The Good Doctor (2017) s06e21 Episode Script

1
Previously on The Good Doctor
Dalisay!
I know I didn't show you enough respect,
and I didn't make enough effort to
see things from your point of view,
but I want to change.
How about dinner?
You pick me up at 7:30, Saturday.
We can try that Filipino place.
I think maybe you and I
could be gifts to each other.
And we should be open to that.
I have no idea what it looks
like for us to move forward.
We'll figure it out.
It's a perfect practice run
for when your own comes along.
I'm going off my IVF meds.
I'm not doing another cycle.
Eden, she's what I've been waiting for.
She's my daughter.
I thought it was Dr. Glassman's
cancer returning,
but it is damage to Dr. Glassman's
brain as a result of a mini-stroke.
It is permanent.
He shouldn't be doing surgery anymore.
Ah.
Two weeks to Peanut Day!
Yes.
So you're making lasagna for breakfast?
It's going in the freezer.
I've packed my hospital bag,
written my Birth Plan,
and soon all I'll have on my list
is to do my nails and relax.
73% of births happen
before the due date,
so you need to start
relaxing immediately.
'Cause if there's one thing
you can cram, it's relaxation.
Yes.
Have you heard anything from Glassy?
Hmm. Oh. No.
He might be mad when he finds out
you went to Lim with his brain scans.
It was very important for his future,
both medically and professionally.
Well, it's not just the information.
It's the whole behind-his-back thing.
He wouldn't listen to me,
so I had no choice.
I think you did the right thing, but
just talk to him?
- Okay.
- Yeah.
I've had a stroke.
Yes. A small one.
- I should probably give you some time.
- Yeah, you should.
He, uh, hit the brakes
instead of the gas
and thumped his head
on the steering wheel.
I'm a shoo-in for the Dumbest
Patient of the Day.
Oh, it's too early to hand that out.
You want to hear about a dumb patient?
Doctor says to her
he's waiting for her X-ray.
She says, "Well, that's weird.
I never dated anybody named Ray."
A little too early for that, too.
The laceration's superficial.
Couple stitches, and you're good to go.
- Yay!
- You sure?
He hit his head pretty hard.
Maybe you should run some tests?
There's no sign of fracture,
closed head injury, or brain bleed.
Dr. Murphy?
It's not about the accident.
He's been behaving very
strangely for the last six months.
Oh. He's alert, responsive,
engaging socially
Which is nothing like him.
His whole life, he's been terrible.
Constantly fired,
been through four divorces,
estranged from all of his kids,
except me.
He was always just a dick.
Then he changed.
Now he's telling dad jokes,
asks about my day.
He gave me a birthday present.
He is a different person.
This does not sound to me
like a medical issue.
But I will order a brain MRI
because it would be
very interesting if it were!
Are you mad at me, for going to Dr. Lim
with your brain scan?
Yeah, a little bit.
But maybe you saved my life, so
I didn't think you were,
but Lea said you might be,
so we were both right.
What are you going to do?
About your job?
I don't know, Shaun.
I just found out I had a stroke.
I-I'm still reeling a little bit.
Maybe when I decide,
I'll let you know.
Okay.
I hear it beating!
Wow. Dr. Wolke has a heart?
I wasn't sure myself, to be honest.
I have one, too.
Now, that, we all knew.
Hey, Nico.
The doctors are gonna take Olivia
to get some ice cream
and you to get some tests.
Followed, of course, by some ice cream.
- Thanks, Dr. Marcus.
- Yeah.
Get some ice cream.
Nico's sarcoma has invaded
his thigh and hip, here and here.
But luckily, there's
no signs of metastasis,
which means we can debulk the tumor.
How much time would that give him?
Nine months, maybe even a year.
We could take him to Salzburg.
With Nico's illness
and all his surgeries,
he's never really had a great Christmas.
He found this photo of the
Salzburg Christmas Market in Austria.
He talks about it all the time.
This surgery could just get us there.
Not "just."
Th-There's always medical advances.
We have to be realistic, Seb.
And you have to keep
a positive attitude.
This is good news.
Some final pre-op testing,
and Nico can have his surgery tomorrow.
Come on. Be reasonable, please.
You've been fed, changed, swaddled.
I have walked. I have rocked.
I have bounced.
I've worn you on my front,
on my back, on my hip.
Shh.
Please, Eden. You have to go to sleep.
Shh.
Be reasonable, please. Shh.
Okay, okay, okay, okay.
So you gonna tell me or not?
- Hmm?
- Where are we going tomorrow?
Oh, it's a surprise.
Hmm.
As in, you have no idea.
It's been harder than I thought.
All right? A movie's too predictable,
an escape room is too dorky,
and, well, dinner at my place is out.
I'll pick something.
No, see, I don't want you
to deal with this.
It's supposed to be fun, Danny,
which it will be,
once we get over this first hump.
So let me do it, okay?
And, yes, I said "hump,"
which I regret saying
for multiple reasons.
His daughter was right.
I will take ace inhibitors,
aspirin, statins
to help reduce the likelihood
of future stroke
to near absolute zero.
I will reduce my workload by 25%.
Any operation over six hours,
I will have a backup in the OR.
I will even eat more broccoli.
I'm not really comfortable with you
doing any surgery right now,
not until we've determined
the full extent of any
potential impairment.
Do I look impaired to you?
No, but I think
we should run a few tests.
Do you see any evidence at all
that my work has suffered?
You are a brain surgeon.
The margin of acceptable error
is miniscule.
I have a pretty good idea
of how precise I need to be.
I'm not comfortable with
subjecting any patient to that risk.
Most of the patients that I take on,
other surgeons won't even touch.
Without me, the likelihood
that they will die is 100%.
I am not questioning your value.
I'm just asking that you wait
until there is no doubt.
There's no such thing as "no doubt."
Aaron, I
I cannot have you operating right now.
I'm sorry.
Then you will have to fire me.
And I will sue you.
You know, I'm thinking
of cooking up
a batch of the world-famous
Poulet a la Andrews tonight.
I'm in.
Hmm.
But I want to give you
a courtesy heads up.
The nurses are gonna send out
an official e-mail
about a unionization drive.
I just increased the nursing budget.
More than a year ago.
And it mostly went to temps
or traveling nurses.
Not mostly. I can show you the numbers.
Point is, we're underpaid,
underappreciated.
A union could protect us.
Sorry to interrupt.
Got Nico's pre-op testing back.
His chemo hit his bone marrow hard.
Platelets only 22k?
He can't have the surgery.
You have a large malignant
hemangiopericytoma
compressing your frontal lobes.
- Malignant?
- Yes.
But it's operable.
Which is good,
because if left untreated,
this would likely kill you
within a year.
- Okay.
- You were right.
The tumor is probably why
your father stopped being
"a dick" a few months ago.
Sorry, Dad.
It's all right.
I knew our relationship had improved.
I just didn't know
it was because of this.
So, if you remove it,
could that change my personality back?
Most likely.
Thank you, Doctor.
I'm gonna pass on the surgery.
If you want to bench our top surgeon,
you're gonna need more
than one indeterminate scan.
Are you worried about losing
our top surgeon or our top earner?
Why does everyone think wanting
to keep this hospital solvent
is something to be embarrassed about?
You want to open up the door
to another takeover?
I just want to be clear
about our agenda.
Well, then, let me clarify.
Yes, I'm worried about
losing our top earner,
but I'm more worried about Theo Singh,
the 27-year-old newlywed
with the pilocytic astrocytoma.
We can refer him
to Dr. Cachoa at General.
Theo's tumor is compressing
his brain stem.
Cachoa probably won't even take him.
I can deal with that.
And you're doing it again.
My department, my call.
Once litigation is threatened,
it becomes my call.
Glassman refused cognitive testing,
and until I have more information,
I'm not letting him into the OR.
So he does all of his
surgeries as planned,
but with a backstop.
You assign another surgeon
on all of his cases
and not just the OR.
And he'll be happy with that?
It's a compromise.
Nobody's ever completely happy.
- I know I'm not.
- Neither am I.
The hallmark
of a successful negotiation.
I forgot you were coming.
That's odd, given how you read
my text ten minutes ago, but
Beautiful, healthy baby.
Beautiful and healthy mom.
So it looks like things are going great.
Definitely.
Is she eating well?
- Like a horse. Shh, shh.
- Nice.
- Sleeping?
- Like a baby.
I underestimated diaper demand,
but everything else is
perfect.
Shh. It's okay.
When Kellan was fussy,
we'd put his car seat
on top of the washing machine.
The vibrations knocked him right out.
Well, this isn't like her.
Okay. Shh.
You mind?
Ah. All right.
Oh, I've missed this.
What?
See? Like a baby.
What?
My patient is refusing
the hemangiopericytoma
resection surgery
that will save his life.
I want you to talk him into it.
That's not how this works, Shaun.
It should be.
You are more persuasive than I am.
Ask Glassman.
He's removed more anterior fossa
tumors than anyone on the West Coast.
But Dr. Glassman should not
be doing any surgery until
I agree, but I was overruled.
If you want someone
to change your patient's mind,
Glassman's your best shot.
You are persuasive.
Nico's body isn't making the
blood cells and platelets he needs.
There's, uh There's got to be
a way to get his counts up.
With Nico so sick
it may be time to consider
palliative care.
- No.
- Let's hear the doctor out.
No, I'm not giving up on him.
Neither should you.
And neither should they.
Nico's been through so much.
You think I don't know that?
I'm trying to save his life.
Dr. Park will pull the team together
and see if there's a solution
that works for everyone.
Thank you.
So much.
He doesn't want his tumor removed,
so I don't know
what there is to discuss.
Given the tumor's impact
on his frontal lobes,
he might not be competent
to make that decision.
And you don't think I'm
competent to be a doctor, so
Oh, no. Just to be a neurosurgeon.
The surgery should give Kurt
about 20 more years.
Let's recap, 20 more years
as a bad father
versus one year as a good father.
There is no medical justification
Yes, there is, Shaun. Yes, there is.
There's an emotional one!
There's an emotional issue!
Your voice is getting louder,
and your face is flushed. Are you upset?
You should have come to me
with the scan.
You don't go to Lim.
You don't show it to Lim.
You said you were
only a little mad at me.
Y-You ratted me out
to the head of the department
when I specifically
asked you not to do that!
Yes, I did that because
you did not believe me
Well, then, you come to me!
You try to convince me.
Again and again and again!
Don't you think you owe me that?
That's four times.
I tried a lot more than that.
What do you want from me?
You want me to go with you to
see if he's competent? Is that it?
Okay. Fine. Let's go.
Hey.
Did Dr. Park find anything?
Not yet.
I just wanted to see
how you guys are doing.
Seb's with the kids.
I, um, needed a little break.
Seb and I used to talk
about how every day was a
A beautiful day.
I remember.
Do you understand what will happen
if you don't have the operation?
Yes. I'll be dead within a year.
And why is that preferable to surgery?
Hailey was right about me.
I was a terrible person,
a terrible father.
Never played with her.
I hardly talked to her.
I can't even remember holding her hand.
The Wizard of Oz.
I was five, terrified
of the flying monkeys,
but when I reached for your hand
I pulled it away.
I never tried to again.
I don't want to go back.
I don't want to lose this.
I don't want to lose you.
The brain is a funny thing.
It wants to do the things
that makes it feel good,
get that dopamine hit.
In fact, it actually can reshape itself
as it continues to try to
experience those good feelings.
So you're saying I m-might
be able to stay this way?
Maybe.
You work hard to be the best
version of the person you want to be.
I've had that fight.
You should listen to Dr. Glassman.
And he has removed
more anterior fossa tumors
than anyone on the West Coast.
Hey, I have faith in you, Dad.
You can do the work.
You could stay a good man.
Whew.
Well, uh, like the patient said,
"I didn't want brain surgery,
but the doctor changed my mind."
That was a dad joke?
And a "yes."
If you do the surgery.
I've heard that you, uh,
know your way around a fossa tumor.
As you wish.
- So, what are we doing here?
- You don't remember?
A bicoronal subfrontal craniotomy.
- And?
- Possible orbital osteotomies.
Drill.
We would place a lumbar drain first.
Before incision, yes.
I thought I'd focus on the surgery.
Be careful of the sutura coronalis.
Why? Does the patient have one of those?
All higher primates do.
If you don't remember
That was a joke. In the OR,
we call that a joke.
Hmm.
Popping the top.
- And let's get under the lobes.
- Wait.
That is not the next step. It's
Assessing and ligating
the anterior third.
I thought I'd do that
after I get a better view.
That
is an acceptable option.
Wonderful.
But you must remember to
Shaun, no more talking
while I'm doing this procedure.
This is my patient,
so I should be able to
Shaun, I'm asking you to leave.
I will be quiet, but if another
One of us is going to leave, Shaun.
It's not gonna be the one
doing the surgery.
Let's get after it.
We'd start with blood transfusions,
plus a cocktail of five medications
to ramp up production of blood cells.
That should get Nico
through the operation.
A few weeks later, we'd follow up
with a stem-cell
transplantation from one of you.
What could the side effects be?
Elevated risk of infection
and bleeds from the surgery
and possible toxicity
from drug interactions.
You know the alternative.
He'd be gone in just a few months.
If you were in our place,
what would you do?
I'd do the surgery.
- Okay.
- Thank you.
Thank you.
We'll prep Nico for surgery.
Okay.
If this works, it'll be a real win-win
because one day
I do plan to do laundry again.
All right, Eden.
I'm just gonna sit down for one sec.
No! No.
That'll stay just between us.
I want Shaun off the case.
It's his patient.
I don't want to crack a man's skull open
while standing next to someone
who's waiting for me to screw up.
I want a team I can trust 100%
and who will trust me.
- Shaun's off the case.
- Thank you.
And I'll be assisting.
Welcome aboard.
This is nice.
Are you talking about the chicken?
Not exclusively.
I just hope it doesn't get
messed up by things at work.
The unionization drive.
What if I could squeeze the board?
Get them to sign off on some
real and meaningful improvements.
You might not even need a union.
Those would have to be
some pretty big concessions.
Okay.
How about a 5% raise,
1-to-4 cap on nurse-to-patient ratios.
Might even be able to get a
Chief Nursing Officer on the board.
That's pretty interesting.
I have no idea if anyone else
would go for it.
Any chance you could find out?
Well, there's a big difference
how hard I can push
for a proposal that might work
versus one that will.
I could float it to a couple people.
Yeah?
Yeah.
Dessert?
Yes.
As soon as the surgery's over,
the case is yours again.
I will watch from the gallery.
No need. I'll have a much
better view from the floor.
The video feed on the monitors
is excellent.
And it couldn't hurt
to have more backup.
Actually, it could, Shaun.
I was wrong, sending you to Glassman.
He's pretty upset right now,
and if you push it,
it could really hurt your relationship.
But if a doctor is making mistakes
You don't have to be
the one to catch them,
not when others can.
Not when the doctor is your dad.
There we go. There we go.
Come on. I have a few left.
It's okay. Don't worry.
Okay.
Oh, no, no, no, no, no. No!
I knew I was running out! I knew it.
What kind of mom runs out of diapers?
Morgan?
Eden, if you're alone, open the door!
- I can't do this.
- Yes, you can.
I'm failing at everything.
You know, when Kellan was three months,
Mia had to go out of town.
It was my first time alone with him,
and he was teething.
It was 4:00 in the morning,
and neither of us had slept.
And suddenly
Hmm.
I knew exactly how to fix everything.
One, or both, of us
was going out that window.
No one went out the window.
We both fell asleep.
Of the many times I've heard
about your failures,
none has ever made me happier.
You're not failing. You're just, uh
muddling through.
I am not a muddler.
Mm. Every parent is.
Key is to not lose your mind
while you're muddling.
What?
I've freed up the lateral aspect.
Cauterizing.
We're ready to take out the tumor.
Dr. Kalu, you want the honor?
Thank you, Doctor.
There's mets all over his liver.
Can we resect
the most involved segments?
It's too widespread.
So what do we do?
We close him up and tell the family.
Start the timer.
Place the lumbar drain, please.
Hey.
- Tough day?
- Yeah, it was.
When I was arguing with the
board and fighting with Lim and
I just found out
I got to tell a kid's parents
that a surgery I recommended failed
and their boy has a month to live. So
that tipped it a bit beyond "tough."
I'll come back later.
No. Look. I'm sorry. I'm okay.
What's up?
- This may not be the time.
- No. It's fine.
I floated your idea to a few nurses.
They don't trust perks that
can be taken away at will.
They want a union. I'm sorry.
Which nurses?
- Their names?
- Yeah.
You're asking me to inform
on my co-workers?
I just need to know how serious this is.
Are we talking influential people
or some disgruntled part-timers?
No!
You need to use a Penfield dissector
to avoid lacerating the sagittal sinus.
- Dr. Murphy!
- I'm using the blunt end
of the drill bit instead.
Okay. Carry on.
Well, thank you. Speak again,
Dr. Murphy, and I'll have you removed.
I heard you were here,
and I said, "Impossible,
because Lea and I talked about
how this is her very precious
and finite me-time."
Tonight's the big date
with Perez, right?
- Mm-hmm.
- What are you gonna do?
I have no idea.
I thought of this Italian place,
but then I remembered they have
house wine on the tables
and figured
that might trigger a relapse.
And then I thought of indoor skydiving,
but what if he gets hurt?
- So I
- You're really overthinking this.
I thought maybe he wasn't ready to date,
but now I'm thinking I'm not.
Maybe you're not,
but you're really gonna regret it
if you don't give it a shot.
Take him to the Batumi Grill,
order the khachapuri.
Now my Slanket is waiting.
Khachapuri. Okay.
- You're giving up?
- That's not what we
You can't do this to us, to him.
I'm so sorry, Sebastian.
You can't promise that you have a
cure for my boy and then abandon us.
- There's nothing we can do.
- So find another surgery.
We need to focus on improving
the quality of the time Nico has left.
Do not tell me where to focus.
He's my son.
I don't I don't
I don't want quality time.
- All I want is my boy.
- Seb.
- I'm talking to him.
- You're being selfish.
Forcing any more operations
will only cause Nico more pain,
and you and Talia and Olivia
will have terrible memories
of his last days.
I don't care about memories.
You should.
Because soon they are all you'll have.
Hey.
You wouldn't let me give up before.
And you were right.
But now it's time.
Dads are supposed to
fight for their kids.
So you fight
to give your son as many
beautiful days as you can.
You need a rest?
No. Just stretching.
Okay.
And there is our houseguest.
Having overstayed his welcome.
- There's a lot of bleeding.
- Vascular clips.
Must be a tear
in the anterior cerebrals.
No, it's from the dural feeders.
Hmm. As expected.
- And there we are.
- Hmm.
Oh, the bleeding's stopped.
Nice.
No!
Dr. Glassman, please tell us
what the next step is.
You hesitated.
You need to say
what comes next in the surgery.
Somebody please call security.
Shaun, you are out of line.
Answer.
Please.
It's, um
We need to decompress the optic nerve.
Rhoton dissectors.
Hey.
The patient's in recovery.
Your surgical plan was flawless.
Alison Borden.
34-year-old mother of two.
My first solo surgery.
Frontal AVM. It was a walk in the park.
I was pumped. I was flying.
And then her feeding artery tore
and I couldn't stop the bleeding.
Bipolaring, clipping, suturing.
We thought we were gonna lose her.
And I couldn't get
this image out of my mind
of her kids coming home from school
and seeing their father
just sitting there, you know?
Finally, I stuck a neuro-patty
on a muscle patch graft.
That did it. It held.
And when I walked out of that OR,
I thought, "I am never
going back in there again."
Then I saw Alison in recovery.
Husband, kids. All smiles.
She gave me a big hug.
Despite my raging ego
I've tried I've always tried
to make it about the patients.
To do what's best for them.
I never thought that would mean
putting down my knife.
The surgery went very well.
We were able to completely
remove your tumor.
Hey. Dad. How are you feeling?
Well, my head kind of hurts.
I bet.
I gave you that locket.
Yeah.
For my last birthday.
Yeah.
Yeah, that seems like a long time ago.
Rock-a-bye baby On a treetop ♪
Okay. I know. I know.
Okay.
Hey, Siri.
Play "Deceptacon" by Le Tigre.
Who took the bomp? ♪
You like this?
You like dancing with me?
Well, I love dancing with you.
Your mommy loves dancing with you.
Every day and night ♪
Every day and night ♪
I can see your disco, disco ♪
Is sucking my heart out ♪
Boo.
- You look great.
- Thank you.
- So do you.
- Thank you.
So, where we heading?
It's a Georgian place.
Lea swears by their khachapuri.
Oh, that sounds amazing.
I have no idea what that is.
I had to look it up. It's cheese bread.
- Oh, okay.
- Yeah.
Sorry about earlier.
Not your finest moment.
This, on the other hand
Amazing.
Wow.
Hey. Do you think maybe
We can do dinner another night.
I like the suit.
Oh! Ho, ho, ho, ho, ho, ho!
No, like, I really like the suit.
Maybe it could, uh, come home tonight?
Ho, ho ho.
It's a beautiful day.
Kurt and Hailey held hands.
It must be hard to accept
you are compromised,
but you did not hurt a patient,
so now you understand why I did it,
and you can't be mad at me.
You didn't have to do it that way, okay?
You were right.
You didn't have to do it that way.
- But if I was right, then
- You humiliated me in public.
In my operating room,
in front of my colleagues.
Do you have any idea how much that hurt,
coming from you?
I don't know what to do.
You could just leave me alone.
Hello? Lea?
The Peanut's coming early.
The Peanut is coming!