The Good Doctor (2017) s03e01 Episode Script
Disaster
1 Previously on "The Good Doctor" You work together and you are sleeping together.
You don't see any way that can go wrong? You went out on a limb for me.
You fire me now, you look like a fool in front of the board.
Dr.
Andrews, I don't think you have the votes to carry it.
But I don't need the votes.
Just as you have the power to fire someone under your supervision, so do I.
MELENDEZ: Did you hear about Han? LIM: Can't imagine Andrews will survive the fallout.
They're gonna need a new Chief of Surgery.
Aoki should be calling you with the offer any minute.
Here are flowers and chocolates.
Are you asking me out? Yes.
I would love to.
[GASPS.]
[INDISTINCT CONVERSATIONS.]
Why are you smiling? I don't know.
I just I wanted you to know that things are okay.
If I start a commotion Good.
I run the risk of losing you, and that's worse [CLEARS THROAT.]
Ever fallen in love with someone Ever fallen in love, in love with someone Ever fallen in love, in love with someone You shouldn't have fallen in love with? I saw a movie last weekend.
Which one? Was it good? What kind of movies do you like? What a shame Oh.
This looks delicious.
Thank you.
Ever fallen in love with someone Ever fallen in love I said no pickles.
- Ever fallen in love - Pardon me? It's okay.
They can just take that off I said no pickles.
Oh.
I am so sorry.
I said no pickles.
- [DISTORTED AUDIO.]
- [GRUNTS.]
SHAUN: It was a disaster.
What happened? Don't you all have work to do? Sorry.
We were just Shaun was on a date.
Hmm.
Congratulations on your promotion.
I believe you're our first female Chief of Surgery.
That's nice.
Uh, thank you.
Yes.
And you're still not working.
[CLEARS THROAT.]
Not you.
We need to go to H.
R.
and break up.
[FOOTSTEPS DEPART.]
[ENGINE REVS.]
- [TIRES SQUEAL.]
- We need a head CT and a trauma panel.
Please! Someone! Help my wife! [GRUNTING, BREATHING HEAVILY.]
We've been married for 45 years.
Two children.
Eh, so far.
Oh, stop it.
Ricky and Tammy.
Ricky's got two kids of his own.
When did you first notice the pain? - This morning.
- No, on Saturday.
He has a history of kidney stones.
I try to get him to drink more water You "try"? When did I ever say no to you? It's probably another stone, but we'll do some imaging to rule out anything more serious.
Oh, thank you.
Did you tell them about the kids? [CHUCKLES.]
We have two, you know.
So far.
[CHUCKLES.]
That's nice.
[SIGHS.]
- Not it.
- What? He's got dementia, and even worse, it's boring.
Probably stones.
Best case scenario, it's a kidney tumor.
We've assisted on eight nephrectomies.
It's your case, your chart, you're primary.
Kellan's coming to town.
I need to be out of here at a decent hour, and we are not children.
We do not decide things by who called it.
You touched the chart first.
It's yours.
- Did not.
- Did so.
We walked up together, Petringa handed the chart to you.
- Did not.
- Did so.
- Did not.
- Did so.
Why? It just wasn't working out.
Oh.
Well, I certainly hope it's not because in light of Dr.
Lim's recent promotion to Chief of Surgery that she's now your supervisor? We knew that arrangement would be unacceptable, and since we only recently started seeing each other You were seeing each other secretly for some time before you reported it, correct? So, maybe you've just gone back to seeing each other in secret.
No.
Uh, we made the decision that this opportunity for Dr.
Lim is just You're What What are you writing? I have accepted your explanation and report.
Thank you.
But I don't believe it.
You're going to keep seeing each other, and I can't do anything to stop that, nor do I even want to.
But know this love doesn't conquer all, lust doesn't either, and like doesn't even come close.
This is gonna be a lot more complicated than either of you think.
SHAUN: Looks like you have a large uterine fibroid that's bled.
It has to be removed surgically.
Yes, routine surgery.
You should be fine.
Uterine? Am I gonna be able to have The surgery won't affect your ability to have children.
[INDISTINCT TALKING OVER P.
A.
.]
I didn't let her finish her question because I anticipated what she was going to ask because the uterus has very few functions.
- Nicely done.
- Yes.
To improve O.
R.
access, we're going to automatic block release and implement staggered starts for anesthesia.
Any questions? Dr.
Andrews and Dr.
Han wouldn't authorize staff overtime.
Now, our nurses Good point.
Thank you.
Yes.
Authorized.
One other thing, and this is really for our third years, but it will affect all of you.
Traditionally, you don't get to lead surgeries until fourth year.
That will be changing.
The earlier you get in there and take responsibility, the more chance you have to learn.
When the right surgery comes along something simple, basic, it'll be yours.
Start prepping.
Maybe I did touch the chart first.
Relax.
It's okay.
I can stay late now and again.
This is my job.
Stop it.
You don't want the case.
It's boring.
I get it.
I know you get it.
Boring is now exciting.
Boring means it's a routine surgery, which means it's a surgery that Lim just said one of us may well lead.
This one's probably no surgery at all.
It's probably just kidney stones and late nights with a man with dementia.
I'll take that chance.
You hate people.
People don't know that.
People like me.
You need to be with your family.
Kellan's 16.
He barely talks to me.
It's who touched the chart first, which, as you said, was me.
- And as you said - HARVEY: Excuse me.
Y-Yes, Harvey? Is everything okay? Why am I in here? Nothing to worry about.
It's likely just a kidney stone.
You just have to Yes! It's cancer.
Nicely isolated, simple surgery.
Perfect for a resident.
Put some traction on the uterus to expose the broad ligament.
I'll slide the pelvic retractor under the fundus.
[SIGHS.]
Did the wine spill all over you? Um Did it spill all over Carly? S-Stop.
Look above the posterior cul De sac.
- Cancer.
- Yes.
Very extensive, I think.
It appears to have metastasized everywhere.
Liver, kidney, abdominal wall.
Close her up.
- [BIRDS CHIRPING.]
- [FOOTSTEPS APPROACHING.]
I rang the doorbell.
Yes, you did.
Are you gonna spend the rest of your life lying around in this backyard? That, and lying next to my future wife.
Congratulations.
I heard.
But what are you going to do professionally? When people think they're going to die, like you did, they assess their life, reevaluate what's important.
You're going to need to make a difference.
Do you have a puppy for me to adopt? I have a vacancy at President.
Again? You're interested, but you think things have to change.
They don't.
You led a meaningful life before cancer, and you will lead a meaningful life after.
Well, thank you.
I'm very inspired.
Think about it.
Also, sunscreen.
What's going on behind the pancreas at the root of the superior mesenteric artery? We need a better angle.
We're not gonna get a better angle.
Definitely not when we're actually operating.
So what's the solution? [SIGHS.]
There isn't one.
Not surgically.
We should refer them to an oncologist.
Chemo might help, but I'm not hopeful.
[SIGHS.]
What are you gonna tell them? You guys are third year.
You want stuff to learn by doing? How about sympathetic communication? Shaun, let the bride know she's probably dying.
[DOOR OPENS, CLOSES.]
This morning, who did you give the Calderon chart to? I gave it to you guys.
Uh, but you handed it to one of us.
One of us actually took it from you.
It was me, right? I don't know.
What does it matter? You just came up and From the right.
I came up on Morgan's left.
You're left-handed? It only makes sense that I would be closer to Excuse me.
Is there any news about my husband? [INDISTINCT TALKING OVER P.
A.
.]
Harvey, you remember Drs.
Park and Reznick.
They did your scan.
R-Right.
For my, uh They were looking for kidney stones.
Unfortunately, we found some cancer.
- It's on your left kidney.
- Cancer? The good news is it's isolated and in a very operable location.
Cancer.
I have cancer? We have to tell the children.
We'll do a biopsy to confirm, but I'm confident that we caught it early.
This is terrible.
I I can't die.
I You need me.
I know.
But with surgery, radiation, and immunotherapy, the prognosis is excellent.
[DOOR OPENS.]
You're supposed to be talking to our patient.
They can wait until we're sure.
We are sure.
Dr.
Melendez is sure.
Dr.
Lim told us we're ready for more responsibility, so I decided I can make a decision on my own, and I decided to do some more research.
Shaun, you need to learn how to do this, and stalling just makes it worse.
I think maybe you're feeling bad about your date, and you're in here burying yourself in things you subconsciously think you can control.
How do people know what's going on in their subconscious? What happened, Shaun when you jumped up? Fallen in love with someone, ever fallen in love In love with someone, ever fallen in love In love with someone You shouldn't have fallen in love with [CELLPHONE RINGING.]
Your phone is ringing.
- It can wait.
- Mm.
It's your mother.
It can wait.
What went wrong? What was the disaster? She called earlier, too.
If stalling is bad, then why are you avoiding your mother's calls? [CLICKS TONGUE.]
Did you ever forgive your mother for not protecting you? Is that what your mother wants to know? My mother was a terrible mother.
It wasn't all her fault.
She was bipolar.
That doesn't change the fact that she was terrible.
I I don't think it's good for her to be in my life.
Are you looking for guidance from me? Am I a role model to you? On some issues, absolutely.
I don't usually think about the past.
It doesn't help.
But the date.
Mm-mm.
Yesterday is part of the past, and the past matters.
What happened? I told a joke.
- No.
- Yes.
Lea said I should.
No.
That is not what I said.
Does this tie look good? Yes.
But not with those pants.
And what I was saying was that jokes are the types of things people do on dates.
They talk about the weather, hobbies, where they went to college.
I'm a person.
Should I change my pants with you in the room? No.
And, yes, I know you're a person, Shaun, but we all have strengths and weaknesses.
Telling jokes is easy.
There are books full of them.
I said no.
Yes, there are a lot of jokes, but you have to know how to tell them.
You have to know when to tell them.
So, I took a gap year before college, which, in hindsight, I think might have been a mistake.
Staying at home.
My relationship with my dad Caesar walked into a bar and asked the bartender for a martinus.
The bartender said, "Do you mean a martini?" And Caesar says, "If I wanted two, I would have ordered two.
" Uh did she laugh? I'm not sure.
Well, what did she say? [CHUCKLING.]
She made a sound.
"Heh.
Heh heh heh.
" You got a chuckle, I think.
- That's That's good.
- No, it's not.
I read six joke books, and all I got was a "Heh.
Heh, heh, heh.
" It was a disaster.
[SCOFFS.]
Because of a joke? Something bigger must have gone wrong.
What happened? [BREATHES DEEPLY.]
A young woman may be dying.
I have a lot of research to do.
[MOUSE CLICKS.]
Boom.
My chart, my case, my patient, my surgery.
You took it from me.
It touched my fingers I know it did - and then you took it from me.
- All I know is I'm the one holding the chart.
That's the evidence we got to deal with.
If you could prove Angles.
We need more angles.
How many cameras do we have in that section? Dr.
Lim, I'm glad you made that decision on the overtime.
Oh.
You're welcome.
But I thought you'd want to know the real issue isn't the overtime.
It's being understaffed.
We need two more nurses on this floor alone, one in ICU I'm sorry.
I'm sure you're right, but we just don't have the budget.
[SIGHS.]
- Excuse me? - [SIGHS.]
Nothing, ma'am.
I gave you the OT.
You're not being fair.
Aren't I? You told me I was right, then you told me you're not gonna do it.
Who's being unfair? Nobody said this job Shaun.
Come with me.
Is everything okay? The nurse told us you didn't finish the surgery.
Suzanne you have very extensive cancer throughout your abdomen.
It appears to be malignant.
[SOBS.]
And it appears to have metastasized around every organ.
[BREATHING SHAKILY.]
But there's hope with surgery.
We can't see the retrohepatic part of the cancer because of the liver.
We can't see the retroperitoneal part because of the right kidney.
Yes, I know.
That's why we should take out the organs.
You want to remove her liver and right kidney? Yes.
And also her left kidney and her pancreas and her intestinal tract and the stomach.
You do know that several of those organs are quite essential.
We'll put them back.
We remove them, clean up the cancer, then put them back.
Ex vivo surgery.
It's been done for pancreatic cancer.
Without much success.
No.
You think it'd work better here? Not really.
But the alternative is death.
[SIGHS.]
[DOORBELL RINGS.]
[SIGHS.]
[BIRDS CHIRPING.]
- Hi.
- Hi.
How are you? Good.
[DOG BARKING IN DISTANCE.]
N-Not working? Yeah.
It's been 72 hours, and I still haven't found a job.
Relax.
I'll be fine.
I got some irons in the fire.
What do you need? How do you say no to a person? I don't think I'm doing it right.
Okay.
Watch closely.
[SIGHS.]
Really? If you're gonna give up that easily, you might as well just quit now.
The biopsy confirmed that the kidney cancer is a renal cell carcinoma.
Cancer? I have cancer? Yes.
Why didn't you tell me? We did.
The good news is that it's treatable with surgery and immunotherapy and radiation.
We have to tell the children.
The children know.
How do they know? What's going on? Am I dying? The cancer is serious, but Ruby, we'd like to talk to you outside.
I'll be right back.
The problem isn't how you said no.
The problem is how you said yes.
She seemed quite happy with the yes.
It came too quickly.
You made her think she was helping you instead of the other way around, so she came asking for more, feeling she was entitled to more.
So I should have said no when I wanted to say yes? You shouldn't tell her what you want to tell her.
You should tell her what she needs to hear.
[SIGHS.]
See, it's your job to figure out what you can give them, convince them that's what they need, and then make them feel like they owe you.
N-None of that sounds like me.
And you want to do the job your way, without changing who you are? Is that amusing to you? Yes, I do.
Yesterday, you were an attending.
Today, you're Chief.
You are a different person.
Want an espresso? [ESPRESSO MACHINE CLICKS, CUP CLATTERS.]
Without surgery, your husband would probably live another two to five years.
He would have very little discomfort until very close to the end, and that can be managed.
- You said it was treatable.
- It is.
But fighting cancer's never easy.
We have to weigh the benefits against the suffering, and the surgery itself is usually the easiest part.
He's strong.
He's healthy.
He's not healthy.
Not mentally.
And the burden on you I am not letting my husband die because caring for him is inconvenient, because I'm gonna have to repeat a conversation.
Just go to hell.
[FOOTSTEPS DEPART.]
This type of surgery's never been done for this condition.
We'd be dealing with every one of your abdominal organs, and something could go wrong with any of them.
You could be on dialysis for the rest of your life.
You could have a very compromised digestive tract, lifelong diabetes.
You could have liver failure.
That's not a complete list.
You could die.
And, um if we don't do the surgery? Chemotherapy and radiation.
Although the likelihood of success is slim, about 25%.
You may prefer hospice care.
You'd probably live maybe a year, but it'd be a good year.
Could you give us some time to think about it? Of course.
[BIRDS CHIRPING.]
SHAUN: We're supposed to be at lunch.
We're gonna be late.
Why? Why? Because I need meaning in my life.
Your heart seems fine.
Your liver seems to be in the right place.
You're a brain surgeon.
You don't think you can get meaning being a brain surgeon? This is a boring patient with boring symptoms.
Shaun, meet Marco Higgins, diesel mechanic, currently in between jobs.
Three sons, two of whom he hasn't spoken to in quite some time, but he's working on that.
Open.
Wide.
It's good to get to know people, Shaun.
It makes you a better doctor.
Say, "Ah.
" MARCO: Ah.
You have boring symptoms.
That's a good thing.
You do not want exciting symptoms.
You had a date last night, didn't you? Mm.
I want to hear about this.
Marco, you want to hear about this? Yes, please.
Yes, please.
Open.
It was a disaster.
[INDISTINCT CONVERSATIONS.]
Oh, thank you, Shaun, but it's really not No, it's polite and chivalrous [CHAIR LEGS SCRAPE.]
and even though chivalry is a problematic notion, politeness is a good thing, no matter which - Ohh! - Shaun! - [THUD.]
- [CROWD GASPING.]
- Are you okay? - Oh, my.
- I'm okay.
- She might not be okay.
- No, I am okay.
- Okay.
Don't get up.
I'm pretty sure she's okay.
[EXHALES SHARPLY.]
Take off his boots.
What? Do you think Marco's diabetic? Based on the color of his skin in the crease of his neck, I do.
Based on what it says on his chart, I do, too.
He could have an infection in his feet, and the pain is being masked by diabetic neuropathy.
That infection could be causing the abdominal symptoms.
Marco, would you mind taking off your boots? I was wrong.
It's not boring.
[DOOR CLOSES.]
[SIGHS.]
I can do it myself.
I'm sure, but our job here is to help each other, and today I didn't do that.
I'm trying to make up for that with a jar of pickles.
I overstepped and [GRUNTS.]
undercut you in front of the patient's wife.
[GRUNTS.]
I accept your apology.
What I should have done was privately tell you that you're wrong.
- Give me the jar back.
- And let you, as lead doctor, tell them that this surgery's a bad idea.
Because we should let a 70-year-old man die of a treatable condition? Because we shouldn't condemn a 70-year-old man to years of confusion and fear.
His life still has value.
Seriously? He has memory issues.
He's not a vegetable.
He's funny, he's charming.
They've lived a life together.
He brings happiness to his wife, to his children.
- He's happy.
- Exactly.
Let him stay happy for whatever time he has left.
[LID POPS.]
[DOOR OPENS, CLOSES.]
Nurse Petringa.
I'm sorry if I overstepped.
I didn't track you down for an apology.
You gonna get us the additional staff? No.
If I get you the additional staff, you lose hours, you lose overtime.
So you're doing us a favor by making sure we never see our families? Your problem isn't the staff.
Your problem is the actual work, the crap part of the work that takes too long and too many of you.
I authorized the purchase of two Hoya patient lifts and a mechatronic ICU bed.
A smart bed? [CHUCKLES.]
Those are actually supposed to be kind of fun.
You got to promise to let me try it.
You got it.
Dr.
Lim? Thank you.
You owe me.
I'm well aware of what he'll be going through.
My sister had cancer.
The chemo, the radiation They beat the crap out of her, didn't they? Yeah.
Now imagine going through that and not understanding, every day.
Throwing up and not knowing why, losing your hair and not knowing why, learning he has cancer and being devastated by it day after day.
But at the end There are no guarantees.
He's old, and his body's breaking down.
His mind is breaking down, and it's gonna end, no matter what we do.
In 45 years, I have never once lied to him.
When memory goes, all that's left is emotion.
What we've learned doesn't matter.
[SNIFFLES.]
What we had for lunch, where we went for vacation, none of it matters.
But how we feel who we're close to He's the same man I've always loved.
[SNIFFLES.]
Same sense of humor.
Same everything.
He hasn't changed.
And what I owe him hasn't changed.
CLAIRE: Have you decided? Not yet.
Take your time.
There is no urgency to What are you waiting for? Dr.
Murphy, they are kind of facing an impossible choice.
But they have to make it.
What additional information are you waiting for? - Shaun - I'll be a better doctor if I understand the patient.
True, but right now, your skills are secondary to their Are you debating whether you should find somebody else to fall in love with, someone healthy? No.
No, of course not.
You should be.
We're kids.
You shouldn't have to spend the rest of your life taking care of an invalid.
You think that's the issue? Me? A-A burden on me? This is so much easier on me than you.
No, it's not.
Whatever happens to me is gonna happen, and I have to live with it.
You You have a choice.
"In sickness and in health.
" That was the commitment I made this morning.
Now, if this had happened yesterday [CHUCKLES LIGHTLY.]
[CHUCKLES.]
So it's not that difficult a decision then, right? I guess not.
[MONITOR BEEPING.]
I can feel her humeral head outside the glenoid fossa.
It's an anterior dislocation.
I can reduce that.
Here? Yes, with traction and external rotation.
- [BONE CRACKS.]
- Ow! [CROWD GASPS.]
Oh.
Oh.
Oh, my, that that that feels better.
I bumped you.
Oh, d-d-don't worry.
It happens.
I-I wasn't watching, either.
[APPLAUSE.]
[LAUGHS.]
Come on.
CLAIRE: That's it? You bumped into a very understanding woman, you amazingly caught a bottle of wine.
Where was the disaster? Unclamp the superior mesenteric to perfuse the organs.
The small intestines look dusky and cyanotic.
We'll need to resect all the necrotic segments.
Claire, find the first viable part of the ilium and clamp proximal to it.
[DOORBELL RINGS.]
I don't think your irons in the fire are very hot.
Any job interviews you get, you're gonna spend a large chunk of time trying to explain why you lasted less than a year as President at St.
Bonaventure.
I mean, how do you put a positive spin on why you spent a fortune on a Chief of Surgery you fired weeks later to protect a second-year resident? You think I made a mistake? No, I think you did the right thing.
I admire you, which is why I want to do you a favor.
What you need to do is prove that you haven't burned any bridges, which means you have to come back to work at St.
Bonaventure.
As what? As a surgeon working for you? And the fact that you're undoubtedly in need of a surgical attending to replace yourself is just a coincidence? It's what you need.
I admire the effort.
But don't con a con man.
[DOORBELL RINGS.]
Your greatest strength and your greatest weakness as a leader was your stubbornness.
Don't let it be a weakness today.
My back hurts on the left side.
That's where you had your biopsy.
It's gonna hurt for a little while.
What biopsy? Harvey, you came in here because you thought you had kidney stones.
We did some imaging, and you don't.
What is it? What What's wrong? What? What's going on, Ruby? I Why isn't anybody saying anything? Am I dying? Ruby? I I can't die.
I need to take care of you.
I I can't They didn't find stones.
Everything is okay.
[SNIFFLES.]
The pain will go away.
We're gonna go home tonight.
Okay? Okay? [SNIFFLES.]
[INSECTS CHIRPING.]
I had a nice time.
[GATE OPENS.]
[FOOTSTEPS DEPARTING.]
That's it? It's over? Where's the disaster? I've listened to an hour of this.
I was promised a disaster.
Where's the disaster? It was exhausting.
Everything was always out of control.
Anything could happen at any time.
Anything did.
There was too much to remember to do, too much to remember not to do, and none of it made sense.
It was hard, uncomfortable, unpleasant.
I spent the whole evening doing unnatural things to make her happy, and I have no idea if she was happy, and I know I wasn't happy.
It was all a disaster.
I want you to meet our new attending, Dr.
Marcus Andrews.
Pleasure to meet you.
[SIGHS.]
How long have you been working here? Ms.
McDougal? She didn't ask for ID.
It's policy.
We take a lot of immigrants here.
She also didn't look at me.
Check the symptom I told her I had A cut over the left eye.
You heal very nicely, Ms.
McDougal.
[CHUCKLES.]
You hate it here.
[SIGHS.]
"Hate" is a strong word.
What would you do differently? [CHUCKLES.]
Give me five things.
Diabetes clinical educator, onsite lab and X-ray, mental health advisor, multidisciplinary care team, electronic medical records.
We had the clinic at the hospital and had to shut it down because it was a money pit.
Come back as President, and we'll re-open it.
Your office can be in the clinic.
Do I have to wear a tie? [SIREN WAILING IN DISTANCE.]
Hey.
Welcome back.
[SIGHS.]
Am I okay? The surgery went very well.
We're confident that we got all of the cancer.
[SIGHS.]
There's a bag by her side.
Is that just to drain stuff post-surgery? There were complications.
We had to remove a large portion of your bowel and divert the waste through a stoma in your skin.
That's an ileostomy bag.
How long will I have that? Forever.
So I have to go to the bathroom in this thing for the rest of my life? Yes.
We'll teach you how to change it, how to dispose of it.
They'll teach both of us.
Now, this is why we do it, Shaun.
Every date is a disaster.
Every relationship is out of control.
But if you stick with it, you wind up with someone in your life who will help you when you need to be helped, love you when you do not feel lovable, be with you no matter what.
It's not worth it.
[CELLPHONE RINGS.]
- [BEEP.]
- Hi, Mom.
My son's coming to town.
Think I'll pick him up at the airport.
And when I see And if I walk And when I run away Hi, Grandpa.
And when I run away Hold me in your arms Don't let go Don't let go And when I see
You don't see any way that can go wrong? You went out on a limb for me.
You fire me now, you look like a fool in front of the board.
Dr.
Andrews, I don't think you have the votes to carry it.
But I don't need the votes.
Just as you have the power to fire someone under your supervision, so do I.
MELENDEZ: Did you hear about Han? LIM: Can't imagine Andrews will survive the fallout.
They're gonna need a new Chief of Surgery.
Aoki should be calling you with the offer any minute.
Here are flowers and chocolates.
Are you asking me out? Yes.
I would love to.
[GASPS.]
[INDISTINCT CONVERSATIONS.]
Why are you smiling? I don't know.
I just I wanted you to know that things are okay.
If I start a commotion Good.
I run the risk of losing you, and that's worse [CLEARS THROAT.]
Ever fallen in love with someone Ever fallen in love, in love with someone Ever fallen in love, in love with someone You shouldn't have fallen in love with? I saw a movie last weekend.
Which one? Was it good? What kind of movies do you like? What a shame Oh.
This looks delicious.
Thank you.
Ever fallen in love with someone Ever fallen in love I said no pickles.
- Ever fallen in love - Pardon me? It's okay.
They can just take that off I said no pickles.
Oh.
I am so sorry.
I said no pickles.
- [DISTORTED AUDIO.]
- [GRUNTS.]
SHAUN: It was a disaster.
What happened? Don't you all have work to do? Sorry.
We were just Shaun was on a date.
Hmm.
Congratulations on your promotion.
I believe you're our first female Chief of Surgery.
That's nice.
Uh, thank you.
Yes.
And you're still not working.
[CLEARS THROAT.]
Not you.
We need to go to H.
R.
and break up.
[FOOTSTEPS DEPART.]
[ENGINE REVS.]
- [TIRES SQUEAL.]
- We need a head CT and a trauma panel.
Please! Someone! Help my wife! [GRUNTING, BREATHING HEAVILY.]
We've been married for 45 years.
Two children.
Eh, so far.
Oh, stop it.
Ricky and Tammy.
Ricky's got two kids of his own.
When did you first notice the pain? - This morning.
- No, on Saturday.
He has a history of kidney stones.
I try to get him to drink more water You "try"? When did I ever say no to you? It's probably another stone, but we'll do some imaging to rule out anything more serious.
Oh, thank you.
Did you tell them about the kids? [CHUCKLES.]
We have two, you know.
So far.
[CHUCKLES.]
That's nice.
[SIGHS.]
- Not it.
- What? He's got dementia, and even worse, it's boring.
Probably stones.
Best case scenario, it's a kidney tumor.
We've assisted on eight nephrectomies.
It's your case, your chart, you're primary.
Kellan's coming to town.
I need to be out of here at a decent hour, and we are not children.
We do not decide things by who called it.
You touched the chart first.
It's yours.
- Did not.
- Did so.
We walked up together, Petringa handed the chart to you.
- Did not.
- Did so.
- Did not.
- Did so.
Why? It just wasn't working out.
Oh.
Well, I certainly hope it's not because in light of Dr.
Lim's recent promotion to Chief of Surgery that she's now your supervisor? We knew that arrangement would be unacceptable, and since we only recently started seeing each other You were seeing each other secretly for some time before you reported it, correct? So, maybe you've just gone back to seeing each other in secret.
No.
Uh, we made the decision that this opportunity for Dr.
Lim is just You're What What are you writing? I have accepted your explanation and report.
Thank you.
But I don't believe it.
You're going to keep seeing each other, and I can't do anything to stop that, nor do I even want to.
But know this love doesn't conquer all, lust doesn't either, and like doesn't even come close.
This is gonna be a lot more complicated than either of you think.
SHAUN: Looks like you have a large uterine fibroid that's bled.
It has to be removed surgically.
Yes, routine surgery.
You should be fine.
Uterine? Am I gonna be able to have The surgery won't affect your ability to have children.
[INDISTINCT TALKING OVER P.
A.
.]
I didn't let her finish her question because I anticipated what she was going to ask because the uterus has very few functions.
- Nicely done.
- Yes.
To improve O.
R.
access, we're going to automatic block release and implement staggered starts for anesthesia.
Any questions? Dr.
Andrews and Dr.
Han wouldn't authorize staff overtime.
Now, our nurses Good point.
Thank you.
Yes.
Authorized.
One other thing, and this is really for our third years, but it will affect all of you.
Traditionally, you don't get to lead surgeries until fourth year.
That will be changing.
The earlier you get in there and take responsibility, the more chance you have to learn.
When the right surgery comes along something simple, basic, it'll be yours.
Start prepping.
Maybe I did touch the chart first.
Relax.
It's okay.
I can stay late now and again.
This is my job.
Stop it.
You don't want the case.
It's boring.
I get it.
I know you get it.
Boring is now exciting.
Boring means it's a routine surgery, which means it's a surgery that Lim just said one of us may well lead.
This one's probably no surgery at all.
It's probably just kidney stones and late nights with a man with dementia.
I'll take that chance.
You hate people.
People don't know that.
People like me.
You need to be with your family.
Kellan's 16.
He barely talks to me.
It's who touched the chart first, which, as you said, was me.
- And as you said - HARVEY: Excuse me.
Y-Yes, Harvey? Is everything okay? Why am I in here? Nothing to worry about.
It's likely just a kidney stone.
You just have to Yes! It's cancer.
Nicely isolated, simple surgery.
Perfect for a resident.
Put some traction on the uterus to expose the broad ligament.
I'll slide the pelvic retractor under the fundus.
[SIGHS.]
Did the wine spill all over you? Um Did it spill all over Carly? S-Stop.
Look above the posterior cul De sac.
- Cancer.
- Yes.
Very extensive, I think.
It appears to have metastasized everywhere.
Liver, kidney, abdominal wall.
Close her up.
- [BIRDS CHIRPING.]
- [FOOTSTEPS APPROACHING.]
I rang the doorbell.
Yes, you did.
Are you gonna spend the rest of your life lying around in this backyard? That, and lying next to my future wife.
Congratulations.
I heard.
But what are you going to do professionally? When people think they're going to die, like you did, they assess their life, reevaluate what's important.
You're going to need to make a difference.
Do you have a puppy for me to adopt? I have a vacancy at President.
Again? You're interested, but you think things have to change.
They don't.
You led a meaningful life before cancer, and you will lead a meaningful life after.
Well, thank you.
I'm very inspired.
Think about it.
Also, sunscreen.
What's going on behind the pancreas at the root of the superior mesenteric artery? We need a better angle.
We're not gonna get a better angle.
Definitely not when we're actually operating.
So what's the solution? [SIGHS.]
There isn't one.
Not surgically.
We should refer them to an oncologist.
Chemo might help, but I'm not hopeful.
[SIGHS.]
What are you gonna tell them? You guys are third year.
You want stuff to learn by doing? How about sympathetic communication? Shaun, let the bride know she's probably dying.
[DOOR OPENS, CLOSES.]
This morning, who did you give the Calderon chart to? I gave it to you guys.
Uh, but you handed it to one of us.
One of us actually took it from you.
It was me, right? I don't know.
What does it matter? You just came up and From the right.
I came up on Morgan's left.
You're left-handed? It only makes sense that I would be closer to Excuse me.
Is there any news about my husband? [INDISTINCT TALKING OVER P.
A.
.]
Harvey, you remember Drs.
Park and Reznick.
They did your scan.
R-Right.
For my, uh They were looking for kidney stones.
Unfortunately, we found some cancer.
- It's on your left kidney.
- Cancer? The good news is it's isolated and in a very operable location.
Cancer.
I have cancer? We have to tell the children.
We'll do a biopsy to confirm, but I'm confident that we caught it early.
This is terrible.
I I can't die.
I You need me.
I know.
But with surgery, radiation, and immunotherapy, the prognosis is excellent.
[DOOR OPENS.]
You're supposed to be talking to our patient.
They can wait until we're sure.
We are sure.
Dr.
Melendez is sure.
Dr.
Lim told us we're ready for more responsibility, so I decided I can make a decision on my own, and I decided to do some more research.
Shaun, you need to learn how to do this, and stalling just makes it worse.
I think maybe you're feeling bad about your date, and you're in here burying yourself in things you subconsciously think you can control.
How do people know what's going on in their subconscious? What happened, Shaun when you jumped up? Fallen in love with someone, ever fallen in love In love with someone, ever fallen in love In love with someone You shouldn't have fallen in love with [CELLPHONE RINGING.]
Your phone is ringing.
- It can wait.
- Mm.
It's your mother.
It can wait.
What went wrong? What was the disaster? She called earlier, too.
If stalling is bad, then why are you avoiding your mother's calls? [CLICKS TONGUE.]
Did you ever forgive your mother for not protecting you? Is that what your mother wants to know? My mother was a terrible mother.
It wasn't all her fault.
She was bipolar.
That doesn't change the fact that she was terrible.
I I don't think it's good for her to be in my life.
Are you looking for guidance from me? Am I a role model to you? On some issues, absolutely.
I don't usually think about the past.
It doesn't help.
But the date.
Mm-mm.
Yesterday is part of the past, and the past matters.
What happened? I told a joke.
- No.
- Yes.
Lea said I should.
No.
That is not what I said.
Does this tie look good? Yes.
But not with those pants.
And what I was saying was that jokes are the types of things people do on dates.
They talk about the weather, hobbies, where they went to college.
I'm a person.
Should I change my pants with you in the room? No.
And, yes, I know you're a person, Shaun, but we all have strengths and weaknesses.
Telling jokes is easy.
There are books full of them.
I said no.
Yes, there are a lot of jokes, but you have to know how to tell them.
You have to know when to tell them.
So, I took a gap year before college, which, in hindsight, I think might have been a mistake.
Staying at home.
My relationship with my dad Caesar walked into a bar and asked the bartender for a martinus.
The bartender said, "Do you mean a martini?" And Caesar says, "If I wanted two, I would have ordered two.
" Uh did she laugh? I'm not sure.
Well, what did she say? [CHUCKLING.]
She made a sound.
"Heh.
Heh heh heh.
" You got a chuckle, I think.
- That's That's good.
- No, it's not.
I read six joke books, and all I got was a "Heh.
Heh, heh, heh.
" It was a disaster.
[SCOFFS.]
Because of a joke? Something bigger must have gone wrong.
What happened? [BREATHES DEEPLY.]
A young woman may be dying.
I have a lot of research to do.
[MOUSE CLICKS.]
Boom.
My chart, my case, my patient, my surgery.
You took it from me.
It touched my fingers I know it did - and then you took it from me.
- All I know is I'm the one holding the chart.
That's the evidence we got to deal with.
If you could prove Angles.
We need more angles.
How many cameras do we have in that section? Dr.
Lim, I'm glad you made that decision on the overtime.
Oh.
You're welcome.
But I thought you'd want to know the real issue isn't the overtime.
It's being understaffed.
We need two more nurses on this floor alone, one in ICU I'm sorry.
I'm sure you're right, but we just don't have the budget.
[SIGHS.]
- Excuse me? - [SIGHS.]
Nothing, ma'am.
I gave you the OT.
You're not being fair.
Aren't I? You told me I was right, then you told me you're not gonna do it.
Who's being unfair? Nobody said this job Shaun.
Come with me.
Is everything okay? The nurse told us you didn't finish the surgery.
Suzanne you have very extensive cancer throughout your abdomen.
It appears to be malignant.
[SOBS.]
And it appears to have metastasized around every organ.
[BREATHING SHAKILY.]
But there's hope with surgery.
We can't see the retrohepatic part of the cancer because of the liver.
We can't see the retroperitoneal part because of the right kidney.
Yes, I know.
That's why we should take out the organs.
You want to remove her liver and right kidney? Yes.
And also her left kidney and her pancreas and her intestinal tract and the stomach.
You do know that several of those organs are quite essential.
We'll put them back.
We remove them, clean up the cancer, then put them back.
Ex vivo surgery.
It's been done for pancreatic cancer.
Without much success.
No.
You think it'd work better here? Not really.
But the alternative is death.
[SIGHS.]
[DOORBELL RINGS.]
[SIGHS.]
[BIRDS CHIRPING.]
- Hi.
- Hi.
How are you? Good.
[DOG BARKING IN DISTANCE.]
N-Not working? Yeah.
It's been 72 hours, and I still haven't found a job.
Relax.
I'll be fine.
I got some irons in the fire.
What do you need? How do you say no to a person? I don't think I'm doing it right.
Okay.
Watch closely.
[SIGHS.]
Really? If you're gonna give up that easily, you might as well just quit now.
The biopsy confirmed that the kidney cancer is a renal cell carcinoma.
Cancer? I have cancer? Yes.
Why didn't you tell me? We did.
The good news is that it's treatable with surgery and immunotherapy and radiation.
We have to tell the children.
The children know.
How do they know? What's going on? Am I dying? The cancer is serious, but Ruby, we'd like to talk to you outside.
I'll be right back.
The problem isn't how you said no.
The problem is how you said yes.
She seemed quite happy with the yes.
It came too quickly.
You made her think she was helping you instead of the other way around, so she came asking for more, feeling she was entitled to more.
So I should have said no when I wanted to say yes? You shouldn't tell her what you want to tell her.
You should tell her what she needs to hear.
[SIGHS.]
See, it's your job to figure out what you can give them, convince them that's what they need, and then make them feel like they owe you.
N-None of that sounds like me.
And you want to do the job your way, without changing who you are? Is that amusing to you? Yes, I do.
Yesterday, you were an attending.
Today, you're Chief.
You are a different person.
Want an espresso? [ESPRESSO MACHINE CLICKS, CUP CLATTERS.]
Without surgery, your husband would probably live another two to five years.
He would have very little discomfort until very close to the end, and that can be managed.
- You said it was treatable.
- It is.
But fighting cancer's never easy.
We have to weigh the benefits against the suffering, and the surgery itself is usually the easiest part.
He's strong.
He's healthy.
He's not healthy.
Not mentally.
And the burden on you I am not letting my husband die because caring for him is inconvenient, because I'm gonna have to repeat a conversation.
Just go to hell.
[FOOTSTEPS DEPART.]
This type of surgery's never been done for this condition.
We'd be dealing with every one of your abdominal organs, and something could go wrong with any of them.
You could be on dialysis for the rest of your life.
You could have a very compromised digestive tract, lifelong diabetes.
You could have liver failure.
That's not a complete list.
You could die.
And, um if we don't do the surgery? Chemotherapy and radiation.
Although the likelihood of success is slim, about 25%.
You may prefer hospice care.
You'd probably live maybe a year, but it'd be a good year.
Could you give us some time to think about it? Of course.
[BIRDS CHIRPING.]
SHAUN: We're supposed to be at lunch.
We're gonna be late.
Why? Why? Because I need meaning in my life.
Your heart seems fine.
Your liver seems to be in the right place.
You're a brain surgeon.
You don't think you can get meaning being a brain surgeon? This is a boring patient with boring symptoms.
Shaun, meet Marco Higgins, diesel mechanic, currently in between jobs.
Three sons, two of whom he hasn't spoken to in quite some time, but he's working on that.
Open.
Wide.
It's good to get to know people, Shaun.
It makes you a better doctor.
Say, "Ah.
" MARCO: Ah.
You have boring symptoms.
That's a good thing.
You do not want exciting symptoms.
You had a date last night, didn't you? Mm.
I want to hear about this.
Marco, you want to hear about this? Yes, please.
Yes, please.
Open.
It was a disaster.
[INDISTINCT CONVERSATIONS.]
Oh, thank you, Shaun, but it's really not No, it's polite and chivalrous [CHAIR LEGS SCRAPE.]
and even though chivalry is a problematic notion, politeness is a good thing, no matter which - Ohh! - Shaun! - [THUD.]
- [CROWD GASPING.]
- Are you okay? - Oh, my.
- I'm okay.
- She might not be okay.
- No, I am okay.
- Okay.
Don't get up.
I'm pretty sure she's okay.
[EXHALES SHARPLY.]
Take off his boots.
What? Do you think Marco's diabetic? Based on the color of his skin in the crease of his neck, I do.
Based on what it says on his chart, I do, too.
He could have an infection in his feet, and the pain is being masked by diabetic neuropathy.
That infection could be causing the abdominal symptoms.
Marco, would you mind taking off your boots? I was wrong.
It's not boring.
[DOOR CLOSES.]
[SIGHS.]
I can do it myself.
I'm sure, but our job here is to help each other, and today I didn't do that.
I'm trying to make up for that with a jar of pickles.
I overstepped and [GRUNTS.]
undercut you in front of the patient's wife.
[GRUNTS.]
I accept your apology.
What I should have done was privately tell you that you're wrong.
- Give me the jar back.
- And let you, as lead doctor, tell them that this surgery's a bad idea.
Because we should let a 70-year-old man die of a treatable condition? Because we shouldn't condemn a 70-year-old man to years of confusion and fear.
His life still has value.
Seriously? He has memory issues.
He's not a vegetable.
He's funny, he's charming.
They've lived a life together.
He brings happiness to his wife, to his children.
- He's happy.
- Exactly.
Let him stay happy for whatever time he has left.
[LID POPS.]
[DOOR OPENS, CLOSES.]
Nurse Petringa.
I'm sorry if I overstepped.
I didn't track you down for an apology.
You gonna get us the additional staff? No.
If I get you the additional staff, you lose hours, you lose overtime.
So you're doing us a favor by making sure we never see our families? Your problem isn't the staff.
Your problem is the actual work, the crap part of the work that takes too long and too many of you.
I authorized the purchase of two Hoya patient lifts and a mechatronic ICU bed.
A smart bed? [CHUCKLES.]
Those are actually supposed to be kind of fun.
You got to promise to let me try it.
You got it.
Dr.
Lim? Thank you.
You owe me.
I'm well aware of what he'll be going through.
My sister had cancer.
The chemo, the radiation They beat the crap out of her, didn't they? Yeah.
Now imagine going through that and not understanding, every day.
Throwing up and not knowing why, losing your hair and not knowing why, learning he has cancer and being devastated by it day after day.
But at the end There are no guarantees.
He's old, and his body's breaking down.
His mind is breaking down, and it's gonna end, no matter what we do.
In 45 years, I have never once lied to him.
When memory goes, all that's left is emotion.
What we've learned doesn't matter.
[SNIFFLES.]
What we had for lunch, where we went for vacation, none of it matters.
But how we feel who we're close to He's the same man I've always loved.
[SNIFFLES.]
Same sense of humor.
Same everything.
He hasn't changed.
And what I owe him hasn't changed.
CLAIRE: Have you decided? Not yet.
Take your time.
There is no urgency to What are you waiting for? Dr.
Murphy, they are kind of facing an impossible choice.
But they have to make it.
What additional information are you waiting for? - Shaun - I'll be a better doctor if I understand the patient.
True, but right now, your skills are secondary to their Are you debating whether you should find somebody else to fall in love with, someone healthy? No.
No, of course not.
You should be.
We're kids.
You shouldn't have to spend the rest of your life taking care of an invalid.
You think that's the issue? Me? A-A burden on me? This is so much easier on me than you.
No, it's not.
Whatever happens to me is gonna happen, and I have to live with it.
You You have a choice.
"In sickness and in health.
" That was the commitment I made this morning.
Now, if this had happened yesterday [CHUCKLES LIGHTLY.]
[CHUCKLES.]
So it's not that difficult a decision then, right? I guess not.
[MONITOR BEEPING.]
I can feel her humeral head outside the glenoid fossa.
It's an anterior dislocation.
I can reduce that.
Here? Yes, with traction and external rotation.
- [BONE CRACKS.]
- Ow! [CROWD GASPS.]
Oh.
Oh.
Oh, my, that that that feels better.
I bumped you.
Oh, d-d-don't worry.
It happens.
I-I wasn't watching, either.
[APPLAUSE.]
[LAUGHS.]
Come on.
CLAIRE: That's it? You bumped into a very understanding woman, you amazingly caught a bottle of wine.
Where was the disaster? Unclamp the superior mesenteric to perfuse the organs.
The small intestines look dusky and cyanotic.
We'll need to resect all the necrotic segments.
Claire, find the first viable part of the ilium and clamp proximal to it.
[DOORBELL RINGS.]
I don't think your irons in the fire are very hot.
Any job interviews you get, you're gonna spend a large chunk of time trying to explain why you lasted less than a year as President at St.
Bonaventure.
I mean, how do you put a positive spin on why you spent a fortune on a Chief of Surgery you fired weeks later to protect a second-year resident? You think I made a mistake? No, I think you did the right thing.
I admire you, which is why I want to do you a favor.
What you need to do is prove that you haven't burned any bridges, which means you have to come back to work at St.
Bonaventure.
As what? As a surgeon working for you? And the fact that you're undoubtedly in need of a surgical attending to replace yourself is just a coincidence? It's what you need.
I admire the effort.
But don't con a con man.
[DOORBELL RINGS.]
Your greatest strength and your greatest weakness as a leader was your stubbornness.
Don't let it be a weakness today.
My back hurts on the left side.
That's where you had your biopsy.
It's gonna hurt for a little while.
What biopsy? Harvey, you came in here because you thought you had kidney stones.
We did some imaging, and you don't.
What is it? What What's wrong? What? What's going on, Ruby? I Why isn't anybody saying anything? Am I dying? Ruby? I I can't die.
I need to take care of you.
I I can't They didn't find stones.
Everything is okay.
[SNIFFLES.]
The pain will go away.
We're gonna go home tonight.
Okay? Okay? [SNIFFLES.]
[INSECTS CHIRPING.]
I had a nice time.
[GATE OPENS.]
[FOOTSTEPS DEPARTING.]
That's it? It's over? Where's the disaster? I've listened to an hour of this.
I was promised a disaster.
Where's the disaster? It was exhausting.
Everything was always out of control.
Anything could happen at any time.
Anything did.
There was too much to remember to do, too much to remember not to do, and none of it made sense.
It was hard, uncomfortable, unpleasant.
I spent the whole evening doing unnatural things to make her happy, and I have no idea if she was happy, and I know I wasn't happy.
It was all a disaster.
I want you to meet our new attending, Dr.
Marcus Andrews.
Pleasure to meet you.
[SIGHS.]
How long have you been working here? Ms.
McDougal? She didn't ask for ID.
It's policy.
We take a lot of immigrants here.
She also didn't look at me.
Check the symptom I told her I had A cut over the left eye.
You heal very nicely, Ms.
McDougal.
[CHUCKLES.]
You hate it here.
[SIGHS.]
"Hate" is a strong word.
What would you do differently? [CHUCKLES.]
Give me five things.
Diabetes clinical educator, onsite lab and X-ray, mental health advisor, multidisciplinary care team, electronic medical records.
We had the clinic at the hospital and had to shut it down because it was a money pit.
Come back as President, and we'll re-open it.
Your office can be in the clinic.
Do I have to wear a tie? [SIREN WAILING IN DISTANCE.]
Hey.
Welcome back.
[SIGHS.]
Am I okay? The surgery went very well.
We're confident that we got all of the cancer.
[SIGHS.]
There's a bag by her side.
Is that just to drain stuff post-surgery? There were complications.
We had to remove a large portion of your bowel and divert the waste through a stoma in your skin.
That's an ileostomy bag.
How long will I have that? Forever.
So I have to go to the bathroom in this thing for the rest of my life? Yes.
We'll teach you how to change it, how to dispose of it.
They'll teach both of us.
Now, this is why we do it, Shaun.
Every date is a disaster.
Every relationship is out of control.
But if you stick with it, you wind up with someone in your life who will help you when you need to be helped, love you when you do not feel lovable, be with you no matter what.
It's not worth it.
[CELLPHONE RINGS.]
- [BEEP.]
- Hi, Mom.
My son's coming to town.
Think I'll pick him up at the airport.
And when I see And if I walk And when I run away Hi, Grandpa.
And when I run away Hold me in your arms Don't let go Don't let go And when I see