The Good Doctor (2017) s06e15 Episode Script
Old Friends
Stop looking at me.
Mm, pancakes. The Peanut is thrilled.
You are wearing the
maternity jeans I bought you.
Glad you're happy about that.
You're 28 weeks pregnant.
Your weight has increased 21.5 pounds,
and our baby is moving lower.
Hmm. At least there's pancakes.
We need to buy a minivan.
No, we don't.
The Striped Tomato
has no infant safety features.
Shaun, I just surrendered
to maternity jeans.
This is not the right time
for broaching the "Mom-mobile."
When would be the right time?
These are amazing.
- Did you use buttermilk?
- Greek yogurt.
Mm.
I will e-mail you my
spreadsheet of child-safe vehicles.
We can discuss it on your lunch break.
Sonja Baylor?
Wait. Who's the Code Gold?
Is it Taylor Swift?
Did her broken heart finally give out?
Better. Roland Barnes.
The green tech guy?
He was attacked by a tiger.
Sorry. In San Jose?
At his exotic animal rescue
in the Santa Cruz Mountains.
Concierge doctor called to say
they're on their way.
San Jose General is much closer.
- Why would he come here?
- Because of you.
Deep chest wall lacerations,
multiple rib fractures,
hemopneumothorax.
I stabilized him and placed a
chest tube, but he needs a CT, stat.
- Dr. Kalu.
- Dr. Andrews.
Good to see you, Dr. Murphy.
Oh, hello Jared.
A famous billionaire and a cute reunion?
This is almost Swift-worthy.
Is Leo a decent poker player?
Us Weekly has photos of Roland
coming out of his game last week.
Won my Lambo off him.
No sign of trauma
to the liver or spleen.
Ugh. Beyonce did a private show
at his birthday?
Ah. It was awesome.
No major intraperitoneal hematoma.
Moving on to the chest.
So, how does one go
from St. Bon's resident
to concierge doctor
for the fifth richest man in the world?
I was working at Denver Memorial
when I met Roland
at a fundraiser hosted by my parents.
His wife collapsed
during the silent auction.
Nutmeg allergy.
I gave her an epi and helped
her to outbid John Legend
for a weekend at an underwater hotel.
Well
Roland hired me that night.
Why does he need a personal physician?
Does he often get attacked
by wild animals?
Uh, chronic sciatica.
And he travels a lot, you know,
so there's vaccines,
plus BOTOX injections,
cholesterol scripts,
medical advice for friends and family.
Why'd you leave St. Bon's?
He was fired for assaulting an
attending who harassed Claire,
and then he sued the hospital.
- You're that guy.
- Yeah.
I hear Andrews is, uh,
not your biggest fan.
Surprised he let me in the building.
Depressed and dislocated sternum,
manubrium, and rib fractures.
They're too fragmented
for a standard sternal reconstruction.
- He still does this, huh?
- Mm.
Always makes my day.
I have an idea.
This is why I brought Roland here.
It's a girl.
We're naming her Esther.
We hope she'll be brave and selfless
like Queen Esther,
baddest bitch in the Bible.
How are the meds going?
Fine.
Any excessive discharge?
Oh, a couple of days ago,
I was on a walk,
and it was a little like
I'd peed myself.
Could that be from the MilliDox?
No, you're actually on the placebo.
Your amniotic fluid is a bit low.
We should admit you for further testing.
He asked for you.
Inoperable leiomyosarcoma
with major vascular involvement.
What are you doing here?
I'm dying.
My doctors say
that there's nothing they can do for me.
I'm hoping you can.
We should get a CT and a PET scan.
Fine.
We will completely rebuild
your sternum and anterior chest wall
with donor bones and titanium plates.
It is a very complicated surgery.
Jared says you're a damn good surgeon.
Yes, I am a damn good surgeon.
He is.
And I'll be overseeing your
care every step of the way.
Appreciate the personal attention.
I want Jared there, too.
Jared is my doctor.
Dr. Kalu will be read in
on every major decision.
I want him in the OR.
I will fast-track
your surgical privileges.
Something's going on between you two.
I'm very perceptive that way.
- It's a long story.
- Hmm.
I saw on his chart he's from Phoenix,
and he broke his arm a couple years ago
at a Tae Kwon Do match, your sport.
So, I'm gonna go with
he's your Johnny Lawrence
who cheated during your match
at the All Valley tournament.
I've been watching a lot of Cobra Kai.
He slept with my wife,
so yes to the cheating,
no to the tournament.
This is from six months ago.
This is from today.
A leiomyosarcoma should have
progressed more than that.
Yeah, maybe they had
the diagnosis wrong.
Release the pectoral
muscles from the attachment medially.
Should I place the low-profile plate?
Don't you need to create
a landing zone for the fixation?
He is right.
Get better exposure by elevating
the right pectoral muscle from the ribs.
I understand SF General's cardiac unit
is named after your boss
and that he sponsored a surgical
exchange program with Haiti.
Dr. Kalu, would you
like to place the screws?
Very much so.
Thank you, Dr. Andrews.
Drill guide, self-tapping screws.
Feels good.
You have been very polite to Dr. Kalu,
despite having fired him.
Is that only because you want
a donation from Roland?
- It's okay. You don't
- It's true.
Dr. Kalu and I did not part
on the best of terms,
but I'm happy you found your niche.
And I believe in the work we do here,
and Roland Barnes
can help us do even more.
I told Roland this was
the best hospital in the state.
When we get him healthy,
I'll be happy to tell him again.
BP's dropping. Cardiac output is awful.
He's in heart failure.
The cardiac contusion must
have been too small to spot on CT.
He needs a balloon pump
to help his heart circulate more blood.
And we need to get it in the
next five minutes, or he dies.
BP has stabilized.
Cardiac output is improving.
He should make a full recovery,
but he should not get so close
to jungle cats in the future.
In the In the OR,
I really missed that.
Then why did you stop being a surgeon?
Um, working for Roland
was too interesting
an opportunity to pass up.
Is sciatica interesting to you?
No, it's more, um
- I came as soon as I heard.
- Hey.
Poor Rolly.
Uh, Shaun, this is my girlfriend Dalia.
Hi.
You
I have seen you on the bus
in a-a perfume ad.
Fern test confirms
it's a premature rupture
of the membranes.
We should terminate
before an infection sets in.
What about in-patient expectant
management and antibiotics?
PPROM pregnancies
can be carried to term.
Rarely, and when they are,
babies are likely to have
cerebral palsy,
neurologic abnormalities,
intellectual disability
Which we'll tell the parents,
but this is a badly-wanted pregnancy.
They've been trying to conceive
for five years,
had two first-trimester
miscarriages already.
Saving the baby may be her priority.
But saving her is ours.
Sonja is our patient.
We should explain her options
but recommend termination.
Morgan is right,
but be clear about the options.
The seat springs allow the car seat
to move more than one inch,
which creates additional injury risk.
There are no over-shoulder seat
belts in the back for the car seat,
no crumple zone, and you
would have to install a roll cage,
which still would not be as
reliable as one built into the vehicle.
Since you hate minivans,
I have looked into hatchbacks and
SUVs with sufficient safety features.
It's not just about hating minivans.
- What is it about?
- I love this car.
It's my history.
My brother and I restored it,
used to drive it to shows
at The Fillmore.
You and I took it on our
first road trip. I can't sell it.
Then we do not have to.
As long as you never put
the Peanut in it.
We still need a family car.
Yeah, we do.
Roland's awake.
But it's possible that
we could save our baby?
You'd have to live here.
We'd monitor you every day
and give you prophylactic
antibiotics and steroids
when the baby gets closer to viability.
To be clear, even with all of that,
you may still develop
a serious uterine infection
that could require a hysterectomy
or cause fatal complications.
I think we should terminate.
What would you do
if it was your baby?
Termination is the safest.
I was talking to Dr. Allen.
I would
pray on it.
And then?
I want to know what you would do.
I think I
would try to save the baby.
We have to fight for our Esther.
We'd need a biopsy
before we can give you
any definitive answer.
Okay.
So, when do we do that?
I'll give you a detailed referral
to take to another doctor.
If I wanted to go to another doctor,
I would have.
I don't have to keep treating you.
But you will.
You're not a quitter.
You worked your ass off
to save your marriage.
You never tapped out in a fight. You
I always admired your persistence.
I kinda hated it, too.
Looking back at my life
I don't like the view.
I hurt a lot of people.
That's the real reason that I came here.
For forgiveness.
The intra-aortic balloon pump worked.
You won't need a new heart.
Great.
So, when can I get out of here?
Oh, not for a few days.
We will need to monitor you
for post-surgical complications.
Your heart rate is elevated.
Have you been exerting yourself?
She did most of the exerting.
Okay.
I need 1,000 milligrams levetiracetam
and 4 milligrams lorazepam, stat!
Is Rolly gonna be okay?
Roland had a seizure.
You should sit down.
Dalia was there.
Naked.
They were having sex.
Dalia and I aren't together.
She's with Roland.
It's part of the gig.
I pretend she's with me so Roland's wife
doesn't get suspicious
that Dalia's always around.
Oh.
You think that sex
brought on the seizure?
Oh. Arousal can increase
the heart rate by 38%,
and if his brain
was also deprived of oxygen,
it could cause a seizure,
which would mean his heart
is still not pumping enough blood.
Does it bother you to have
to lie on a regular basis?
It's not my favorite responsibility,
but it's a great job, so
Why is it a great job?
On my last day, Shaun, you told
me that one day I will be very happy.
But I was miserable.
I felt like a failure.
And then I met Roland,
and he saw something in me,
this guy that I really admired,
that the world admired.
You know, he he valued me.
And I certainly don't mind
flying private to Amsterdam
to have rijsttafel with
the Queen of the Netherlands.
I also said you would
fulfill your potential.
And I'm not doing that?
No.
Sciatica?
Thanks for reminding me
I'm still a failure.
I'll get the BNP test and echo
and check out his heart.
Inject saline
to get us to submucosal plane.
Why'd you stay on the case?
There's the tumor.
He was right.
I take my obligations seriously.
Take four samples.
Not because some part of you
wants to forgive him?
Withdraw the scope slowly.
He doesn't deserve it.
Let's start with a sofa.
Let's take a look.
Finally, somebody recognizes
my interior design genius.
Looks nice.
Hey, I love this. I'll take it.
No.
This is literally
the first thing you've sat on.
Okay, I'll sit in ten other ones,
and then I'll take this one.
No. If you know you like something,
stick with it.
Like my car.
Shaun wants to buy a minivan.
And what, you want to put
your infant in a '75 Gran Torino?
No. It's not safe for a baby.
But
it is
cool.
Even when I am going
to my super grown-up job
in my lady-boss pantsuit,
I get to get out of that car,
and I'm cool.
And soon, I will be
just another 30-something mom
in a practical car
with a baby seat in the back
and spit-up on my shirt.
Maddie's mom used to warn me
to take two shirts
whenever I went out with the baby.
- I had to learn the hard way.
- How?
H-How do I want this baby so badly,
but feel so icked out by being a mom?
Define "icked out."
Like
mnh.
I don't know.
Okay, that's well said.
I don't know.
Hey, you got mixed emotions.
Welcome to the human condition.
I'm gonna take this one.
Her fever's hiked.
She's in a lot of pain.
Her heart rate's 117. Fetal heart
rate 180. They're both tachycardic.
500 milligrams acetaminophen
and start ampicillin.
This is the infection
we were worried about.
Your baby is very unlikely to survive,
and your life is in danger.
We need to terminate now.
But her heart's still beating.
Esther can only stay alive in utero,
and as long as she's in there,
you'll keep getting sicker.
I'm so sorry.
I'm here. We can get through this.
We can try again.
No.
Your baby needs at least
two more weeks to be viable,
and if we wait that long,
you will probably die.
"If I perish, I perish."
That's what Queen Esther said
before she risked her life
to save her family.
Sonja.
"If I perish
I perish."
According to your BNP test and echo,
your seizure was not related
to heart trauma.
The EEG will let us assess your brain.
So, what's your pitch?
Hospital presidents
don't supervise EEGs.
I've been very impressed
by your Global Engineers Initiative,
and I think we can do
the same thing with medicine,
train doctors from the developing world
to take care of their own people.
What makes St. Bon's the place to do it?
We're very hands-on here.
Our residents don't just
do appies and lap choles.
With the guidance of our attendings,
they come up with
complex treatment solutions,
untangle the thorniest ethical dilemmas,
and learn how to provide
top-notch patient care.
If we could sponsor more residents
from the developing world,
we'll send them home ready
to serve their communities.
But Jared, who I trust with my life,
wasn't good enough to be
one of those residents.
You fired him.
You saw something in him I missed.
- Mm.
- But I'm seeing it now,
and I've granted him full access.
That's a very politic answer.
What do you think, Jared?
Has he earned my money?
I learned a tremendous amount
here at St. Bon's,
and as you've experienced,
the care is top-notch.
Mm, unfortunately, the food isn't.
Oh, text Dalia and ask her to
bring us back some of those, um,
pork buns from Yank Sing. Ohh.
Dalia went into the city?
Mm-hmm, to meet up with friends.
And you're okay with that?
Why wouldn't I be?
No reason.
Uh, all right.
Let's start this.
Close your eyes and relax.
Labs confirm Sonja has chorioamnionitis.
We should add gentamicin.
That would damage the baby's kidneys.
It's our only way to keep Sonja alive,
and it buys us time
to convince her to terminate.
She's being suicidal.
Risking your life for your child
is usually considered admirable.
Not if you're both going to die
because of the false hope you gave her.
I answered a patient's question.
You gave her permission.
We're supposed to at least
try to be objective.
Objectivity is a myth,
especially on this subject.
I know the pain Sonja's grappling with.
So do I.
I was in med school, on birth control,
and I got pregnant anyway.
I wasn't ready for a kid.
I was scared
and sad
and relieved.
It was medical procedure
I had years ago,
and I'm at peace with it now.
Most women are.
Because it was their choice.
A choice you got to make,
and I did, too.
Let Sonja make hers.
It's not our job
to help patients choose death.
Her lungs are failing.
- Her O2 sets are falling.
- Fever's climbing.
Intubation cart.
Administer propofol and rocuronium.
Hey, we need to sedate you
so we can intubate.
That'll keep you breathing,
but the only way to
No. You can't kill her.
Esther's life before mine.
- Sonja, please.
- Promise me.
- I can't.
- Promise me.
Anthony.
I p
I promise.
I love you.
Shaun, check out the activity
in the left frontal lobe
from Roland's EEG.
Interictal spikes.
They are very small, likely incidental.
Hmm.
Roland's selfish and possessive.
He hates it when people
have fun without him,
but today he was totally fine with Dalia
hanging out with friends
while he's stuck here.
Being unselfish is a symptom.
Maybe one of his wounds got infected.
Bacterial encephalitis
from the claws or teeth.
This could be subtle edema.
Plus behavioral changes
and interictal spikes.
That sounds like neurocysticercosis.
- A tapeworm cyst.
- With larva in the brain.
But it would take a tapeworm weeks
to fully form larva
and a cyst in his brain.
The attack was two days ago.
Ooh.
Roland's last local safari
was about two months ago,
and he fell into
a giant pile of tiger crap.
We can remove the cyst and larva
with stereotactic navigation
and hydrodissection.
- Awesome.
- Oh!
You're not a failure.
Seriously? Four guesses?
I got it in two.
What's up with you?
You lose a patient?
Actually, I might save one.
Joe.
Mia's Joe?
Waiting on his biopsy results.
He asked me to forgive him.
What did you say?
I refused.
You would have, too.
Hmm, well, maybe.
Then again, I am capable
of letting things go.
I can let things go.
I prioritized my career for a day,
which you decided was unacceptable,
even after I changed my mind.
And how long did it take you
to forgive Mia?
Dr. Park.
Your diagnosis is in.
Right this way, guys.
Be careful. You've got history
you're carrying right there.
There's a couple of steps. Be careful.
Thanks, guys. First door on the right.
Stadium seats?
Authentic Candlestick Park
stadium seats.
Got them from a broker.
- Very cool.
- Right?
- Thank you for the inspiration.
- You're welcome.
Your turn next. Get your coat.
You have a stromal tumor in your stomach
and a small lesion on your liver.
And we can remove both.
You'll be cancer-free.
Hmm.
T-That's incredible.
Thank you.
You get it, right?
You're not dying.
Yes.
This is amazing.
I'm so grateful.
- But it
- That's not why you came here.
Sonja will likely
be in multi-organ failure
within the next 48 hours.
And when that happens,
Esther will not survive.
But if we terminate now,
Sonja still can.
You can save your wife's life.
It's all up to you.
He says
He says he can't do it.
He needs to keep his promise.
I know what to do.
- Sorry, man.
- Bring it.
You okay?
A worm laid eggs in my skull?
Larva.
You were right. Murphy's the best.
What would you say to $100 million?
I'd say that's remarkably
generous, uh, but
You can't accept it.
You are not medically fit to be
making any major decisions
because of the larva.
I closed a huge deal last week
with Mr. Worm as my consigliere.
I feel pretty competent.
Well, I'd be happy to accept
your money after the surgery.
Sonja, it's okay.
I turned off your sedation.
I need to talk to you.
I'm gonna let go of your hands,
but you can't pull out the tube.
When I was 18,
I had an abortion.
That child would have been 11 now,
just starting middle school.
Every time I see a kid that age,
I think about who they would have become
or what kind of mom I would have been.
I believe God's forgiven me.
That's kinda His thing.
And I believe God picked you
for motherhood.
You are so strong,
so brave,
with such a deep capacity for love.
But your Esther isn't developed enough
to survive outside of the womb.
The infection will kill both of you.
I told you if I were you,
I would try to save the baby.
I prayed for a miracle.
And I don't know
why it didn't come today.
The only way for you to be
the mom God wants you to be
is to let Esther go.
Please sign this consent form.
Yes.
Speculum.
If your soul
has not yet left your body
I baptize you, Esther.
Cervix is sufficiently dilated.
In the name of the Father
and of the Son
and of the Holy Spirit.
Amen.
- Amen. Amen.
- Amen.
- Amen.
- Amen.
the margins were clean.
We were able to get all the tumors.
No additional metastasis.
Your prognosis is excellent.
Thank you.
I forgive you.
Thank you.
Extracting the cyst
and larva.
Awesome.
- And I might hurl.
- Let's close.
Can Dr. Kalu do the closing?
Be my guest.
4-0 NUROLON.
You said you missed being a surgeon.
If you complete your residency here,
you can do more than closing.
I doubt he wants to go
from five-star restaurants
to hospital vending machines.
Actually someone, um,
helped me realize
that I'd love a second chance here.
The Chief of Surgery's responsible
for all hiring decisions
in her department.
I've, uh I've learned
a lot about myself,
how to better communicate,
how to manage challenging personalities.
Hmm.
I hear Roland can be a handful.
Prepared me for tough patients
and tougher attendings.
And my surgical skills are still sharp.
Andrews actually
let me do Roland's closing.
I'm impressed.
Murphy really wants you on his team.
That carries weight.
But I don't have any openings
for third-year residents.
I understand.
But I do have a slot for a first-year.
I-I'm so sorry for your loss.
So our Esther will always be with me.
Someday,
maybe we can tell her
brothers and sisters all about her.
Oh.
Aw yee
This car is perfect for the Peanut.
- And pretty cool, too.
- Aw yee
Oh, let's take this
rocket ship for a ride.
Oh, man.
Aw yee
Dr. Andrews.
Here's your check.
And this is what happens
when you poach my employees.
This is so good,
especially after a day like today.
- To our differences.
- Mm.
Mm. If you'll excuse me.
Time to exercise
my reproductive freedom.
I'm doing my third round of IVF.
You're gonna go jab yourself in the
belly alone
in the hospital bathroom?
Gimme.
- I am a doctor.
- Mm.
Have at it.
To reuniting with old friends.
And a mommy mocktail
with fresh rosemary.
Yum.
Love having bougie Kalu back.
To Jared
Mm.
fulfilling his potential
as my new first-year resident.
Oh, it's probably Glassy.
You Dr. Shaun Murphy?
Yes.
I am an attending surgeon
at San Jose St. Bonaventure Hospital.
You've just been served.
You're being sued for malpractice.
It wasn't Dr. Glassman.
Mm, pancakes. The Peanut is thrilled.
You are wearing the
maternity jeans I bought you.
Glad you're happy about that.
You're 28 weeks pregnant.
Your weight has increased 21.5 pounds,
and our baby is moving lower.
Hmm. At least there's pancakes.
We need to buy a minivan.
No, we don't.
The Striped Tomato
has no infant safety features.
Shaun, I just surrendered
to maternity jeans.
This is not the right time
for broaching the "Mom-mobile."
When would be the right time?
These are amazing.
- Did you use buttermilk?
- Greek yogurt.
Mm.
I will e-mail you my
spreadsheet of child-safe vehicles.
We can discuss it on your lunch break.
Sonja Baylor?
Wait. Who's the Code Gold?
Is it Taylor Swift?
Did her broken heart finally give out?
Better. Roland Barnes.
The green tech guy?
He was attacked by a tiger.
Sorry. In San Jose?
At his exotic animal rescue
in the Santa Cruz Mountains.
Concierge doctor called to say
they're on their way.
San Jose General is much closer.
- Why would he come here?
- Because of you.
Deep chest wall lacerations,
multiple rib fractures,
hemopneumothorax.
I stabilized him and placed a
chest tube, but he needs a CT, stat.
- Dr. Kalu.
- Dr. Andrews.
Good to see you, Dr. Murphy.
Oh, hello Jared.
A famous billionaire and a cute reunion?
This is almost Swift-worthy.
Is Leo a decent poker player?
Us Weekly has photos of Roland
coming out of his game last week.
Won my Lambo off him.
No sign of trauma
to the liver or spleen.
Ugh. Beyonce did a private show
at his birthday?
Ah. It was awesome.
No major intraperitoneal hematoma.
Moving on to the chest.
So, how does one go
from St. Bon's resident
to concierge doctor
for the fifth richest man in the world?
I was working at Denver Memorial
when I met Roland
at a fundraiser hosted by my parents.
His wife collapsed
during the silent auction.
Nutmeg allergy.
I gave her an epi and helped
her to outbid John Legend
for a weekend at an underwater hotel.
Well
Roland hired me that night.
Why does he need a personal physician?
Does he often get attacked
by wild animals?
Uh, chronic sciatica.
And he travels a lot, you know,
so there's vaccines,
plus BOTOX injections,
cholesterol scripts,
medical advice for friends and family.
Why'd you leave St. Bon's?
He was fired for assaulting an
attending who harassed Claire,
and then he sued the hospital.
- You're that guy.
- Yeah.
I hear Andrews is, uh,
not your biggest fan.
Surprised he let me in the building.
Depressed and dislocated sternum,
manubrium, and rib fractures.
They're too fragmented
for a standard sternal reconstruction.
- He still does this, huh?
- Mm.
Always makes my day.
I have an idea.
This is why I brought Roland here.
It's a girl.
We're naming her Esther.
We hope she'll be brave and selfless
like Queen Esther,
baddest bitch in the Bible.
How are the meds going?
Fine.
Any excessive discharge?
Oh, a couple of days ago,
I was on a walk,
and it was a little like
I'd peed myself.
Could that be from the MilliDox?
No, you're actually on the placebo.
Your amniotic fluid is a bit low.
We should admit you for further testing.
He asked for you.
Inoperable leiomyosarcoma
with major vascular involvement.
What are you doing here?
I'm dying.
My doctors say
that there's nothing they can do for me.
I'm hoping you can.
We should get a CT and a PET scan.
Fine.
We will completely rebuild
your sternum and anterior chest wall
with donor bones and titanium plates.
It is a very complicated surgery.
Jared says you're a damn good surgeon.
Yes, I am a damn good surgeon.
He is.
And I'll be overseeing your
care every step of the way.
Appreciate the personal attention.
I want Jared there, too.
Jared is my doctor.
Dr. Kalu will be read in
on every major decision.
I want him in the OR.
I will fast-track
your surgical privileges.
Something's going on between you two.
I'm very perceptive that way.
- It's a long story.
- Hmm.
I saw on his chart he's from Phoenix,
and he broke his arm a couple years ago
at a Tae Kwon Do match, your sport.
So, I'm gonna go with
he's your Johnny Lawrence
who cheated during your match
at the All Valley tournament.
I've been watching a lot of Cobra Kai.
He slept with my wife,
so yes to the cheating,
no to the tournament.
This is from six months ago.
This is from today.
A leiomyosarcoma should have
progressed more than that.
Yeah, maybe they had
the diagnosis wrong.
Release the pectoral
muscles from the attachment medially.
Should I place the low-profile plate?
Don't you need to create
a landing zone for the fixation?
He is right.
Get better exposure by elevating
the right pectoral muscle from the ribs.
I understand SF General's cardiac unit
is named after your boss
and that he sponsored a surgical
exchange program with Haiti.
Dr. Kalu, would you
like to place the screws?
Very much so.
Thank you, Dr. Andrews.
Drill guide, self-tapping screws.
Feels good.
You have been very polite to Dr. Kalu,
despite having fired him.
Is that only because you want
a donation from Roland?
- It's okay. You don't
- It's true.
Dr. Kalu and I did not part
on the best of terms,
but I'm happy you found your niche.
And I believe in the work we do here,
and Roland Barnes
can help us do even more.
I told Roland this was
the best hospital in the state.
When we get him healthy,
I'll be happy to tell him again.
BP's dropping. Cardiac output is awful.
He's in heart failure.
The cardiac contusion must
have been too small to spot on CT.
He needs a balloon pump
to help his heart circulate more blood.
And we need to get it in the
next five minutes, or he dies.
BP has stabilized.
Cardiac output is improving.
He should make a full recovery,
but he should not get so close
to jungle cats in the future.
In the In the OR,
I really missed that.
Then why did you stop being a surgeon?
Um, working for Roland
was too interesting
an opportunity to pass up.
Is sciatica interesting to you?
No, it's more, um
- I came as soon as I heard.
- Hey.
Poor Rolly.
Uh, Shaun, this is my girlfriend Dalia.
Hi.
You
I have seen you on the bus
in a-a perfume ad.
Fern test confirms
it's a premature rupture
of the membranes.
We should terminate
before an infection sets in.
What about in-patient expectant
management and antibiotics?
PPROM pregnancies
can be carried to term.
Rarely, and when they are,
babies are likely to have
cerebral palsy,
neurologic abnormalities,
intellectual disability
Which we'll tell the parents,
but this is a badly-wanted pregnancy.
They've been trying to conceive
for five years,
had two first-trimester
miscarriages already.
Saving the baby may be her priority.
But saving her is ours.
Sonja is our patient.
We should explain her options
but recommend termination.
Morgan is right,
but be clear about the options.
The seat springs allow the car seat
to move more than one inch,
which creates additional injury risk.
There are no over-shoulder seat
belts in the back for the car seat,
no crumple zone, and you
would have to install a roll cage,
which still would not be as
reliable as one built into the vehicle.
Since you hate minivans,
I have looked into hatchbacks and
SUVs with sufficient safety features.
It's not just about hating minivans.
- What is it about?
- I love this car.
It's my history.
My brother and I restored it,
used to drive it to shows
at The Fillmore.
You and I took it on our
first road trip. I can't sell it.
Then we do not have to.
As long as you never put
the Peanut in it.
We still need a family car.
Yeah, we do.
Roland's awake.
But it's possible that
we could save our baby?
You'd have to live here.
We'd monitor you every day
and give you prophylactic
antibiotics and steroids
when the baby gets closer to viability.
To be clear, even with all of that,
you may still develop
a serious uterine infection
that could require a hysterectomy
or cause fatal complications.
I think we should terminate.
What would you do
if it was your baby?
Termination is the safest.
I was talking to Dr. Allen.
I would
pray on it.
And then?
I want to know what you would do.
I think I
would try to save the baby.
We have to fight for our Esther.
We'd need a biopsy
before we can give you
any definitive answer.
Okay.
So, when do we do that?
I'll give you a detailed referral
to take to another doctor.
If I wanted to go to another doctor,
I would have.
I don't have to keep treating you.
But you will.
You're not a quitter.
You worked your ass off
to save your marriage.
You never tapped out in a fight. You
I always admired your persistence.
I kinda hated it, too.
Looking back at my life
I don't like the view.
I hurt a lot of people.
That's the real reason that I came here.
For forgiveness.
The intra-aortic balloon pump worked.
You won't need a new heart.
Great.
So, when can I get out of here?
Oh, not for a few days.
We will need to monitor you
for post-surgical complications.
Your heart rate is elevated.
Have you been exerting yourself?
She did most of the exerting.
Okay.
I need 1,000 milligrams levetiracetam
and 4 milligrams lorazepam, stat!
Is Rolly gonna be okay?
Roland had a seizure.
You should sit down.
Dalia was there.
Naked.
They were having sex.
Dalia and I aren't together.
She's with Roland.
It's part of the gig.
I pretend she's with me so Roland's wife
doesn't get suspicious
that Dalia's always around.
Oh.
You think that sex
brought on the seizure?
Oh. Arousal can increase
the heart rate by 38%,
and if his brain
was also deprived of oxygen,
it could cause a seizure,
which would mean his heart
is still not pumping enough blood.
Does it bother you to have
to lie on a regular basis?
It's not my favorite responsibility,
but it's a great job, so
Why is it a great job?
On my last day, Shaun, you told
me that one day I will be very happy.
But I was miserable.
I felt like a failure.
And then I met Roland,
and he saw something in me,
this guy that I really admired,
that the world admired.
You know, he he valued me.
And I certainly don't mind
flying private to Amsterdam
to have rijsttafel with
the Queen of the Netherlands.
I also said you would
fulfill your potential.
And I'm not doing that?
No.
Sciatica?
Thanks for reminding me
I'm still a failure.
I'll get the BNP test and echo
and check out his heart.
Inject saline
to get us to submucosal plane.
Why'd you stay on the case?
There's the tumor.
He was right.
I take my obligations seriously.
Take four samples.
Not because some part of you
wants to forgive him?
Withdraw the scope slowly.
He doesn't deserve it.
Let's start with a sofa.
Let's take a look.
Finally, somebody recognizes
my interior design genius.
Looks nice.
Hey, I love this. I'll take it.
No.
This is literally
the first thing you've sat on.
Okay, I'll sit in ten other ones,
and then I'll take this one.
No. If you know you like something,
stick with it.
Like my car.
Shaun wants to buy a minivan.
And what, you want to put
your infant in a '75 Gran Torino?
No. It's not safe for a baby.
But
it is
cool.
Even when I am going
to my super grown-up job
in my lady-boss pantsuit,
I get to get out of that car,
and I'm cool.
And soon, I will be
just another 30-something mom
in a practical car
with a baby seat in the back
and spit-up on my shirt.
Maddie's mom used to warn me
to take two shirts
whenever I went out with the baby.
- I had to learn the hard way.
- How?
H-How do I want this baby so badly,
but feel so icked out by being a mom?
Define "icked out."
Like
mnh.
I don't know.
Okay, that's well said.
I don't know.
Hey, you got mixed emotions.
Welcome to the human condition.
I'm gonna take this one.
Her fever's hiked.
She's in a lot of pain.
Her heart rate's 117. Fetal heart
rate 180. They're both tachycardic.
500 milligrams acetaminophen
and start ampicillin.
This is the infection
we were worried about.
Your baby is very unlikely to survive,
and your life is in danger.
We need to terminate now.
But her heart's still beating.
Esther can only stay alive in utero,
and as long as she's in there,
you'll keep getting sicker.
I'm so sorry.
I'm here. We can get through this.
We can try again.
No.
Your baby needs at least
two more weeks to be viable,
and if we wait that long,
you will probably die.
"If I perish, I perish."
That's what Queen Esther said
before she risked her life
to save her family.
Sonja.
"If I perish
I perish."
According to your BNP test and echo,
your seizure was not related
to heart trauma.
The EEG will let us assess your brain.
So, what's your pitch?
Hospital presidents
don't supervise EEGs.
I've been very impressed
by your Global Engineers Initiative,
and I think we can do
the same thing with medicine,
train doctors from the developing world
to take care of their own people.
What makes St. Bon's the place to do it?
We're very hands-on here.
Our residents don't just
do appies and lap choles.
With the guidance of our attendings,
they come up with
complex treatment solutions,
untangle the thorniest ethical dilemmas,
and learn how to provide
top-notch patient care.
If we could sponsor more residents
from the developing world,
we'll send them home ready
to serve their communities.
But Jared, who I trust with my life,
wasn't good enough to be
one of those residents.
You fired him.
You saw something in him I missed.
- Mm.
- But I'm seeing it now,
and I've granted him full access.
That's a very politic answer.
What do you think, Jared?
Has he earned my money?
I learned a tremendous amount
here at St. Bon's,
and as you've experienced,
the care is top-notch.
Mm, unfortunately, the food isn't.
Oh, text Dalia and ask her to
bring us back some of those, um,
pork buns from Yank Sing. Ohh.
Dalia went into the city?
Mm-hmm, to meet up with friends.
And you're okay with that?
Why wouldn't I be?
No reason.
Uh, all right.
Let's start this.
Close your eyes and relax.
Labs confirm Sonja has chorioamnionitis.
We should add gentamicin.
That would damage the baby's kidneys.
It's our only way to keep Sonja alive,
and it buys us time
to convince her to terminate.
She's being suicidal.
Risking your life for your child
is usually considered admirable.
Not if you're both going to die
because of the false hope you gave her.
I answered a patient's question.
You gave her permission.
We're supposed to at least
try to be objective.
Objectivity is a myth,
especially on this subject.
I know the pain Sonja's grappling with.
So do I.
I was in med school, on birth control,
and I got pregnant anyway.
I wasn't ready for a kid.
I was scared
and sad
and relieved.
It was medical procedure
I had years ago,
and I'm at peace with it now.
Most women are.
Because it was their choice.
A choice you got to make,
and I did, too.
Let Sonja make hers.
It's not our job
to help patients choose death.
Her lungs are failing.
- Her O2 sets are falling.
- Fever's climbing.
Intubation cart.
Administer propofol and rocuronium.
Hey, we need to sedate you
so we can intubate.
That'll keep you breathing,
but the only way to
No. You can't kill her.
Esther's life before mine.
- Sonja, please.
- Promise me.
- I can't.
- Promise me.
Anthony.
I p
I promise.
I love you.
Shaun, check out the activity
in the left frontal lobe
from Roland's EEG.
Interictal spikes.
They are very small, likely incidental.
Hmm.
Roland's selfish and possessive.
He hates it when people
have fun without him,
but today he was totally fine with Dalia
hanging out with friends
while he's stuck here.
Being unselfish is a symptom.
Maybe one of his wounds got infected.
Bacterial encephalitis
from the claws or teeth.
This could be subtle edema.
Plus behavioral changes
and interictal spikes.
That sounds like neurocysticercosis.
- A tapeworm cyst.
- With larva in the brain.
But it would take a tapeworm weeks
to fully form larva
and a cyst in his brain.
The attack was two days ago.
Ooh.
Roland's last local safari
was about two months ago,
and he fell into
a giant pile of tiger crap.
We can remove the cyst and larva
with stereotactic navigation
and hydrodissection.
- Awesome.
- Oh!
You're not a failure.
Seriously? Four guesses?
I got it in two.
What's up with you?
You lose a patient?
Actually, I might save one.
Joe.
Mia's Joe?
Waiting on his biopsy results.
He asked me to forgive him.
What did you say?
I refused.
You would have, too.
Hmm, well, maybe.
Then again, I am capable
of letting things go.
I can let things go.
I prioritized my career for a day,
which you decided was unacceptable,
even after I changed my mind.
And how long did it take you
to forgive Mia?
Dr. Park.
Your diagnosis is in.
Right this way, guys.
Be careful. You've got history
you're carrying right there.
There's a couple of steps. Be careful.
Thanks, guys. First door on the right.
Stadium seats?
Authentic Candlestick Park
stadium seats.
Got them from a broker.
- Very cool.
- Right?
- Thank you for the inspiration.
- You're welcome.
Your turn next. Get your coat.
You have a stromal tumor in your stomach
and a small lesion on your liver.
And we can remove both.
You'll be cancer-free.
Hmm.
T-That's incredible.
Thank you.
You get it, right?
You're not dying.
Yes.
This is amazing.
I'm so grateful.
- But it
- That's not why you came here.
Sonja will likely
be in multi-organ failure
within the next 48 hours.
And when that happens,
Esther will not survive.
But if we terminate now,
Sonja still can.
You can save your wife's life.
It's all up to you.
He says
He says he can't do it.
He needs to keep his promise.
I know what to do.
- Sorry, man.
- Bring it.
You okay?
A worm laid eggs in my skull?
Larva.
You were right. Murphy's the best.
What would you say to $100 million?
I'd say that's remarkably
generous, uh, but
You can't accept it.
You are not medically fit to be
making any major decisions
because of the larva.
I closed a huge deal last week
with Mr. Worm as my consigliere.
I feel pretty competent.
Well, I'd be happy to accept
your money after the surgery.
Sonja, it's okay.
I turned off your sedation.
I need to talk to you.
I'm gonna let go of your hands,
but you can't pull out the tube.
When I was 18,
I had an abortion.
That child would have been 11 now,
just starting middle school.
Every time I see a kid that age,
I think about who they would have become
or what kind of mom I would have been.
I believe God's forgiven me.
That's kinda His thing.
And I believe God picked you
for motherhood.
You are so strong,
so brave,
with such a deep capacity for love.
But your Esther isn't developed enough
to survive outside of the womb.
The infection will kill both of you.
I told you if I were you,
I would try to save the baby.
I prayed for a miracle.
And I don't know
why it didn't come today.
The only way for you to be
the mom God wants you to be
is to let Esther go.
Please sign this consent form.
Yes.
Speculum.
If your soul
has not yet left your body
I baptize you, Esther.
Cervix is sufficiently dilated.
In the name of the Father
and of the Son
and of the Holy Spirit.
Amen.
- Amen. Amen.
- Amen.
- Amen.
- Amen.
the margins were clean.
We were able to get all the tumors.
No additional metastasis.
Your prognosis is excellent.
Thank you.
I forgive you.
Thank you.
Extracting the cyst
and larva.
Awesome.
- And I might hurl.
- Let's close.
Can Dr. Kalu do the closing?
Be my guest.
4-0 NUROLON.
You said you missed being a surgeon.
If you complete your residency here,
you can do more than closing.
I doubt he wants to go
from five-star restaurants
to hospital vending machines.
Actually someone, um,
helped me realize
that I'd love a second chance here.
The Chief of Surgery's responsible
for all hiring decisions
in her department.
I've, uh I've learned
a lot about myself,
how to better communicate,
how to manage challenging personalities.
Hmm.
I hear Roland can be a handful.
Prepared me for tough patients
and tougher attendings.
And my surgical skills are still sharp.
Andrews actually
let me do Roland's closing.
I'm impressed.
Murphy really wants you on his team.
That carries weight.
But I don't have any openings
for third-year residents.
I understand.
But I do have a slot for a first-year.
I-I'm so sorry for your loss.
So our Esther will always be with me.
Someday,
maybe we can tell her
brothers and sisters all about her.
Oh.
Aw yee
This car is perfect for the Peanut.
- And pretty cool, too.
- Aw yee
Oh, let's take this
rocket ship for a ride.
Oh, man.
Aw yee
Dr. Andrews.
Here's your check.
And this is what happens
when you poach my employees.
This is so good,
especially after a day like today.
- To our differences.
- Mm.
Mm. If you'll excuse me.
Time to exercise
my reproductive freedom.
I'm doing my third round of IVF.
You're gonna go jab yourself in the
belly alone
in the hospital bathroom?
Gimme.
- I am a doctor.
- Mm.
Have at it.
To reuniting with old friends.
And a mommy mocktail
with fresh rosemary.
Yum.
Love having bougie Kalu back.
To Jared
Mm.
fulfilling his potential
as my new first-year resident.
Oh, it's probably Glassy.
You Dr. Shaun Murphy?
Yes.
I am an attending surgeon
at San Jose St. Bonaventure Hospital.
You've just been served.
You're being sued for malpractice.
It wasn't Dr. Glassman.