The Good Doctor (2017) s05e17 Episode Script

Previously on The Good Doctor I'm producing a reality wedding series for Hulu about atypical couples.
You are not a reality show person.
Have you guys thought any more about doing my show? There are people who need to know you exist, Shaun.
When I was younger, I would have liked to see a TV show about a man like me lucky enough to marry a woman like you.
We are going to be reality show people.
You and Lea and your relationship, that is what will give hope.
Is it time for the surprise? Congratulations, Shaun and Lea.
Ah, the first time I met Shaun.
Um, he was wet and cold and a bit like, um Like, I remember thinking he was like a lost puppy.
So adorable, but so helpless, and definitely not a likely source of medical insight.
Um, but he was the only one who knew how to save that little boy's life.
Pancakes are ready.
I'm supposed to pretend you aren't here.
But you are also welcome to my pancakes.
Even though I really do not like all of you being in my apartment.
There are 11 chocolate chips in each pancake.
So much to do in just two days.
That is why Sophie is the genius.
Each book is a different theme.
We pick one and all the decisions are made.
Flowers, decor, food, music.
I actually feel kinda great.
Oh.
Someone is at the door.
Oh.
I heard there would be pancakes and a chance to see my friend! Hi.
- Aw.
- I'm so glad you're here.
Oh, I wouldn't have skipped the wedding of the century.
And maybe I missed you a bit too.
As much as you miss the chai lattes from Josefa Joe's? Almost.
Hmm? Thank you.
You must be very proud of Dr.
Browne, soon to be following in your footsteps.
Oh, uh, they offered me chief of surgery in Guatemala.
Wow, congratulations.
I haven't decided yet, but Well, either way, I'm, yeah, very proud.
Fifty-two hours and counting till wedded bliss.
Let's move.
Okay, the limo-bus is outside.
Time for you to get manicured, massaged, and fitted for your dream dress.
A limo-bus? Goodbye, my soon-to-be husband.
Bye, have fun.
Ah, Lucho just landed.
Gotta get ready.
Okay.
Does Claire have a boyfriend? Sophie will need to know if he likes chicken or beef or veg Not a boyfriend.
A patient.
Sophie offered me a "plus one," and I decided to go for it.
Apparently I have some leverage.
If you're gonna be chief of surgery, you'll have a lot of it.
Do you think I could cut it as chief? Sure.
Oh, my gosh! It's so good to see you.
Buenos dias.
Buenos dias y gracias, Alyssa.
Doctora Claire! Hola, Lucho! Como estuvo tu vuelo? I had pizza and chocolate milk, and I flew over the, uh, Grand Canyon and Fresno.
- Mm.
- You got the royal tour.
These are your friends who are going to save my life? Si.
Y si.
Doctora Claire nos dijo que tienes tumores en los rinones.
Si.
Y si.
Okay.
Oh.
These tumors have been growing for many years.
Lucho is from a small village with very limited access to medical care.
I will play futbol again? Ahora que viajaste a Estados Unidos, podemos ayudarte.
Your Spanish is impressive.
Turns out, immersion works.
You did mispronounce via-chah-stay.
Via-hah-stay.
Okay.
Your English is impressive, too.
I teach Spanish.
Doctora Claire teach English.
He taught me how to watch futbol.
How you say marcando? Scoring.
El portero? The goalkeeper.
El arbitro es un culo? The referee is a rectum.
Ah.
What did his imaging show? Guatemala, remember? Closest MRI is an 11-hour bus ride.
I'll catch up with you in radiology.
Hasta luego, Lucho.
He's in V-tach.
We already tried defibrillating him twice.
His heart rate is over 180.
I'm giving him 12 milligrams adenosine.
Rhythm's normalizing.
His rhythm had a retrograde P wave.
The beta blockers were working perfectly the last 48 hours.
What happened? Patient didn't get them last night.
Why not? Who was covering the floor? Villanueva.
Let me know when her shift starts.
Hey.
Have you seen Claire today? She's here with her ridiculously adorable patient from Guatemala.
- Kidney tumors, right? - Mm-hmm.
Not yet.
I've been slammed.
Then you'll be glad to scratch getting Shaun and Lea a wedding present off your to-do list.
What did "we" get them? - A bread maker.
- Do they even eat bread? Everyone eats bread.
And the correct response is, "Thanks for taking care of that.
I really appreciate it.
" So happy you're playing hooky with me.
Girl, I'd take a week off for this.
This is bigger than my apartment.
Whoo! Okay, come on.
You have to help me choose my theme.
I'm so not Rustic.
Traditional feels stuffy.
Glam could be fun.
Too over-the-top.
Tropical? I am definitely not wearing a coconut shell bra.
As I said, Tropical, hard pass.
What about Retro? You would kill in a '50s dress, and I can see Shaun going Buddy Holly.
Too Happy Days.
I'm thinking something more sophisticated.
Then Nautical is out.
And Celestial, whatever that is, just, no.
Harry Potter? Okay, well, one day someone is gonna choose Harry Potter.
And it will be glorious.
What about this one? Ooh.
Upscale Elegance.
I think I kinda love it.
Satin, crystals, candles, and flowers everywhere.
It's more beautiful than I could have dreamed.
Okay, now all you two have to do is choose between brut and extra brut before we get to the spa.
Okay.
How many ring options did Sophie give you? Ninety-four.
But they are all very expensive.
Lea would rather have a new laptop.
You sure about that? An eternal symbol of the unbreakable bond of love versus a faster processor? Anything? Imaging coming up now.
Do you really think I would make a good chief of surgery? Dr.
Lim often leaves before I do, so it can't be that hard a job.
Maybe that's me making it look easy.
Maybe.
I think you'd be great.
But But nothing.
Come on.
You hesitated earlier.
I want to know what you really think.
Your opinion matters to me.
Some days can be very challenging and you have to be prepared to put your emotions aside.
Right, so you don't think that I can do that? You are the kindest, most caring Oh, come on.
and empathetic person I know.
It's why I miss having you here so, so much.
But you may find, running a department, despite the short hours, trickier than you think.
Sometimes you have to be a real hard-ass.
Oh, this ring is perfect.
Lea can sell it and get two laptops.
There's the tumors.
Oh, marked vascularity.
Gonna be a high risk of bleeding.
And look at that, left atrium.
He has a tumor in the heart too.
It's small, but it will be difficult to access.
And one in his brain.
And that one is not small.
Rather than bring us one case, it appears Dr.
Browne has actually brought us three.
All complex, all potentially fatal surgeries.
So, I've assembled three surgical teams.
Doctors Glassman, Browne, and Murphy are on Team Brain.
On Team Heart, Doctors Lim and Wolke.
And on Team Kidney, Dr.
Park and myself.
Each of our procedures will be enormously impacted by the other two.
We need someone to oversee the entire process.
I'll do it.
I was thinking of someone a little more experienced.
You mean someone a little more detached.
I think there's an overlap there.
Not necessarily.
Take it away.
We now have the bouquets, the centerpieces, the music set list, and the menus with the extra brut.
You're amazing.
Yesterday, she was a documentarian.
Today, she's a field general.
Yeah.
Deadlines are my friends.
We have 48 guests confirmed for your side, and only nine guests confirmed for Shaun.
No parents? No extended family? Well, his father and brother have passed, and he doesn't talk to his mom.
Oh.
That's hard.
Yeah.
Eh, we'll just cover it up with seat fillers.
Seat fillers? Oh, yeah.
No one will know the difference.
And we just bumped your parents up to first class on their flight.
Seriously? Oh! They're gonna love that.
I will have a camera crew waiting for them at the airport when they land.
And I believe, here come the seaweed wraps.
Yes! Oh, my God.
Mmm.
Dissecting.
Damn.
Going again.
Have you decided on Shaun and Lea's wedding present? You know how I love a good cab, so I'm giving them a weekend in Napa.
Yeah.
It's a working vineyard and dairy farm, so Lea drinks wine, Shaun drinks one percent.
You? Uh, a bread maker.
Morgan chose it.
Mm.
I didn't know they were into bread.
I'm sure they'll love it.
How's Team Kidney? There's just too many tortuous vessels.
We're never gonna do this without excessive bleeding.
Right.
So, what else do we have? Removing the kidney is the safest option.
Putting him on dialysis for the rest of his life? It may be our only option.
Dialysis in Guatemala Lucho would be institutionalized.
You need to come up with a better plan.
I like going through the posterior wall.
It gives us the best access to the tumor.
We'd be cutting through a massive amount of tissue.
Wouldn't that seriously weaken his heart muscle? Not as much as the tumor will.
Hey.
Making any progress? Uh, you tell me.
Hmm.
It'll decrease his cardiac output.
Not as much as the tumor will.
It's the same surgical plan that I came up with.
Which is why I've looked into a non-surgical plan.
M.
T.
O.
R.
inhibitors.
Proven effective at shrinking small tumors like the one in Lucho's heart.
Those meds take months to work.
Months that Lucho will have because the heart surgery won't have killed him.
His heart will still be stressed during the other surgeries.
He could have a cardiac arrest on the table.
Which is why we'll have a non-surgical team, Morgan and Asher, in the O.
R.
watching for any arrhythmias.
What about Dr.
Lim? She's been promoted to Team Brain.
Well, I hope it comes with a raise.
I could tell you everything that was happening with my boyfriend last night, but I know you don't want to hear excuses.
I'm sympathetic that things are bad at home, but a patient could have died.
I understand if you need to fire me.
Depriving you of income isn't gonna help anything.
But I am gonna put you on administrative duties.
Thank you, Dr.
Lim.
I Dalisay.
You need help.
This is the director of Bayshore Women's Shelter.
She's expecting your call.
It's a really great place.
It's complicated.
Simplify it for me.
Two years ago, when my mother was diagnosed with liver cancer, it was really tough.
She was a single mom.
I was her only child.
And when she passed, I was alone.
And that's when I met Owen.
I desperately needed someone, and he was there for me.
And now, he's going through a lot.
Not that he should take it out on me.
I know it must be hard.
But I also know it's necessary.
I'll call her.
Thank you.
Look at that ventricle.
It's the size of the Lincoln Tunnel.
That's where we're gonna go in.
It still may not give us full access to the tumor.
To get full access, we'd have to pop off the skull and then burrow through his brain.
If we don't excise all of the tumor, your surgery will be a waste of time.
Whaddya say, chief? I'm going with Dr.
Glassman.
That would be the correct answer.
Okay, we're all done here.
Let's close him up.
Lea chose our wedding theme.
She texted me a picture of what I'm supposed to wear.
It is called The Gosling.
Ooh, very debonair.
The cummerbund looks very restrictive.
Oh.
And that hairstyle requires a lot of gel.
I hate gel.
It makes my head feel tight.
Well, then you need to tell Lea so the two of you can figure something else out.
What do you think, Dr.
Glassman? I think if, 30 years ago, my wife had asked me to wear that suit, I probably wouldn't have married her.
And if Debbie had asked me two years ago, I probably would have laughed her right out of the room.
So I don't have to wear the suit? No, you don't have to wear it.
I'm just saying that I don't know, maybe my marriages would have turned out a little bit differently if I had, you know, worn the suit.
You think Lea wouldn't want to know how you feel about this? It's your big day, Shaun.
BP is 201 over 123.
He's having a seizure! The brain tumor is obstructing CSF flow, causing seizures.
It needs to be removed as soon as possible.
After we remove the kidney tumors.
If we go into his brain while his kidneys are impaired, we risk hypertension, AML rupture, cerebral edema.
If we go into his kidneys while his brain is under pressure, then we risk brain herniation, stroke, anoxic brain injury.
Only in the case of serious blood loss.
Have you seen his tumors? There's gonna be some serious blood loss.
Well, we think we have a better plan.
We ligate the feeding artery before tumor resection.
And, if we do the kidney surgery first, we also minimize the risk of S.
I.
A.
D.
H.
, which could very easily lead to long-term heart damage.
So, brain first, safer, but more likely to leave him compromised.
Kidneys first, riskier, but more likely to lead to a full recovery.
For the past four months, I have seen Lucho stare out the window of his hospital room watching the kids play soccer in the schoolyard.
If there is a chance I can get him back out there, I'll take it.
That's a lot of weight to put on playing soccer.
We do the kidneys today, the brain tomorrow.
Let's say half-a-dozen oysters per person.
Oh.
Olympias or Kumamotos? Uh mix of both.
Mix of both, please.
I think this is the one.
Wow.
Mm! Really? You don't love it? Oh, no.
I love it.
I want to get married and buried in it, but that's me.
Just wondering if all of this If it's you.
I picture you in something more like that.
Me, too, but, this is what the occasion calls for.
When Shaun and I decided to do this, this became more than just our wedding.
It's a chance to represent atypical couples, to show that someone on the spectrum can marry a neurotypical person in the most perfect Magical, frickin' awesome wedding of all time.
And if Shaun doesn't like it, he'll definitely let me know.
To a frickin' awesome wedding.
Exposing the renal vessels.
Cerebral perfusion pressure holding steady at 65.
Mmm.
Is there anything better than the aroma of fresh-baked bread? Lots of things, actually.
Ligating the feeding artery.
I try to avoid carbs.
Cardiac ejection fraction is good.
How about you, Shaun? You like your bread, right? As long as there's no cinnamon, nuts, seeds, or berries.
Or sprouted grains.
You like to be able to choose your own ingredients.
Unless you're sharing the bread with someone else.
Then the ingredients should be something you both like.
Resecting away the tumor.
Unless that person went out of their way to buy the ingredients, in which case, the other person might be more appreciative.
You know, Jerome and I are having a tiff, too.
I suggested we wear matching suits to the wedding.
He immediately dismissed it, saying, "That's tacky.
" And I know it's tacky, but cute tacky, not "you're trash" tacky.
Maybe it's not about suits or ingredients, but about respecting a person for who we are.
And we got a bleeder.
It's from the renal vein.
CPP is dropping.
Ejection fraction, too.
Compressing the renal hilum.
Brain perfusion is under 35.
We need to repair the vein.
There's not enough time.
We need to take the whole kidney.
Stop! Satinsky clamp.
Give phenylephrine to increase CPP.
Recheck T.
E.
E.
and give fluids to increase cardiac pre-load.
Barbed suture on the renal surface.
CPP's back up to 65.
Ejection fraction's normal.
Myself, I'm a sucker for an everything bagel.
Detaching the angiomyolipoma.
I think Guatemala has been good for you.
Hmm.
Thanks.
I do, too.
When you left, you were about a two on the hard-ass scale, and now I'd put you at a solid five.
Hmm.
Which is still a couple short of being a successful chief.
We never should have been working on the kidneys in the first place.
No, it was the right decision.
He almost died, in exactly the way we expected when you made the call.
Audrey, I haven't seen you in a year, and I get this? For considering a patient's quality of life? One of my nurses is screwing up, badly.
And if I ask you what happened, do I lose a point on the hard-ass scale? She's a victim of domestic abuse.
Well, that's terrible.
And she almost killed a patient because she's distracted.
And I don't know if she's gonna get the help she needs.
So, this is your object lesson? To be a good chief, you have to be able to fire battered women? When they endanger patients, you may not have a choice.
I always admired you.
You know, the way you prioritize your career, even when it came at a cost.
Choosing your job as chief over your personal life.
Now, I admired that.
But I don't know if it's Guatemala or just another year of life, but now I'm not sure if I do admire your choices.
Not in the same way.
When I left, you were a fantastic chief.
But I think you just could be creeping too far up the scale.
What's all this? Huevos rancheros con salsa verde.
But you hate huevos rancheros.
It is repulsive, but it's your favorite.
Mmm! And if you're only doing things you want to do, you're not doing enough.
This is about your wedding look, isn't it? I know it's not your style.
It's just that you would look amazing in it.
But if you want to try something you'd like better Do you like your dress? It's gorgeous.
Upscale Elegance will make you happy? I think everything is gonna look amazing.
But I need you to be okay with it.
I'm okay with it.
Okay.
Hey.
It's my resignation.
Last night, I sat in the parking lot for two hours trying to call the number you gave me.
It's been an honor working with you, Dr.
Lim.
Transcortical approach during surgery will avoid white matter tracts and preserve Lucho's brain function.
Bit tight under the arms? No.
Thank you, it's good.
Except the elbows and thighs and calves, and the cummerbund is restricting the blood flow to my rectus abdominis.
So, we let it out a little bit.
Vincent? - Okay.
- Great idea.
Which I did 10 minutes ago.
You didn't talk to Lea, did you? I did.
She is very excited about this, so I need to make this work.
Let's just size up.
Well, the slim-fit cut would look like a-a tent-cut.
Okay.
Shaun, Lea would not want you to be tortured like this.
No.
I am doing this for Lea.
Okay? - Sir, I-I need for you to stand still.
- Yeah.
It is compressing my external obliques.
You shouldn't have to I want to be a good husband! Shaun, it's okay.
- We can just find another tux and - N-No! Okay.
It's Lucho.
He's got a bleed in his brain.
Hang frozen plasma and clamp the drain.
He has a blood clot obstructing his cerebral ventricle.
It was our only access to his tumor.
Dr.
Lim was right.
We should have operated on Lucho's brain first.
Yes, we should have.
If we treat it with meds, we could clear the clot in four months.
The tumor will kill him in three.
Shaun.
What are you seeing? Nothing.
Lucho is going to die.
Hable con tu mama y papa.
Ellos nos encontaran en al aeropuerto.
We're going home? Si.
No more operations? Por ahora no.
So, we'll come back soon? No lo se.
Lo siento.
- Three, two, one, cheers! - Oh! Murphy, drink up.
It's stag night, a rite of passage.
Shaun, this time tomorrow, you're gonna be Mr.
Lea Dilallo.
There is no safe path around the clot.
No, there isn't.
Drink up.
Drink your tequila.
He's right, Shaun.
You brought Lucho here so we could save him, - and I tried to, - but I failed.
And I tried to wear the suit, and I failed at that too.
And I am going to fail as a husband.
Shaun, you are not.
You're so open with each other.
At least you tried, Shaun.
Trying doesn't matter if it leads to failure.
No.
Love isn't measured by accomplishments.
It's measured by how much you care.
And what shows you care more than trying to do something that isn't easy? You won't always succeed, but if you don't try, you never will.
You're kidding, right? Shaun, you know, you don't have to You don't have to, uh You don't have to do this.
We can go to dinner at the Wh-where do you get the linguini? Yeah.
Where Intermittent photothermic laser light therapy.
We've gotta go back! Okay! I scared.
I am confident.
Using a laser combined with chemical thrombolysis to break up the clot in your Lo se.
I had the operation? Si.
Salio de maravilla.
The tumor is gone? Adios, tumor.
Muy pronto vas a estar marcando contra el portero.
Do you remember when we first met? I was very wet.
Yeah, and you saved that little boy's life that day too.
Why are you crying? Because I'm so happy.
And I'm a little bit sad.
How can you be happy and sad at the same time? Well, I'm happy for you.
For how far you've come and for the joy you've found, the amazing man you've become.
And I'm sad because I miss you.
I miss you, too.
Oh.
Oh.
I need to go.
Oh.
Shaun, you gotta get married in Five hours! I'm getting married in five hours.
Wha What are you gonna wear? I don't know.
Don't look yet.
I just need to flare out the veil a little more.
And voila.
Oh! Meghan Markle is so jealous right now.
They're the most adorable couple ever.
Well, maybe second.
And what I really admire about them is that they respect each other for who they are.
- Mm.
- Accept each other as individuals.
There.
I canceled the bread maker.
What do you want to get them? Ah, something that represents us.
Marriage counseling? Perfect.
I've been totally shipping Shaun and Lea.
Hashtag She-Ea.
Hashtag Le-Ash.
Uh, that spells "leash," so, no.
Ah.
Oh, I should explain about the matching suits.
For the record, I think they're fabulous and we look great in them.
Thank you for saying that.
We look like a couple of dorks.
I was wrong about the matchy-matchy vibe.
I'm sorry.
Ah, I love a man who can admit when he's wrong.
And I may look like a dork, but I'm his dork.
- And he's mine.
- Mm.
Wow.
You look great.
I kept trying.
Last night, I wore it for two minutes, and then five, and then ten.
I got up to 44 minutes.
So, 44 minutes is your max, huh? Yes.
Weddings don't run like a Swiss watch, you know? I timed the service at 42 minutes if I skip the redundant parts of my vows and exit the church with Lea very quickly.
I covered the "In sickness and in health" part in my Hippocratic Oath.
Let's hope the flower girl keeps up the pace, huh? Oh, yes.
You ready? I'm ready.
Yeah, you are.
We need to talk.
I'm not accepting your resignation.
That's very nice of you, but I can't.
Well, not on your own.
That's why I want you to come stay with me.
With my boss? With your friend.
Please say yes.
You look so handsome.
You look so beautiful.
Gosling and Markle.
But not Shaun and Lea.
I am so sorry, Shaun.
I knew the world would be seeing us, and I wanted to show everyone how amazing you are and how good it is to be in a relationship with you.
But you're so uncomfortable, aren't you? I can only last for another 39 minutes.
I love you so much for putting yourself through this.
But we shouldn't have to.
I can't wait to marry you.
But not like this.
Yes.
Not like this.
Everything okay? Yes.
But there's not gonna be a wedding.
Oh.
Not today.
I'm so sorry.
We ruined your show.
Wedding show without a wedding.
Yeah, pretty much.
I thought this was bigger than Shaun and me, but it shouldn't be.
It's our day, and this just isn't us.
Couldn't have figured this out 45 minutes from now? I know.
Go be happy.
Go be you.
- Oh.
- Oh! Thank you! Okay.
Oh! Hell of a twist.
You heading back tomorrow? The cases will be piling up.
Hm.
You should take the job.
You'd make a fantastic chief.
I don't know about fantastic.
I do.
You made me a better one.
We're losing serious points, aren't we? So many.