gets pooped out.
Maybe if we take another look at the component specs.
I have drawn up a list of house rules that apply to Dr.
Allen when she is working at our apartment.
One, no work on scheduled sex nights.
I can get down with that.
Two, no brushing teeth in the kitchen sink.
Three, do not wear perfume.
Four, do not speak in a loud voice.
Five, please avoid eye contact.
- Shaun - I'm not finished.
- Avoid eye contact? - Mm Yes.
Shaun, do you not like having me at your apartment? I don't like having anyone other than Lea at the apartment.
With Lea, I feel safe.
I am not obligated to follow the guidelines around social interactions.
By the time I'm done with work, I have had enough of following guidelines.
Shaunie, I never knew.
We can work someplace else.
The apartment is half Lea's.
I am very happy she has found a friend and partner.
Allen you are part of my tribe.
You are welcome in our home.
As long as you follow the rules, including, six, I am allowed to ignore you when you are there.
Does it ever feel to you like we go round and round, but we always find our way back to this same, sad place? I remember when we first got here.
You were 12 on a school field trip to the Municipal Garden.
And I got there and watched you sketch roses.
So confident, at peace, innocent.
Then I had to tell you Mom and Dad were dead.
I swore that I'd do everything I could to keep you from being hurt like that again.
I know you're just trying to protect me.
I'm protecting me, too.
I've been so scared that I could lose you.
(SIGHS) During the fMRI, Dr.
Reznick asked me to think of a happy memory.
Silver top, Nevada.
You and me on that river in the canoe.
That cabin was such a dump.
(CHUCKLES) It was.
And we were only there 'cause I screwed up and forgot to sign you up for that camp.
Camp Capistrano.
That was the first summer after Mom and Dad died.
You had an excuse.
That was a good trip.
Best vacation I ever had.
I want that again.
We can always go back.
Not the trip.
The freedom, that happiness without the next bout of pain and depression landing over me.
This is my chance.
Please let me take it.
(EXHALES SHAKILY) I'm dying to take this next step with you.
Says the guy who's sandbagging the search.
It's the money.
Between Kellan's college tuition and my med school debt, there's not much left at the end of the month.
And on top of that (SIGHS) My credit's a mess.
This is just about money? Just? If you can't afford it, I got you.
I pay my own way.
Always have, always will.
Your financial issues are no reason to put our plans on hold.
An easy thing to say when you've never had to worry about money, but some of us have had to live in the real world.
And if you had the money and I didn't, you wouldn't want to improve both our situations? This isn't about the real world.
It's about your pride.
I have your prescriptions and therapy referrals.
I can do it.
Then do it.
(SIGHS) I'm guessing this is my fault, as well.
The way you behave is very confusing and frustrating.
It doesn't make sense at all.
You criticize every choice Trent makes and never ask why he's making them.
See? You deliberately made choices you knew your mother wouldn't approve of, and then were very angry when she didn't approve.
Even he thinks you took your bio hacking too far.
She's been mad at me since Dad left.
- Oh, that's not true.
- Yes, it is.
You don't like me.
You don't like my friends.
I don't understand your friends.
You never tried to.
You're just mad at me because You're stuck with me.
I have been mad, but not at you, at your father for leaving.
Afraid I couldn't take care of you or support us.
You were so hurt when your father left.
All I wanted to do was make you feel better, but I just I was too damaged and jealous of your new friends, when I should've been grateful.
But I was afraid of losing you to them.
After all, you like them.
You're my mom.
I'm not supposed to like you.
(CHUCKLES) Come here.
Can I do the surgery now? You are gonna like this.
Time to prep you for surgery.
Before I go, um I got a little inspired.
I'll hang on to them for you.
Ready? Yeah.
LIM: Carpal resection looks good.
What did you say to change Carrie's mind? I'm not sure.
I tried to understand them.
Maybe you could do me and my father next.
Carpal and radial bones prepped for the upgrade.
I'd say you get the honors.
Resolving conflict is a crucial skill for an attending.
Nicely done.
Placing carpal ball onto the distal component.
For the next few days, expect some headaches and fatigue, but the post-op symptoms should quickly pass.
Kayla, how do you feel? (EXHALES DEEPLY) Strange.
Something's missing.
The pain.
And I think I'm still me.
(CHUCKLES) You were listening to The Dark Side of the Moon I could barely see your eyes We have to go see a judge.
Psilocybin in a hotel room It's time I was just your brother.
I'll be your bright side Baby, tonight Tonight The arthroplasty fixed Trent's wrist like I said it would.
You will need significant therapy, but your prognosis is good.
And you better take this seriously.
Take your meds, do your rehab.
Invite that friend of yours, Dixie, over for dinner.
Really? Well, she seems interesting.
These are the schematics of your wrist implant.
The engineering specifications are quite interesting.
Thanks, Dr.
You're stranded on the bridge You're crying for your kids I'll be your bright side Baby, tonight Tonight Tonight I'm glad my key still works.
It was about my pride.
And I used that as an obstacle, instead of being honest with you.
I'm sorry.
It's a big step, but let's keep talking.
I'm sure I'll get over myself, in time.
Can you do it in a month? Because I found a house that I love.
And at that price, it should be.
I would be very grateful for a studly roommate who could cover the utility bills.
What about rent? I was thinking services rendered, like Shirtless lawn mowing, shirtless pool cleaning, shirtless meal prep.
Well, certain studly men would argue if we don't start on equal footing, it'll never be our house.
It'll be our home, because we'll make it that.
A pool? What about a hot tub? Our power issue is a software issue.
Because your data domain requirements mandate a specific chip that requires way more power than we can actually I could see it in the air Every word was like smoke from a cigarette What if the sensor had bad manners? Shuts down when it needs to rest, ignores what doesn't matter.
It works, it rests, it works, it rests.
We could extrapolate between the data points.
That could double the sensor's life.
You're pure inspiration, Shaun.
I am ignoring you.
I'll be your bright side Baby (DOOR CLOSES) Tonight, tonight Tonight (CLOSING THEME MUSIC PLAYING)
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