The Good Doctor (2017) s07e08 Episode Script

The Overview Effect

Did he finish his
What are you doing?
Steve has little vocalization,
is fixated on ceiling fans,
and makes eye contact less than 10%.
He's a baby.
And as his daycare noted,
he is not upset when his parents leave.
He's a happy baby. That's not a symptom.
Autistic children often demonstrate
less attachment to significant
Shaun, you know a six-month-old
cannot be diagnosed with autism.
Not definitively, but it is
important to look for signs.
Which may not appear
for another 18 months.
I would still like to consult
a pediatric neurologist.
No. No matter what they say,
you'll still be looking for signs,
you'll still be trying to
find out what's wrong with him.
Not wrong. Just different.
You're right. I'm sorry.
It's just
I don't want to be evaluating him
every time he smiles
or he looks at a ceiling fan.
I just want to enjoy the magic
of watching our baby
experience the world.
Ignoring the possibility
may help you feel better,
but it will not help Steve.
I have to go to work. Goodbye.
Can you grab more diapers
on the way home tonight?
And salsa for Taco Tuesday.
- Chunky, not the smooth kind.
- Yep.
And can you skip your workout
tomorrow morning?
It's leg day.
We need to be
at the courthouse at 8:00 a.m.
To get married.
Our attorney says a marriage license
will expedite the adoption process.
We can carpool.
I don't want to get married
as an item on your to-do list.
Actually, it's on our need-to-do list.
Okay, this is more than
an administrative appointment.
It needs music, flowers,
romance, something special.
I'll get you a boutonniere
and a harmonica.
The other stuff we don't have time for.
Then we should make time.
Just like I'm making time for leg day.
Did he swallow anything?
He He has asthma,
but his inhaler's not helping.
Get a suprasternal view.
Holy cow, he has a third arm.
That's his aburo.
His "little brother."
- You speak Yoruba?
- My father's Nigerian.
I only speak six words.
Seven counting aburo.
They say his little arm is
all that's left of his ibeji.
His twin.
He's too constricted to intubate.
Okay, bag mask ventilate.
He needs a tracheostomy, stat!
[JORDAN] Mason Landover, 41.
Severe neck, back, and extremity pain.
[DR. PARK] I'm gonna feel for
tenderness along your spine.
Anything that could be
causing this pain?
Well, I just spent eight months
on the International Space Station.
Whoa. Like, spacespace?
Yeah, I'm a botanist.
Studying the effects
of zero gravity on soybeans.
[SPANISH ACCENT] Selected from
hundreds of others for the job.
[DR. PARK] That could explain the pain.
Returning to Earth's gravity
puts enormous stress on the joints.
It was worth it.
He can barely walk.
And he's had a bunch of other
health problems since coming back.
Palpate arms and legs for pain.
Low gravity decreases bone mass.
We should do a DEXA scan
to assess how much he's lost.
- Oh!
- [DOM] Oh, my God. I'm so sorry.
Skip the bone scan.
Let's head right to the OR.
[SHAUN] Tracheostomy tube.
[JARED] And the bronchoscope is in.
Let's find out what's causing
his breathing problems.
[CHARLIE] Have either of you
seen a third arm before in person?
[SHAUN] I have seen a third thumb,
a third kidney, and a third nipple.
[JARED] Must be tough
for the kid, living with that.
[CHARLIE] Not if he learns
to embrace his differences.
[SHAUN] Do you think we should
get Steve tested for ASD?
[CHARLIE] Attempting
a diagnosis at Steve's age
will likely lead to a misdiagnosis,
and then you'll likely be disappointed
if you discover that your child
is just typical.
[JARED] Approaching bifurcation.
There it is.
Constriction coming from
outside the trachea.
[SHAUN] Something very strange
is going on inside Tayo's chest.
So, your recovery is going very nicely.
We can discharge you now.
Oh. Cool.
What's next for you?
Like? Like, where are
you gonna be living?
What are you gonna do for money?
Do you have any friends
out there that can help you?
I'll be okay.
Uh, I just need something for the pain.
I can give you Tylenol.
No, that's not gonna be enough.
Hannah, you just had
a very successful surgery.
Your neuro exam
is completely normal now.
You don't need anything stronger.
Yes, I do. I do.
You just want the oxy?
Yeah, because I'm in pain.
Because you're an addict.
Thank you for everything.
Hold on. Hold on, Hannah.
Hold on a second.
I'm just trying to help here.
Are you hungry?
I could eat.
[DOM] I-I can't believe I broke his arm.
[DR. PARK] Not your fault.
He must have lost
a lot of bone mass in space.
[JORDAN] Do you and Morgan still need
me to watch Eden tomorrow morning
while you get married?
[DR. PARK] No. Because we're not
getting married tomorrow morning.
You can place the last screw.
[JORDAN] I don't know much
about weddings,
but it seems like agreeing on
a date is a prerequisite.
[DOM] He's in V-tach and hypotensive.
[DR. PARK] Push lidocaine.
He's coding. Defibrillator pads.
- 150. Clear.
Charge to 200.
- Clear.
[JORDAN] Normal sinus rhythm.
[DOM] Did I almost kill him?
[DR. PARK] No.
But we need to figure out
what almost did.
Tayo doesn't have asthma.
Because of his third arm,
he has an unusually large blood vessel
compressing his trachea
and constricting his air flow.
We placed a tracheal stent
to relieve the pressure,
but that is a temporary fix.
We can't remove the vessel
because that supplies blood
to both left-side arms.
But we can't leave it as it is
because he can't breathe properly.
We need to remove one of his arms.
A blood-flow test will
We talked about this.
His big arm should go.
We talked. We never agreed.
I want to remove the little arm.
The big arm can't hold a pencil
or squeeze a hand or
The little arm is not much better.
He doesn't want to lose
his little brother.
Without his big arm,
do you know how odd he will look?
Okay. Stop talking.
We need to do a Doppler ultrasound
to test the blood flow.
That is how we will choose.
The echo showed he has
a dilated heart chamber.
It's causing arrhythmias.
We'll have to implant a defibrillator.
Is this from being in space, too?
[DR. PARK] Most likely.
In zero gravity, the heart
can weaken significantly.
Ana, I'm gonna be fine.
They warned me my body would change.
Not just your body.
Let's talk about this later.
Mason's been a totally different person
since his return.
I think something's off
with him mentally.
What's off about wanting
more time with you?
More time with me means I give up
a dream fellowship in Buenos Aires,
so we can both stay here
and take care of the children
you now suddenly want?
Being up there made me realize
what's important.
Putting down roots, starting a family.
So, give me a brain scan.
Show her this isn't
just some tumor talking.
We need a medical reason.
Marital disputes don't count.
Right now we need to implant
the defibrillator.
So, what's your sport?
Your jacket. It's yours, right?
Oh! Um, yeah. Uh, track.
Four-by. I ran anchor.
What's your PR in the hundred?
12.2? That's like scholarship speed.
UC Davis offered me a full ride.
It meant having to live in Davis.
Are you a big fan of track or something?
I used to be.
What about your folks?
They live around here?
[SIGHS] You ask a lot of questions.
Okay, well, let me see if I can
answer some of them.
You're living on the street.
You're panhandling or, worse, stealing,
and you have absolutely no one
who can help you.
Well, I live in an '04 Dodge Neon
with a really sweet rear spoiler.
I have a job at Goodwill, part-time.
And I probably have
more friends than you do.
[CHUCKLES] You're probably
right about that.
What about recovery?
I have it under control.
Well, y-you have to go to rehab.
You know that, right?
I tried quitting. It didn't work for me.
Because you need rehab.
You can't do this alone.
No one can do this
No No one should have to
do this on their own.
Thanks for the pancakes.
Whatever you thought was gonna happen,
it's not happening.
Sorry, what
What the hell does that mean?
Wow, okay.
My daughter died of an overdose, okay?
[VOICE BREAKING] She thought
she had it under control.
So, you know
Her PR was 12.8, by the way.
- I'm sorry.
- Yeah.
My number's on that card.
If you need a meal
reach out.
[DR. REZNICK] ♪Love lift
us up Where we belong ♪♪
♪Where eagles cry ♪♪
♪On a mountain high ♪♪
♪Love lift us up Where we belong ♪♪
[WHISPERING] What the hell
are you doing?
♪Far from the world below ♪♪
[WHISPERING] I'm proposing, you idiot.
♪Up where The clear winds blow ♪♪
Alex Park, will you marry me?
You wanted music.
I wanted sincerity,
not the song that ruined
Moulin Rouge! for me.
[SIGHS] Just say yes already.
You sure know how to make
a girl feel special.
This will show which arm
has better blood flow.
That will help decide
which one to amputate.
Are you feeling sad, Tayo?
Because you are losing an arm?
Dr. Murphy and I have a condition
that sometimes makes it hard
for us to understand
what other people are feeling.
Can you tell us why you're feeling sad?
My parents.
They fight a lot about my arm.
What school I should go to.
Who I should play with.
I make them unhappy.
When parents fight about their child,
it's their fault,
not the child's.
Does it say which one to cut off?
Not yet.
Which one would you choose?
It doesn't matter.
No matter what I say,
my parents will be upset.
[DAD] I know. I know.
Okay, but a doctor is
just gonna want to run tests,
then they refer you to
another doctor for more tests,
and we can't afford that.
He needs help, Ethan,
and we have no idea
No, what he needs is discipline.
I don't need tests to tell me that.
[DR. PARK] Entering the right
cardiac ventricle.
Leads placed.
Remove the sheaths and
connect the defibrillator leads.
Doesn't seem like a crazy ask,
wanting your wife to bend a bit.
[JORDAN] But if they love each other,
they'll compromise.
Fluoro looks good.
[DR. PARK] Tough to compromise
when one party is reasonable
and the other just isn't.
[JORDAN] Like when one party
does an amazing,
romantic public proposal,
and the other one
just leaves them hanging?
[DR. PARK] It wasn't romantic.
It was transactional and manipulative,
and I'm proud I didn't give in.
[JORDAN] You're a modern-day Gandhi.
[DR. PARK] This is
decerebrate posturing.
Something's jacking up
his intracranial pressure.
Push 75 grams mannitol.
[JORDAN] Pupils non-reactive.
[NURSE] Pushing.
- [JORDAN] He's stabilizing.
[DR. PARK] This has nothing
to do with his heart.
Looks like he's getting
his brain scan after all.
[JORDAN] Okay, we're done.
[MASON] Can I just lie here
for a second?
- You all right?
- Yeah, yeah.
It's just it's ironic.
I was remembering
looking at the most
precious thing in the universe
and realizing exactly what
I had to do with my life
Get back to Ana.
Turns out the thing I thought
would bring us closer together
is actually the thing
that may break us up.
Uh, did you figure out
what's wrong with my head?
You have hydrocephalus
excess fluid compressing your brain.
A delayed reaction to being in space.
We have to install a shunt to drain it
before it damages your brain.
The blood flow
is 8% better in the little arm.
So we should amputate the big arm.
Should have done this years ago.
For only 8%?
If you are going to keep arguing,
we should move to
where Tayo can't see you.
He thinks he makes you unhappy.
And that makes him sad.
He said this to you?
Can we remove the big arm?
I will schedule
the surgery for tomorrow.
Could the hydrocephalus
explain his personality change?
No. Based on his post-landing test,
hydrocephalus is a recent issue.
You know the Overview Effect
what many astronauts experience
when they see Earth from space?
Is that a medical condition?
No, but it is a real phenomenon
that can change their priorities,
the way they want to live their lives.
And it can be wonderful.
Assuming they want their life to change.
I don't.
We had a great thing.
Mason pursued his research,
I pursued mine,
and we'd present at conferences
all over the world.
We flew coach,
we stayed at cheap, little hotels,
eating nothing but street food.
But we loved that life.
Seems like he's ready for more.
I've waited years for this fellowship.
He knows how important it is to me.
And what was important to me
used to be important to him.
You'll find a middle ground.
I'm not so sure.
[DAD] He's just not making eye contact.
[MOM] He's tired.
I read this thing in a magazine
It's a way to get kids
to make eye contact.
What is it?
Shaun, look at me.
Hello? Look at me.
- Aah!
- What are you doing?
- Relax, It's just water.
- He hates it.
[DAD] Well, that's the point, isn't it?
- It's okay, Shaun. He didn't mean it.
- Baby.
It's okay, Shaun.
It's okay.
We need to get a diagnosis
from an expert in autism
as soon as possible.
Any assessment before Steve
is two is a waste of time.
I discovered a new study
that uses fMRI imaging
to identify earlier predictors
of autism.
We can't subject Steve to that.
An fMRI is non-invasive and harmless.
Not for a baby.
Steve would have to be sedated.
That is non-invasive and harmless.
No, Shaun, I'm not signing
Steve up for any study.
Okay. I can do it.
This is not the kind of decision
you can make on your own.
Neither can you.
That's why we have to compromise.
I want to get Steve tested.
You do not. How can we compromise?
I don't know. I just I just
This This doesn't feel right to me.
- Why?
- I don't know.
That is not a reason.
I will make an appointment
for the study,
and if you think
of a reason before that
No, Shaun!
We are not doing this!
You are being loud.
I am being loud
because you're not listening!
- We're not going to drug our baby
- Okay, s-stop it.
- Stop Stop talking!
- and put him into a machine
- O-Okay.
- just because you think that
- that is what we need to be
- Stop Stop talking!
I'm sorry.
I'm sorry. I
After ligating nerves, arteries,
and veins of the big arm,
we will amputate at the mid humerus.
[JARED] Maybe use some of
the big arm's skin for the closure?
Oh. That is a good idea.
Like Bust 'Em Custom?
It was a show where they took
two identical old cars
and stripped one to restore the other.
Ah, you're into car restoration?
No. But my dad was.
Whenever I'd feel anxious,
he'd put it on
and we'd watch it together.
My father was not supportive.
Mine was my biggest advocate.
Wouldn't it be awesome if
we could strip Tayo's big arm
to restore his little arm
to full capacity?
That would be awesome,
but the big arm
has neurological deficits
and atrophied muscles, so
I think we need to strip the other car!
I used a metaphor.
- Hey.
- Hey.
How did things end up with Hannah?
Oh, she was discharged yesterday.
I saw. Did she agree to any
follow-up addiction treatment?
I even bought her pancakes,
and I couldn't get through.
You You bought her breakfast?
More like brunch.
[SIGHS] You should stick
with the medicine
and let social services do the rest.
- I mean, there are rules for a reason.
Where would Shaun be
if I followed the rules?
- Shaun wasn't your patient.
- Excuse me.
Yes, hello?
Okay. Where Where are you?
Are you okay?
Okay. I'll be right there.
This new surgery
is much more complicated.
There is a small chance that Tayo
will be left with only one working arm.
Then that is not an option.
He said the risk is small.
But Tayo could end up worse off.
Or he could finally have
a proper-sized arm that works.
That is what is important
to you? How it looks.
- That is not what
- Stop arguing.
You should ask Tayo.
It is his life you are fighting about.
You okay?
It was the crappiest car ever.
Why [SNIFFLES] would anyone
Maybe it was that sweet rear spoiler.
Hey, I know a-a shelter on Lexington.
It's clean, it's secure.
No, I have a friend I can stay with.
I just need a ride.
You were right.
And as humiliating as that was,
I deserved it.
But I am taking this seriously.
In World War I,
my great-grandfather survived
a winter in the trenches.
He met this lovely French farm woman.
They fell in love.
When they were married,
my great-grandmother gave him this ring.
And now I want to give it to you.
Will you marry me?
For real.
I'm not gonna do
the whole knee thing again.
Yes. I will.
There's an inscription here.
Something like "MF DR"?
I didn't notice.
Marie Francois and Daniel Reznick.
That's incredible.
It would be, except that it
actually says "Bunny Hearts Irv."
And let me rephrase
No, I won't.
I spent my lunch hour at a pawnshop
so you could feel romantic
about your second marriage.
Well, maybe if my first marriage
had been a bit more romantic,
I wouldn't need a second one.
I'm sleeping in the guest room tonight.
I sleep better without you anyway!
I could lose my big arm too?
Unlikely, but possible.
Your mother and I fight far too much.
But it is because we both
care so much about you.
More than anything else in the world.
But I know it makes you sad,
and that breaks my heart.
I am sorry, Tayo.
What do you want to do?
You're a big boy.
We want to hear what you think.
I don't want to say goodbye
to my little brother.
But I know he'll understand.
The shunt procedure went very well.
- How are you feeling?
- Okay.
Uh, where where's Ana?
D-Did she "shay" s-she "shay"
Pupils are blown.
Pressure's back up, pumping. OR now.
No, no, no, no.
You know what? There are
housing-first shelters
you don't even have to
be clean before you
I know a guy who got stabbed
in one of them.
Right, like no one's ever
gonna get stabbed here.
My friend is waiting for me.
I wasn't lying about that.
I really appreciate all you did.
You're a good person.
[MADDIE] Daddy, please!
- What are you doing?
- I can't believe you're doing this.
- I hate you!
Hey, hey, hey, hey. Hannah?
Hey. Look
I have a-a very comfortable
couch in my living room.
Nobody's using it.
What do you think?
Good morning.
I wasn't lying about the couch, was I?
You were not.
Unnecessary, but
The key is adding the chips by hand
after the batter's already on the grill.
That way, there's no weird
clumps of chocolate.
I like to pay my own way.
Uh, there's a guy at work
who said he'll rent me
a room in his house.
I'm checking it out today.
You know what?
I can get you a bed
in the St. Bons rehab unit.
When I tried to quit,
it was the worst week of my life.
Well, you can always stay here
until you get back on your feet.
I don't feel good putting you out.
It wouldn't put me out. You just
Couch is right there.
You can earn your keep in pancakes.
I guess I could stay one more night.
I'll even restock the chocolate chips.
Is he okay?
When he was in space,
his brain shifted
due to the microgravity,
and now it's shifting back and
blocking the flow of the shunt.
And we need to remove a piece
of the skull to relieve the pressure.
Could he die?
This is a risky surgery.
But it's our best shot.
We need your consent.
Thank you.
Oh, God, and then I lost it,
and then Shaun lost it.
Now he's totally dug in,
but there's no way I'm gonna
let Steve do this study,
but he's being so unreasonable.
Why are you so worried about this study?
It's way too early
for Steve to be tested.
And no matter what happens,
it'll label him.
And that's what you're
worried about, being labeled?
Once that happens,
he'll be seen as different.
- By whom?
- By everyone.
Since when are you
so concerned about everyone?
Since I became a mom? I don't know. I
How can I not?
You're a new parent. That's scary.
But how often do we make the
right decision when we're scared?
♪Light the sky ♪♪
♪On fire ♪♪
♪Who could've known? ♪♪
[SHAUN] Isolating the median,
ulnar, and radial nerves
of the small arm.
Beginning side nerve transfer.
Goodbye, little brother.
I might have been a little
tough on you yesterday.
Tough I don't mind.
It's the ethics lecture
I can do without.
I just I-I know
you want to do right by her.
It's fine.
You were trying to help. I get it.
Do you think you'll ever
hear from her again?
Who knows?
Can Can I have a kiss?
That was quite a thing
we had the other day.
When you raise your voice,
it makes me very upset.
I know.
We both got pretty emotional.
But I've been thinking.
And I don't think it was
about you or the study
or even about us disagreeing,
not really.
It was about me.
A child on the spectrum has so
so many different needs
than a neurotypical child that I
that I got scared.
I'm scared I might not
be up to it as a mom.
That doesn't make sense.
You are a very good mother,
and you are very supportive of me.
That's the thing about being scared.
It doesn't always make sense.
Anyway, if you'd like,
we can try the study.
I would like to make an appointment.
Thank you.
♪Down by the delta
Not too far from here ♪♪
♪Can't wait to show you ♪♪
♪Hurry up, can't you hear? ♪♪
♪The rhythm is calling
And it came without a warning ♪♪
♪Can't help How it makes you feel ♪♪
♪You're better off knowing
That I'll be about showing ♪♪
♪You'll swear That it ain't real ♪♪
♪This right here
Gonna blow your mind ♪♪
What, what? What? No! No! No!
[CRYING] Hannah.
Hannah, Hannah.
♪Whoo-hoo ♪♪
♪Whoo ♪♪
♪Gonna blow your mind Uh-huh ♪♪
♪Whoo-hoo ♪♪
♪Whoo ♪♪
♪This right here's
Gonna blow your mind ♪♪
[DR. PARK] Welcome back, Mason.
Pupils reactive.
Am I gonna be okay?
I wouldn't go into orbit again,
but if you stick to Earth,
you should be fine.
You remember that horrible
hotel in Dar es Salaam?
Every time they flushed
upstairs, our ceiling leaked.
You took the shower curtain
and tented it over our bed.
Said we were having a campout.
When I thought you were dying,
I had my own Overview Effect.
A world without you would be so cold.
So empty.
I don't need to take that
fellowship in Buenos Aires.
But I'm not sure about the kids.
Maybe we can start with a puppy.
No, no. W-We're going to Bueno Aires.
I-I'll take a sabbatical.
And the puppy.
Thank you, Dr. Murphy, for your advice.
When you snapped at us to stop fighting.
Simple, direct, and very wise.
It is very good advice.
You OD'd.
In my house.
Must have been fentanyl in those pills.
I'm sorry.
You have any idea how lucky you are?
That I happened to come home when I did,
that I happened to have
naloxone in the house,
that there wasn't more fentanyl
in those damn pills?
This can't happen again.
I'll go.
No, no, no.
That's not what I meant.
I'm gonna write you
a prescription of oxycodone.
I can deal with you being an addict.
I can't deal with you being dead.
You can stay here until we
figure out a way to get you better.
I'm gonna give you
each pill on a schedule.
No more scores on the street.
Can't you get in trouble?
You let me worry about that.
♪So, see, it seems
We've settled down ♪♪
♪Quite a bit
From the energy we once had ♪♪
♪Oh, believe me We've settled down ♪♪
♪Way down ♪♪
♪Way down, way down ♪♪
How is he ever gonna be a man
if he can't even look me in the eye?
He's just a little boy.
[DAD] Yeah, and he's gonna stay
that way if you keep coddling him.
It's mint chip.
[DAD] At least I'm doing something!
♪And all we are Is burning stars ♪♪
♪Shining brightly ♪♪
♪Making sure
You don't float too far ♪♪
♪I'll keep an eye on you
If you keep one on me ♪♪
Would you like to get some ice cream?
♪And then what happens We'll see ♪♪
♪Shining brightly ♪♪
♪Making sure
You don't float too far ♪♪
♪I'll keep an eye on you
If you keep one on me ♪♪
♪And then what happens We'll see ♪♪
♪And then what happens We'll see ♪♪
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