The Good Doctor (2017) s06e01 Episode Script

Afterparty

Previously on "The Good Doctor"
Shaun Robert Murphy,
do you take Lea Abigail Dilallo
I do.
To Shaun and Lea!
How'd the interview go?
I want the job.
I understand.
Your father's prognosis was wrong.
He only has a few weeks to live.
I love you, son.
Goodbye, Dad.
- Dalisay?
- My
Aah!
Shaun.
Look at me. Hey.
Look at me!
Shaun, it's okay. I'm here.
Look at me.
I feel married.
Do you feel married?
What does married feel like?
I don't know.
Different?
Amazing?
More to-have-and-to-hold-y?
I feel like
I love you more
than I have ever loved anybody.
And I'm very happy.
So, the same as before.
Me, too.
Dalisay?
Oh!
Ooh.
Dalisay?
- Hey.
- I'm hurt.
- I'm stabbed.
- I'm sorry.
I can't hear you. You're breaking up.
In the break room.
Ah!
Lim?
Lim?
Your call has been
forwarded to an automa
You're bleeding.
What?
Your neck.
I was putting a psych patient
in physical restraints.
It got rough. Thanks for the heads up.
Where's your badge?
Must've fallen off when he grabbed me.
Glad you're okay.
Code Silver! We're in lockdown!
Code Silver in lobby and main stairs.
Code Silver in lobby and main stairs.
Code Silver in lobby and main stairs.
Code Silver in lobby and main stairs.
Get him to trauma bay two.
I recognized the guy who attacked him.
He's Villanueva's ex-boyfriend.
She's not answering her phone.
He got on on the fifth floor, right?
Yeah.
That's where Lim
was heading to, the break room.
We gotta get trauma bags.
The shooter is still loose.
We're supposed to st
I'm coming with you.
Last time,
it was just a guy with a box cutter.
No one was hurt.
Hey. Where are you?
I'm out front. Are you okay?
You bailed on me?
I wasn't in the best mood.
You said you understood.
Doesn't mean I'm happy about it.
Oh, my God.
Jerome says there's an active shooter.
Lim and Villanueva might be hurt.
I gotta go.
Dr. Glassman says Dr. Lim and
Nurse Villanueva may be hurt.
- On the fifth floor.
- Lim went to the break room.
I told her we needed glasses.
Okay. Okay. I need to get down there.
Shaun, you can't.
We just have to stay here.
Shaun, you cannot go down there.
Dr. Lim may need my help.
Then I'm going, too.
No. You're not a doctor.
They don't need you.
I will see you soon.
I'm a doctor, too.
Well, I'm not staying here alone.
Hello? Is anyone here? I'm really sick.
I don't know. Could be the shooter.
Or a sick guy,
seeing as we're in a hospital.
Hello?
Shh, shh.
I was waiting in the ER.
I tried to make my way
to the pharmacy for antacids.
I'm Dr. Reznick. This is Dr. Wolke.
Ezra.
How bad is your stomach pain?
I have Crohn's disease.
The last time this happened,
I needed surgery.
We should get out of the hallway.
It's not safe.
Ready? One, two, three.
Thank you.
Oh, my God.
Lea, look in the cabinets
for scalpels, sutures,
gauze, syringes, needles.
Large neck wound,
anterior triangle, maybe more,
defensive wrist lac with
possible radial artery injury.
At least two deep thoracoabdominal
penetrating wounds.
She's lost a lot of blood.
Use this.
Weak and thready carotid pulse.
Tourniquet's on forearm.
- I found the gauze.
- Muffled heart sounds.
She has a cardiac tamponade.
Did you find needles?
Yeah. Yeah. And the syringes.
Put firm pressure on Dr. Lim's
wounds with the gauze.
Add more when they're saturated.
Two stretchers, now.
Backboards, blood, and saline,
if you can find them.
Mm.
I'll get the door.
What now?
We stay quiet and we wait
for them to lift the lockdown.
Distant heart sounds.
- Is she dying?
- Yes.
Her blood's being choked off
by blood buildup.
Okay. Palpating the xiphoid process.
Point to the left shoulder.
I'm in.
Jugular distention
and tachycardia improving.
Let's get them to the OR.
Dr. Andrews.
Who's on the floor?
Me and a couple anesthesiologists.
That's it?
How we doing on blood and supplies?
Low on all.
We had three transplants
and two GSWs today.
You're on one with Lim.
Jerome, you're with Villanueva in two.
Cop's on the line.
This is Dr. Andrews.
This is Captain Holland.
We're taking operational control.
Understood.
Already diverted incoming ambulances.
Copy that.
Is there Is there anything I can do?
You can be our circulating nurse.
I, I meant more like
get people coffee, but, um
Okay, yeah, what do I do?
Find the supplies we ask for
and hand them to the surgical field,
like you did just now.
Okay.
Shaun, start with the abdomen.
Sternum saw.
Cooley retractor.
Lacerations to the pulmonary hilum.
Left ventricle is nicked.
That's what caused the tamponade.
It's not very wide, though.
Pledgeted prolene sutures, please.
She has a grade four liver laceration
with active bleeding
into the peritoneum.
Lea, d-do you know what a lap sponge is?
It's like a hand towel
with two blue handles.
- How many do you need?
- As many as you can find.
There's a third drawer down there.
Safest bet is to remove
the damaged lobe.
That's half her liver.
We can do an angio-embolization instead.
If that goes south, she'd need
a major transfusion.
That can't happen. We're in a lockdown.
A hemi-hepatectomy would decrease
her life expectancy by ten years.
Life expectancy, Shaun?
She has 20 minutes, maybe,
unless we can stop his hemorrhage.
You are being shortsighted.
I'm very shortsighted.
I want to keep her alive.
Dr. Glassman?
Dr. Andrews needs your help
with Villanueva.
Ventricle is sewn up.
Shaun, you are going to cut out the
damaged lobe, do you understand?
Yes.
Okay.
Full thickness tracheal
laceration with sub-q emphysema
and a nick in her jugular
below the facial branch.
And the left carotid is shredded.
We're gonna have to patch that up first.
I'm thinking closed stent.
If we have to anti-coagulate
her, she'll bleed out.
We got to stop the flow,
tie off the artery upstream.
She's unconscious.
There's no way to test
the collateral circulation
to see if there's enough
to perfuse her brain.
She's young.
I'm willing to take that bet.
You're willing to risk a massive stroke?
As opposed to letting
her bleed to death? Yeah.
Vascular clamp and a silk tie.
Oh!
No, no, please, please. Ow!
Tender with guarding and rigidity.
His bowel's perforated.
Okay, well
I'll look for supplies in case
we need to operate in here.
Just lock the door behind me.
Dr. Murphy?
The bleeding is confined
to an aberrant vessel.
We do not need to take half her liver.
We can do the angio-embolization safely.
But you told Dr. Glassman you
were gonna do the hemi-hepatectomy.
Parameters have changed.
The angio-embolization
is the proper choice.
Should someone let Dr. Glassman know?
Inform him if you like.
I need to proceed to avoid
further hemorrhaging.
Argon beam coagulator.
Morgan?
Stay where you are.
Don't move.
- What's going on?
- Shh!
What's the tray for?
Where were you going?
I'm sorry. I just
There's a kid in there
with a perforated bowel.
If we don't do surgery,
he's going to die.
Shaun, did you change the surgical plan?
The parameters it was based on changed.
I adjusted accordingly.
And ignored my instructions
in favor of what you wanted to do?
Yes.
Why didn't you ask me?
Why didn't anybody ask me?
It seemed like a reasonable call.
That's not your call to make.
Nor is it yours.
How far into this are we?
I located the site
of contrast extravasation
and the catheter is in position.
Well, that's just great.
We're locked in. Gimme a coil.
There was a skyway, bridge-type thing.
I went there for a smoke once.
Not that far off the ground.
What are you gonna do?
Jump? It would kill you.
- Where is it?
- I-I-It's two floors down.
All the stairs and elevators
are locked off.
There's really
There's no way out of here.
No!
Come on! Let's go! Let's go!
Go! Go! Go! Go! Go!
Open the door! Open up! I have a gun.
I'm gonna shoot this doctor in
the head if you don't open the door!
Morgan, don't!
I have three hostages!
You stay back or I start shooting!
One area of extravasation remaining.
Deploying my coil.
Heart rate 168.
Big drop in BP.
Coils are fine. Where's the bleeding?
Large collateral vessel must be damaged.
We can inject gel foam particles
for distal embolization.
BP's critical.
- I'm gonna pivot back.
- I'm almost there.
We're going to resect the liver.
Don't touch her.
I am injecting contrast
I am removing the packing, Shaun.
No. I see how to stop the bleed.
Injecting particles.
Complete embolization
with no residual bleeding.
BP's rising.
Okay.
Let's close her up.
It was a reasonable call.
Nice work with the needle driver.
Thanks.
Jerome.
There's a hostage standoff
on the fifth floor.
Everyone's fine.
But it's Dr. Reznick and Asher.
I'm sorry.
Let's finish this.
You guys stay back or you
won't like what happens.
How is she?
- Who?
- Dalisay.
Now you're concerned for her well-being?
I love her.
Ezra?
Ezra.
He needs surgery or he'll die.
Do it in here.
I need to make a call.
Do you have a ten-blade?
No, just a fifteen.
Okay. How many GIA staplers?
None, but we can
hand-sew or anastomosis.
As long as he doesn't have
a history of bowel surgery.
He does.
I love you.
If we open him up here, we'll kill him.
I spoke to the OR earlier.
Your ex, Lim, that guard,
they're all expected
to make full recoveries.
So, right now, all they have
you on is attempted murder.
But if this kid dies
You You didn't talk to the OR.
I did.
You, take him out of here.
You're staying with me.
I have blood on my sleeve.
You okay?
It's not my blood.
Okay. I just
I don't know. I was concerned about you.
You shouldn't be.
I made the right call,
and Dr. Lim's recovering.
Dr. Lim's waking up.
I have to go.
Oh. I'm here if you need me.
Thank you. I don't.
My dad beat up my mom.
Put her in the hospital a couple times.
I hated his guts.
Spent my childhood saying I'd
I'd be different than him.
My dad's dying.
He has a couple weeks
at most.
Cancer.
I just put him on a plane
back to New York.
What went wrong between us
will never get fixed.
We're out of time.
There's still time for you.
It's okay.
Yeah, she's recovering.
She had trauma to her carotid,
trachea, and jugular,
but we were able to repair it all.
You had pulmonary hilum injuries,
a nicked ventricle,
a grade four liver laceration.
It was a tough call, but Dr. Murphy here
opted for an angio-embolization
and managed to preserve
your entire liver.
You're welcome.
A security guard was stabbed,
but he's expected
to make a full recovery.
Oh.
- Abdominal pain?
- Oh!
- Right upper quadrant?
- Mm.
Higher?
Her heart.
Well, you'll serve your sentence,
make amends, and then
and then start again.
There's only two ways out of this.
You either turn yourself in,
or you die.
Thank you.
Is Dalisay really still alive?
I have no idea.
Drop the gun!
There.
A traumatic VSD in the
inferior portion of the septum.
The cut went deeper than we thought.
The defect can be repaired
with a GORE-TEX patch.
I need help.
SWAT got him.
Multiple GSWs to the arm and chest.
Was in PEA, but we got him back.
BP 60 over palp.
Dr. Glassman!
Ash. You okay?
OR two, set up for bypass with
whatever O-Neg we have left.
Aaron, you handle this with Dr. Wolke.
- Shaun, we'll fix Lim's heart.
- Okay.
Wait. Does Lim need bypass, too?
We've only got enough tubing and
cannulas to operate one machine.
Resupply doesn't come in until 5:00 a.m.
Are we pretending that there's a debate?
We're not risking Lim's life
for this man.
We do have another option.
We can repair Lim's heart with an
occluder device. She won't need bypass.
No. No. That is a terrible idea.
Percutaneous closure is too risky.
Open heart surgery is the optimal
procedure for traumatic VSD.
I, I know, but he will die
without bypass.
Lim's surgery will just be
harder without it, but doable.
Do you agree?
I agree with Dr. Andrews.
No. This is not fair.
Dr. Lim didn't hurt anyone. He did.
And now we need to help her.
She needs the bypass machine.
I've made my decision.
I've deployed the occluder device.
Slipped through.
Placing again.
Looks good on the frontal.
No. Still not seating.
We should have used bypass.
Repositioning.
Cardiac output's dropping.
- She's in fulminant heart failure.
- No. No.
- Murphy.
- No.
- Shaun.
- I-I can't.
No!
I can't. I said it wouldn't
Shaun, it's okay.
No, it's not. It's not okay.
No!
- No, it's not okay.
- Lea, get him out of here.
- Shaun, let's go on a break.
- No, it is not okay!
- I-I can't leave!
- Take a break.
- Jerome, get him out of here, now.
- I-I will not leave!
- And get Glassman.
- I have to to
- Dr. Murphy, let's go. Come on.
- No, no, don't touch me!
- Let's go.
- Shaun! Shaun!
No, don't touch me! Don't touch me,
okay? Don't Don't touch me!
Don't touch me, okay? Don't touch me!
Okay.
No.
Okay.
Okay. Okay. Okay.
Hey. You know what?
No!
Shaun.
I'm here.
Shaun, can you
can you look at me?
Shaun?
Shaun?
Shaun?
Dr. Glassman, please.
Shaun?
Dr. Glassman, please,
we need you in there.
If they're placing a device,
they need Shaun, not me.
Shaun?
Shaun, please.
Look at me.
Shaun? Shaun?
Shaun?
Shaun.
It's a hell of a wedding day, Shaun.
I couldn't save you.
You were a kid.
You died because of me.
I was walking backwards
on top of a train.
You only left home because of me.
Shaun?
Shaun?
I gotta go.
Maybe we should show him the surgery?
You said they needed Shaun.
Video-call me from the inside
and we'll show him the problem.
Okay.
Maybe there's not
enough uninjured tissue.
It's not that.
SVT. Push adenosine.
Shaun?
Shaun, I'm gonna show you
the front and lateral views.
Can you see
why the device isn't seating?
Shaun?
Please focus.
You're right.
I left home
'cause I wanted to protect you.
My big brother who I loved.
Nothing could've changed that.
Nothing could've changed
where I was that day.
None of it is your fault.
You remember what I said to you
when I gave you the scalpel, right?
Never forget. You can do anything.
You can do this.
You can save your friend.
You just need to look.
Okay.
Shaun?
Shaun, can you see that?
I know what to do.
- We need more pressors.
- We're maxed out.
There's a second VSD.
We would have seen it.
Here.
We assumed it was
ventricular turbulence.
It's oblong.
Deploy a second device
and angle it posteriorly.
Loading device.
Angling.
It's holding.
Thank you, Shaun.
Code Silver, all clear.
Code Silver, all clear.
I love you, too.
Hi.
Hello. I have to wait
for Dr. Lim to wake up.
You should go home and sleep.
I'm not spending my wedding
night across town from you.
I'll take a nap
in the residents' lounge.
I saw Steve earlier.
Oh.
He told me it wasn't my fault he died.
Do you believe him?
I'm trying.
Tonight was very hard.
I would not have been able
to help Dr. Lim
if you hadn't shown me the surgery.
As much as I loved you before
I love you even more now.
I am so happy you are my wife.
Do you feel married now?
I think I do.
I thought I was gonna die today.
And I didn't think about that job.
I thought about you.
I just e-mailed New York Medical Center.
I turned them down.
You need to e-mail them back.
Tell them you made a mistake.
When you decided to take the job
you chose your career over us.
And, uh
I finally had to face it.
That's who you are.
And you're not gonna change.
But I did change.
Today.
For the moment.
Morning.
Welcome back.
I might need a couple personal days.
Okay, but don't go overboard.
The boss is right here.
Mm.
I'm having trouble with my legs.
Probably some post-surgical myopathy.
Push against my hands.
I am.
Try again.
You're paralyzed.
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