The Good Doctor (2017) s04e07 Episode Script

1 Oh! We can't both shower at the same time, Lea.
One of us would block the stream of water for the other.
Oh, Shaun, this is not for the purpose of cleanliness.
This is for the purpose of having sex with you.
Oh.
N-No.
No.
It would be inconvenient, possibly dangerous.
Soap might get into difficult places.
If we leaned against the shower handle, we could scald ourselves.
Bottles could be disarranged.
It was just a thought.
It was a bad thought.
I'm surprised.
You're such an intelligent person.
I'll reset your alarm.
It's a three-day weekend and a full moon.
People are gonna do stupid things.
I'm asking everyone to take an extra trauma call in the E.
R.
Make yourselves available if you're needed.
Questions? How'd you get the bruise? First casualty of the full moon.
I smacked my head on a cupboard door when I was reaching for my coffee mug.
Any other questions? Why is there a Subaru in your parking space? Because it's my car.
You have a car? You're gonna be seeing a lot of it.
I sold the Ducati.
What? No.
It just wasn't practical.
Is it already gone? Because A guy from Craigslist snatched it up.
Any other questions Not dealing with the bike? It wasn't that much of a bruise.
But the doctor at the ski resort told us I might develop a hematoma? It's not unusual, but it'll need to be drained.
I see you were treated for melanoma six years ago, and, more recently, breast cancer.
Hence the ski trip.
A celebration.
One year cancer-free.
Also five years cancer-free.
I don't suppose a long needle will be involved in this? Your hematoma extends pretty deep, so the needle will have to be long.
But it's over quickly.
Sorry, I have to intervene before this deal goes south.
You don't mind if I step out? Would you like us to wait for your husband to come back? No.
Let's go ahead.
How do you get frostbite in San Jose? Cryotherapy accident.
I stayed in the booth a little too long.
I was going to stand outside for the full three minutes, - but he said - I said, "No need.
" I'd set the stopwatch on my phone After which, my thoughts immediately drifted, and I came back to find him frozen in carbonite.
You know, I'm more worried about the fever.
Was the cryotherapy meant to treat something? No.
Routine self-care.
We've made life extension part of our health regime Supplements, meditation, exercise.
Three of my gaming apps have gone viral.
I'm lucky enough to afford basically whatever I want, so I spend it on my health.
No, I figure fever, must be an infection.
Well, I know that frostbite can make you vulnerable.
It just It didn't seem severe enough to Oh, sorry.
I feel a little queasy.
Aah! Wyatt.
Ow! I need a medical transport team, stat.
Perforated bowel.
He needs immediate surgery.
No.
No.
Why do people hate wind farms? Everyone thinks they're noisy.
This could make a turbine sound as quiet as a page turning in a library.
That's not worth our investing in? Did you even look Hold on.
Anything I need to know? Hematoma's drained.
We're sending a sample to Pathology routine.
Should have it back sometime tomorrow.
- Thank you.
- Mm-hmm.
I couldn't help overhearing a little.
Are you a venture capitalist? The only people who ask me if I'm a VC are people who want a VC to invest in their project.
Maybe, after we get your wife healthy again, we could talk? Call whenever you're ready.
My life is listening to ideas.
If it's good, I'll run it by my two partners.
If it's really good, we'll take a 30% equity position in your company.
Yeah.
Yeah, you're the one who wanted us to get into clean technology.
I think I've been asked out on a date.
Nice.
No, I work with him.
- Hasn't stopped you before.
- I supervise him.
Schedules can be changed.
He's polyamorous.
Unless he also texted you a ring, it's just a date.
And you need to get out more.
So do I.
You want to take down the splenocolic ligament.
Just don't nick the inferior mesenteric artery.
I feel the I.
M.
A.
under my finger.
Placing the stapler.
And cutting.
I voted "approve.
" Disapprove.
No opinion.
There's a poll? Yes About shower sex.
I know it's wrong to discuss shower sex at work, so I did a poll instead.
Much better.
Dr.
Murphy, do you really want people knowing the details of your personal life? You don't think they took it as an abstract question? No.
We all take it as something that happened between you and Lea.
And that there was a fight.
Sometime before 8:00 a.
m.
today, which was when the poll was sent out.
You are very astute.
I'm seeing diffuse dilation of the large bowel here.
Is that normal? Some calcified lesions.
Wall's thin, too.
Hirschsprung's.
I thought Hirschsprung's was a disease only babies and young children got.
It is.
But he has it.
We treated the Hirschsprung's by removing the dilated part of your colon.
It won't impact your life, but we would like an explanation.
Dr.
Murphy doesn't mean we expect you to be a diagnostician.
It's just this was kind of singular.
So, if you have any thoughts Did anyone in your family suddenly develop these symptoms? I did something singular to myself about six months ago.
I modified my genetic code.
I did a CRISPR procedure under the guidance of some researchers I know in China through my work.
They put together a series of cocktails.
They FedExed them to be, and Sophie helped me inject them into my bone marrow.
Why? If you know anything about CRISPR, you know how risky it is to tinker with your genome.
You have no idea what problems you might let loose.
I needed to optimize my telomerase activity.
It's the enzyme responsible for correcting cell replication errors Essentially, the cause of aging.
You can't stop aging through changing your telomerase activity.
You might extend your life a little, but exercise It does the same thing.
Much less risky.
Your decision makes no sense.
Extending my life by a few years is only my short-term goal.
Look, you know how fast medicine is moving.
The day isn't that far away when cloning will make transplants as easy as switching out a light socket.
AI will start to make breakthroughs that we can't predict or understand.
Medical knowledge will rise exponentially.
There are babies born now who could live to see it, could live to be 1,000 years old.
Maybe more.
Maybe forever.
Or at least, as long as they want to.
So, our plan is to give my CRISPR a year to make sure the telomerase change works, and then we'll do her.
We'll aspirate a sample of your bone marrow.
See if we can figure out what the hell you did.
Hey.
Um I don't think coffee's a good idea.
Entire civilizations rely on it.
But I don't think you're referring to the beverage itself.
I don't think it's a good idea for first-years and fourth-years to go out.
I am bound to supervise you at some point in the future, and it'd get complicated trying to change dates out, and the fact is seeing somebody you work with rarely ends happily.
So, I appreciate you thinking of me, but I Oh, you thought it was a date.
I'm still new here, and I thought it was a good opportunity to get to know each other.
Coffee's perfect because you're asking the least amount of commitment from another human being.
It's not even lunch.
If it's still a "no," it's still a "no," but I'll let you re-think your answer.
He only claimed it wasn't a date to save face.
Or maybe I just assumed.
But why did I assume? I don't think I'm some kind of narcissist who thinks every man wants to get close to me.
Or we both assumed it's a date because it's a date.
This is fun.
I like being your bestie.
Slumber party? I made a poll to test the popularity of shower sex.
I heard.
I fielded some questions about that.
"Approve" has won, but don't get too excited, Lea.
It's only 58-38, with several complicated noncommittals, so clearly my attitude is reasonable.
We don't have room for a skier exercise thing.
I'm only putting it together so I can take a picture and sell it online.
Why do you have it if you don't want it? My ex sent it.
"Ex"? Husband.
I left this thing in the attic until I got settled somewhere with enough space.
And okay, that was 10 years ago, but it's not like it was in his way.
We got married, not for long, right out of high school.
Literally the boy next door.
We grew up together.
People expected it.
It was a big mistake.
We both realized it pretty quickly.
Why would you even want to live forever? You'd be bored out of your mind.
The person I am now is miles away from the person I was at 14.
I only get more distant every year.
You learn to understand, love books that you once hated, sometimes people you once hated.
Music that you didn't get the point of becomes magical.
And a thousand new doors will open.
I look forward to the adventure.
Ow.
Sorry.
Adventure's not always gonna be fun.
I figure it takes 40 or 50 years just to get over the things your parents did.
If only we lived long enough, the human race might finally have a chance to grow up.
What size shoes do you wear? 7 1/2.
"Dr.
Allen's Walking On Clouds Inserts.
" Putting "doctor" in the name is always good marketing strategy.
They're designed to reduce inflammation that could lead to plantar fasciitis, calluses, arthritis, and they feel damn good.
Does this have anything to do with our patient's venture capitalist husband? I need testimonials.
Labs and Path for Hannah Palmer.
Aren't we all busy enough learning how to be surgeons? Do you really want to divide your focus onto something trivial? Because wanting to make money taints the purity of medicine? I have five brothers.
I've been taking care of people my whole life.
Someone got hurt, they came to me to patch them up.
I became a doctor so I could get paid for it, but also because I'm good at taking care of people.
It's possible to do something for more than one reason.
The news is bad.
There's an abnormally healthy population of hematopoietic progenitor stem cells.
He did it? It's significant.
He's succeeded in optimizing enough telomerase activity to potentially add 10 years to his natural life.
Well, assuming it doesn't subtract about 50.
There's already an autoimmune reaction that mimics Hirschsprung's.
Who knows what else he did? What if this is the opposite of an auto-immune condition? What if he's done something that lowers his resistance to infection? Then we'd be seeing more opportunistic infections of the lungs and skin.
If you lived another 1,000 years, would you be with the same person at the end as at the beginning? - No.
- No.
No, if you assume monogamy.
I mean, that puts too much strain on a relationship.
Is one person supposed to be everything to another, all the time, for 1,000 years? Apparently Jesus agrees.
On monogamy.
He said that, in Heaven, there'll be no more marriages.
I guess humans can't sustain a relationship that long.
You read the New Testament, too? And the Qur'an.
And other things.
It's like you're a stalker.
It's like you and God had an acrimonious divorce.
What if he caused neurofibromatosis? Microscopic tumors forming on the nerve sheath? Mm.
Possible, but there'd have been some evidence of Schwann cell growth around his colon.
Would you still love your wife in 1,000 years? You have three answers.
That should be enough.
Park's marriage failed in far less time, and Enrique doesn't even try.
Asher is an unknown quantity.
You're committed.
You've made promises.
I've made promises based on an understood human life-span, Murphy.
Most likely diagnosis is autoimmune polyneuropathy.
It damaged the enteral ganglion nerve and led to the perforations.
Start him on steroids and immunosuppressants.
Dr.
Andrews.
So, you wouldn't have gotten married if you thought it would be forever.
You expect all relationships to fail over time.
It's just a question of how long? I love her now.
I intend to love her as long as I live.
But, eventually, everything breaks.
I always go back to comfort reading when I'm in the hospital.
Cozy mysteries in little English villages, where nothing bad happens to anyone we like.
We've gotten your results back.
When will your husband be Is it cancer? Yes.
Thyroid carcinoma.
We're gonna do a complete imaging series to pinpoint just how advanced Treatment? Surgery to remove some or all of your thyroid is usually the first line of defense.
Sometimes, we can wait, but given the hematoma was probably caused by the tumor invading nearby vasculatures, we should probably do it in the next few days.
Later, there'll be radioactive iodine treatment Panic attack? Her trachea's deviated to the right.
The tumor's compressing it.
We're doing surgery now.
What happened? The nurse just said "surgery.
" Was it the hematoma? It's more serious.
I-It's not cancer again.
Thyroid carcinoma.
We've removed her thyroid.
She's doing well.
We're looking into potential causes Genetic, environmental.
There may be a deeper issue that we can find and address.
I can't do this.
You've done it before.
You'll do it this time.
Do you know what it's like to wake up every morning and know your wife might not be here next year? All those treatments they all they all have this little tag attached to them that says, "Because she might die.
" And you see them put those gloves on before they hook up the chemo.
You know why they do that.
It's because it's poison.
And you sit there and you watch them shove poison into the person you love.
And why? Because she might die.
We're killing her because she might die.
Go for a run.
Go punch a wall.
You need to release some endorphins.
My release is my job.
That's why I love it.
My work requires total focus.
And every minute I'm working is a minute I'm not thinking about losing her.
I have to go.
Your pain and weakness are consistent with polyneuropathy, treatable with steroids and immunosuppressants.
If you live 1,000 years, will you still love Sophie? Yes.
How can you be sure? People change.
You expect to change.
Sophie and I will change together.
We'll go through the same adventures and learn the same lessons.
What if you go through the same adventures and learn different lessons? Even if we did, whoever, whatever we become, Sophie will always be beautiful.
I mean, she could turn into a machine or a set of pixels or a giant purple flower, and she'll still be beautiful, because it's part of her essential nature.
But if you don't know how you'll change, you don't know how you'll change.
Shaun.
We'll let you get some rest.
The steroids should make you feel a lot better.
Why didn't you ever mention you had an ex-husband? Shaun, I've barely thought about him in years.
I didn't mention him because he's not important.
I know.
That's the problem.
At one time, you felt he was important enough to your life to marry him, and now you barely think of him.
You make long-term plans, you have expectations, and then something happens to you, and suddenly you're a different person.
I know you don't like change, but it's not all bad.
After all, you are working to change yourself all the time.
I'm working to be a better surgeon, a better boyfriend, better at the things I've chosen, but this other change It's unpredictable.
You don't choose it.
It just comes at you.
Oh, it's like hurricanes before 1873, when the Army Signal Corps first put up flags to warn people storms were coming.
Before that, houses were flattened, lives destroyed, and there was no way to see it was heading for you.
Shaun.
Our relationship will not end in natural disaster.
It did begin in one.
I'm going to look in on my patient.
Okay.
Blood and saliva will tell us if there's a genetic cause, and the samples we take from your house will tell us if there's something environmental.
I know it's s-stupid.
I've almost felt guilty for my cancer, like I arbitrarily decided to be sick and burdensome.
Do the people you're close to ever act like you're a burden to them? You mean Alan.
He's scared.
He takes the exit he's got and he turns to his work.
You're okay with that? I accept this compromise.
That's not the hard part.
The hard part is not knowing.
Each new thing that happens, I worry, "Is this it? Is this where I lose him? Is this where he breaks?" So, this is boiled coffee.
Some people call it "Turkish coffee," or "Greek coffee," or "Egyptian coffee" Because we need to take ownership and put things in categories.
Yeah.
You actually live in this thing, in the hospital parking garage? Why not? Convenient for work.
When I want to spend a few days off the beaten track, it's convenient for that, too.
Ooh.
I'm gonna get three sips in this.
But three really great sips.
That's how I try to live my life Try to appreciate, savor, not pass by.
Is that what the polyamory is about? Does it really work, or is it one of those theories about life that people regret later? No regrets so far.
Mm-hmm.
No, I guess not.
Not while you're young and having fun.
It is fun, but not for the reasons that you're thinking.
It isn't about sex.
It's about commitment, emotional connection.
The joy I'm sure you get out of a relationship, I get a little more.
Also, I have to give a little more.
But that's meaningful, too.
Hmm.
Do you mind if I ask you something, since we're getting personal? Sure.
What's your favorite misheard song lyric? This is nice.
I'm glad it's not a date.
Me, too.
I don't believe in those categories.
He reported widespread bilateral pain, then he keeled over.
B.
P.
dropped to 80 over palp.
I'll order a vasopressor.
- Already did.
- Good.
We need an EKG, CBC, and chest images, and a new diagnosis.
Whatever he caused with CRISPR, it's not just neuropathy.
Something else is killing him.
What if he's caused something that mimics carcinomatous autonomic neuropathy? It explains the B.
P.
and bowel issue.
That doesn't explain the sensory issue that led to the frostbite.
A connective tissue disorder? That would have shown up on the scans.
His chest looks normal.
Maybe we can't think of the answer because there is no answer.
We keep trying to jam it into these categories we know, the diseases that we know.
But this never existed before.
He created a new combination of genetic code.
That means a new combination of symptoms.
So, we shouldn't be looking at what fits the picture, but at what's closest to the picture, so we can at least figure out a treatment.
And what it's closest to is amyloidosis.
This isn't an autoimmune neuropathy, so the nerves must be under attack by something else.
Something like amyloid disease could leave deposits along the nerves, causing the symptoms we've seen.
Where do we look for those deposits? The spleen.
Drink all 8 ounces.
We talked.
We had a few laughs.
Well, sounds date-y to me.
I don't think Enrique's a player.
No, he's kind of the opposite of a player.
With him, emotional connection is the point.
He's trying to live some idealistic fantasy where everyone is nice and no one is jealous.
I am so staying away.
Well, of course.
Once I heard "emotional connection," I knew the game was over.
What does that mean? I'm against emotion? I'm not the one with "cold-hearted bitch" as my social media hashtag.
She's an excellent doctor.
Every time you've loved somebody, it's ended in disappointment or death Sometimes both.
It's like a reflex now.
You just expect that everything ends badly, so why start? So, despite the many practical reasons not to go out with a first-year, this is all about me? Is that a diamond ring? I mean, it's pretty.
Our patient caught her fiancé cheating.
Big fight.
He demanded the ring back.
She swallowed it.
I did.
You don't even know if this is "going out," and that's the point.
It doesn't matter what Enrique's offering.
Whether it's friendship or romance, you're not investing.
You're risk-averse.
Your portfolio right now is entirely in T-Bills and money market.
I have no idea what that means.
And it's too bad, because a guy that can make you laugh might be just what you need right now.
It's progressed to your large intestine.
Here's a plastic bag.
Put it over the toilet seat.
You'll have every opportunity to recover your property.
Don't run away from a chance at love.
It's a date maybe.
I don't know.
Oh.
Her house is full of T.
C.
E A side effect from chip-making back in Silicon Valley's early days.
So, they move away from their toxic home, and hopefully things get a little better.
Probably not much.
She also has a genetic predisposition.
It's both? She shouldn't go outside in a rainstorm.
How do you tell a woman that her third cancer likely won't be close to her last? Unfortunately, this is a teaching moment.
Dr.
Allen, after 12 hours on duty, I can report that your inserts came through.
Check your e-mail.
You'll find my testimonial.
Claire.
Olivia.
And if you're right, what will you do? We'll treat the symptoms with targeted drug therapies.
There really isn't a disease, as such, that we can address.
Ow.
The pain shifted? Yeah.
Oh.
Never mind about the ultrasound.
It'll be easier to check for deposits after the organ's been removed.
After it's Yeah.
His spleen's about to rupture.
Call a transport team.
It's called Li-Fraumeni Syndrome LFS.
An inherited predisposition to developing a wide range of cancers.
Yes, there was a toxin in your environment that likely played a role in this, but there will be other triggers in the future.
Your body is super sensitive and will respond with tumors for the rest of your life.
I know that's a shock, but here's what you should know Most cancers are treatable if found early enough.
We know the most common associated with LFS, and we can do surveillance Nip anything in the bud before it becomes a problem.
It may not seem this way now, but this is good.
We know what we're dealing with.
We're warned, and we'll be ready.
He won't be able to handle this.
Liver, pancreas Other organs look normal.
Ah.
But there are calcified lesions along these nerves.
He's gonna be in pain like this for the rest of his life.
No.
There's a reasonable chance it'll get worse as time goes on.
I need my sharp-blunt curved scissors.
What if we used CRISPR to reverse CRISPR? Researchers have identified a protein in certain bacteria that inhibits CRISPR.
What if we insert the DNA that makes that protein into our patient's genome? That would deactivate the CRISPR gene.
So, CRISPR messed him up permanently, and you think we should do more of it? I don't know.
Our patient is a risk-taker.
We'd need a delivery mechanism.
The code would have to be introduced through a virus A virus that specifically targets nerves.
Polio targets nerves.
Because this isn't risky enough.
Polio is such a dangerous virus because it's so good at penetrating the nervous system.
Dr.
Murphy? She's going to be this way forever.
She'll have good periods and bad periods.
But she will always have to be on her guard.
Is she always gonna have to be on guard against you, too? What does that mean? Chronic illness puts strain on relationships.
Statistically, it is more often the man who can't handle it.
Our marriage is none of your business.
Her health is my business.
And your behavior adds to her stress.
You look at her, and you imagine she's gone, and that is hard.
I get it.
She thinks the same thing when she looks at you.
I never complain to her.
I know it's nobody's fault.
You don't think she knows you have trouble with all this? Every time something new happens, she wonders, is this the straw that is gonna break your marriage? You've got her living in a constant state of uncertainty.
That is practically the definition of stress.
So, this is the "straighten up and fly right" lecture.
No.
I am I'm telling you to consider how best to time your divorce.
There are gonna be a lot of new issues dropping on Hannah, and if you're gonna end up leaving anyway, you should start planning now.
I don't want to leave my wife.
My best advice? Help her through this next round of treatment as best you can, and then get out.
It's hard living with someone who needs so much.
I know you feel there is a point where you have nothing left, where you're ready to break.
Just don't break when she needs you most.
Get out before that happens.
Reading an article that's five years old? Dr.
Glassman was once involved in an experimental attempt to treat Parkinson's with CRISPR technology.
It failed.
So, it's both old and it didn't work? Dr.
Glassman likes his failures to be informative.
That's why his articles are longer.
Do you worry about losing the people you love? Because we can't stop ourselves from changing, which means we might stop loving someone, or they might stop loving us.
It is a very bad thing.
It is.
So, no one can ever feel safe.
How can you keep going if you never feel safe? Well, sometimes, not changing is just as dangerous.
So, how do you know when to do what? If you find the answer to that, let me know.
- I have it.
- You do? Dr.
Glassman used varicella zoster virus as the delivery mechanism, which didn't work.
His first choice was herpes simplex, but the technology was not up to putting their DNA package into it.
The technology has improved.
It can be done.
Using conventional treatments, there's nothing more we can do for you.
The pain will be permanent, and it could get worse.
Well, I've not been one to be limited by the conventional.
We think we can reverse the CRISPR.
You want to reverse what I did? My telomerase change? They want to stop your pain.
Soph, it's temporary.
What is it, 40 years? That's nothing.
Our real lives are ahead of us.
Hey, look, as long as this doesn't kill me, I've made the right choice, no matter how bad things get.
No.
I was willing to exercise for hours and fast, to give up all sugar and alcohol and do all the other things that we needed to do to get to a future that I knew might never come.
But now, you're asking me to watch you suffer for the rest of your life.
You're the one who embraces change.
So, change to the person who can be happy with me here and now.
Doctors, would you mind waiting outside? Why did she want us to leave? I think she's delivering an ultimatum.
Are you sure about this? It seems there's always something else that I have to give up.
But this isn't like sugar or cigarettes.
You won't get over this in a hurry.
No.
Not in 1,000 years.
Are you gonna be okay? I'm fine.
Alan's at work, but there should be a taxi waiting.
I won't say goodbye, Dr.
Browne, 'cause I'll probably be seeing you again pretty soon.
I sent your cab away.
I'm sorry I wasn't here sooner.
I had to present a proposal to my partners.
I'm selling them my share of the business.
Is Is there something else you want to do? Yes.
What you're doing here? I want to be your husband.
I realized I was so afraid of losing you in the future I was losing you now.
Sorry.
I hear your VC contact decided to quit the business.
He did the right thing.
Baby, don't lie to me You know my feet are killing me.
I'm open.
To being friends.
That's great.
I'm open, too, to wherever this goes.
It's going to friendship.
Understood.
But life is about change, which means, one day, you might change your mind.
And if you did, I'd be open to that, too.
It's not gonna happen.
Okay.
First, there should be no soap involved.
Also, we need to stay at one end of the shower, so we don't accidentally knock into the temperature control.
What changed your mind? I've been thinking about change over time.
I spoke with people and also graphed several possibilities for us, using time as the horizontal axis and change as the vertical.
I realized that the problem isn't really change.
It's whether two people change in the same direction.
We want to keep our coordinates close to each other for the rest of our lives.
We certainly do.
But people sometimes do drift apart.
Yes.
You need a warning when you and your partner might be starting to veer off, so you can both change course a little.
You don't want a surprise realization when it's too late.
Surprises are awful.
The U.
S.
Army Signal Corps used flags to warn of hurricanes.
I brought us this.
A cowbell? If you see us heading in different directions, you ring it.
Do we really need a bell? Can't I just tell you? Oh! When you ring it, I'll pay attention.
I really hate the sound.
Only in emergencies.
I've already moved the shampoo bottles.
What? Oh.
You mean now? Don't worry about putting the bottles back.
I'll do it later.
I love you.
It's no trouble.
I remember where they all go.