The Good Doctor (2017) s06e02 Episode Script

Can I give you a hand?
Oh. No, thanks.
Everything in its place.
Ah!
Aah!
No. Please stop.
What's wrong?
That noise hurts my ears,
and you don't need pencils.
Our orders are electronically entered.
I use pencil when I'm doing research.
Congratulations.
I come bearing gifts
for our new attending surgeons.
Bummer you have to share an office,
but I can make sure your
first day starts with a smile.
Is it noise-canceling earbuds?
It is not.
You guys are big decision-makers now.
Figured you might need some help.
But of course!
Sounds like a brilliant idea!
- Eh?
- Is the answer always yes?
I don't know. Ask.
Is the answer always yes?
Tequila stat!
Oh!
Am I awesome or what?
- You are awesome.
- Mm.
But tequila can't be
the answer to everything.
I would not be so sure.
Uh, Lim is in the parking lot.
Hmm.
You You okay?
Yes.
Why wouldn't I be?
Whoo!
Welcome back, Chief.
Thank you.
I've never been
this happy to be at work.
- We've missed you so much.
- Ah.
It's only been a few months.
It's been 14 and a half weeks.
Awkward.
Her and Murphy.
It's awkward between
Murphy and most people.
He didn't paralyze everyone.
He didn't paralyze her.
He saved her life.
If he would've done the surgery
Glassman ordered him to do
There's no way to know what
the outcome would have been.
The M&M was clear on that.
The final determination
was "inconclusive."
I'd hug you, but I'd have
to steal your wheelchair.
Oh, no. What happened?
Oh, I lifted the front end of a bus,
you know, to save a kid. Normal Monday.
Got to lift with your legs.
Yeah.
So, I tried to keep your inbox empty,
but that was impossible.
Everybody, party's over.
She's got work to do.
Well, no, actually, um, before you go,
I just want to thank you
for the flowers, the food, everything.
It was incredibly helpful.
And I'd like to thank Dr. Murphy.
You saved my life.
You're welcome.
Oof. So awkward.
Doctors Wolke and Allen,
meet our new first years,
Doctors Danica Powell and Daniel Perez.
Newbies.
- Don't call them that.
- Sorry.
Welcome to St. Bonaventure.
Thanks. Glad to be here.
I look forward to working with you both.
Have a great first day.
Thank you.
Nurse Hawks showed us around,
introduced us to the OR staff.
Everyone seems super helpful.
I'm sure they were.
Hmm.
You want the soldier or the farmboy?
Naval Academy grads are called sailors,
not soldiers.
Well, she's been in combat.
That makes her a soldier in my book.
They both have excellent USMLE scores.
Well, she has more
real-world experience,
but he'll be useful getting
extra help from the nurses,
which could come in handy
on our first day.
It's not our first day.
We've been here five years
and have leadership experience.
Being an attending
shouldn't be much different
than being a senior resident.
I'll take Handsome Dan.
Okay.
Good morning.
I'm Dr. Shaun Murphy.
I'm an attending at San Jose St.
Bonaventure Hospital.
You and Dr. Wolke will be with me today.
Allen and Perez, you're with me
in the ER today.
Actually, I was just about
to take Perez.
You may have been "about to,"
but I just did.
- Come on. Let's go.
- Hold on.
Dr. Murphy and I
Were decorating your new shared office,
while I was getting
this approved by Andrews.
Oblivious to anyone else's
needs but your own, as usual.
Pathetically blaming everyone
else for your problems,
as usual.
They used to be in a relationship.
It ended badly.
Let's go.
It still feels like I'm choking.
The EMTs said they could barely
get into your apartment.
Looked like you hadn't
been able to clean up
or take out the trash in months.
Those are my collections.
It's none of their business.
Large, palpable anterior mass.
When was the last time you saw a doctor?
I don't know. Ten, twenty years.
When was the last time
you left your house?
What does that matter?
We just want to make sure
you're taking care of yourself.
If you want,
we could have a social worker
come down to talk to you.
You know, this is exactly why
I don't come to hospitals.
All you want to do is meddle in things
that are none of your damn business.
It looks like you may need some surgery
to remove this mass.
You think you'd be okay with that?
What the hell do you think I'm here for?
The donor heart is on its way,
so we need to start
prepping you for surgery.
I see you brought in reinforcements.
Hi. I'm Dr. Danni Powell.
Dr. Powell's one of our new residents.
This is her first day.
- Oh, and she's assisting?
- Yes.
I don't want a first year
on her first day
in on my husband's heart transplant.
You're a surgeon yourself.
You are aware
the only way residents learn
difficult surgeries
is by participating in them.
Yes, and I'm also aware that
residencies last five years,
so there's no reason
she needs to do this day one.
Honey, it's okay.
I'm sure Dr. Murphy
knows what he's doing.
Mm.
It's gonna be fine.
How can I be more worried than you?
You're smarter.
It's part of why I love you.
And hopefully my new heart will, too.
It definitely won't change that.
Can you hear me?
Code Blue! I need a cart!
Aah!
I've been looking for you.
I have a patient in the ER
who needs a mass removed from his neck.
I need an attending for Allen and Perez.
Okay. Uh, I'm pretty swamped.
Well, obviously, I wasn't
expecting you to do it,
but Murphy's on a transplant,
Park's busy decorating his office
"Obviously"? Why wouldn't I do it?
I just Andrews said
Surgeries are still done
with our hands, right?
The only thing that should be obvious
is that I'm not on call, but Park is,
so get over your stupid
breakup drama and go talk to him.
So, I'll reschedule your 11:00?
I can fit it in.
Didn't you want to make sure
you had the funding confirmed first?
Good point.
I will be doing
Mr. Persiko's hernia repair.
Audrey, I'm amazed
by your courage and fortitude,
and I will do everything in my
power to assist in your return.
But that might not include surgeries.
I have pretty much lived
at physical therapy
the last three months.
I have practiced extensively
in a custom chair that holds me upright
so that I can see and reach
the entire surgical field.
You know practicing in P
is not the same as working in an OR.
And your office is not the same
as a courtroom,
so I won't bore you
with my rights under the ADA.
I can do all the duties
of chief surgeon.
Okay.
But I'm joining you on Persiko.
There is no reason
the president and chief surgeon
need to tag team a hernia repair.
Yes, there is.
Heparinization complete.
Bypass initiated.
Cross clamping the aorta.
And tighten the caval snares.
Dr. Powell, prep the donor organ.
Check the atrial septum.
Make sure there's
no patent foramen ovale.
Looks good.
The mitral, pulmonic,
and aortic valves also good.
Thank you.
I will transect the superior vena cava
while you divide the aorta
and pulmonary arteries.
Are you serious?
That's the most difficult part.
Are you confident you can handle it?
Definitely.
Then so am I.
Potts scissors.
Wait, hold on.
The donor heart has a floppy tricuspid.
There was no evidence to suggest
severe tricuspid insufficiency
on the donor's echocardiogram.
The valve is damaged.
That must've happened during
the organ recovery surgery.
We can't replace one
damaged heart with another.
It took three months to get this one.
He won't last three more.
Aborting now and putting him on ECMO
would move him
to the top of the wait list.
We should be able to find
a new one in a few days,
a week at most.
You really want to take that risk?
It's not her decision. It's mine.
Abort the surgery.
We need to find a better heart.
We had to abort the transplant.
The damage was too severe.
We placed him on ECMO
and closed his chest.
He's being transferred to ICU
while we wait for a new donor.
You made that decision
without even consulting me?
It was surgical judgment.
And I'm a surgeon.
Not at this hospital.
Here, you're just the patient's wife.
"Just"? My husband's life
is in your hands.
I have every right to ask questions.
Excuse me, Dr. Hall,
may I ask you something?
What?
I understand that you're upset
and frightened,
and you may disagree with our
decision to abort the transplant.
But we are gonna do everything
in our power
to find a new heart.
Is there any way that we can help you?
Any pre-op echo or operative
reports that you'd like to see?
Is there anyone else
that you'd like to talk to?
Can I see him?
Absolutely.
As soon as he's stable in the ICU,
we'll have a nurse bring you in.
Anything else that we can get for you?
Any food or a coffee?
Um, no.
Thank you.
So, what kind of stuff
do you like to collect?
I collect Egyptian pottery.
I got obsessed with King Tut
in elementary school.
I know. My friends all think
it's very odd, too.
Uh, I collect electronics, mostly.
Hi-fi stereo, computers, TVs.
All people care about now
is the next shiny thing.
Use it once, toss it in the trash.
You go to flea markets or garage sales?
Mm. They try to rip you off there.
I can shop and compare a
hundred different places online,
select what I want, have it
delivered right to my door.
It's just nice to go out sometimes.
I'm not a hermit or a hoarder.
No one's calling you that.
Everyone calls me that.
Just do your damn test.
Remove the thing,
and I can get out of here.
Okay.
Let me help you.
No, I can do it.
I know, but you've never had a problem
asking me to scratch your nose
during surgery.
Thanks.
This thing
I feel slow and awkward.
You're like Ripley in Aliens.
A total badass.
I'm sorry.
You didn't do anything.
I wish I was as strong as you.
I can't sleep. Still have nightmares.
You're stronger than me.
I'm just a better poker player.
Your bedside manner is impressive.
I spent two years in Afghanistan,
so had plenty of practice
de-escalating conflict.
What about a biventricular
assist device?
Could extend the function
of his current heart.
Well, that's pretty short-term.
I was actually thinking
Okay, he isn't oxygenating
sufficiently despite the ECMO,
and he's bleeding
from his cannula sites.
Have you considered a CARMAT?
We looked into
artificial hearts weeks ago.
He is not a candidate.
I shouldn't have aborted the transplant.
What about a xenotransplant?
I was just reading a study
about the use of pig hearts.
That's not an option.
Why not?
The most recent patient
lasted two months,
which is longer than
ECMO will keep him alive.
Because it's immoral.
Animals aren't surgical devices.
They are living beings who have
a right to self-determination.
Well, so was the guy whose
heart we just threw in the trash
a few hours ago.
That man made a free choice
to have his heart removed
after he died.
No one executed him
so they could take it.
We execute millions of pigs
every day for food,
and saving a human life
is more important.
Killing animals for food
or for medicine is wrong.
I won't do it.
Okay.
Dr. Powell, you have no choice.
Refusing to comply
with an attending's decision
would be grounds for termination.
Everything I've ever done
has been my choice.
So, you can fire me if you want to,
but I won't participate
in a xenotransplant.
Mm.
So, what are we doing?
As long as his wife consents,
xenotransplant.
Right. I will be here if you
need me for another patient.
Cut.
Can you loosen the top strap so
that I can lean forward a bit more?
And someone get her brow.
Thank you.
Okay. That should be good.
3-0 vicryl sutures.
Yeah.
- You need help? You want me to
- No. I got this.
I got it.
It's okay.
This is a damn hernia repair.
I should be able to do it in my sleep.
Metz scissors.
You okay?
No. Take over.
Metz.
The mass has completely grown
into the larynx.
With possible bilateral involvement.
We should still be able to excise
without doing any more damage
to his voice.
I-I don't think the patient
cares about his voice.
He's not interested
in talking to anyone.
Or he just likes solitude.
I used to spend every summer alone
in the cab of a combine, and I loved it.
So, Mister-Already-
Knows-Every-Nurse-By-Name is a lone wolf?
I don't buy it.
Our lone wolf
has refused a psych consult,
so we should focus
on what we can actually fix.
- I agree.
- Then let me finish.
We need a laryngoscopy
to assess the compression
from the mass on his vocal cords.
I disagree. Better to do a needle
aspiration to assess malignancy.
He's my patient. Laryngoscopy.
But I'm the attending.
Needle aspiration.
We could do both.
Fine.
Sure.
The chief of surgery is responsible
for a lot more than just cutting.
I'm not giving up just because
I failed on my first try.
That wasn't what I was suggesting.
I'm just
impatient.
I screwed up, which could've
endangered a patient.
You should be pissed off at me,
not giving me a damn pep talk.
Do I have the power to fire residents?
Yes.
I have a heart transplant patient
who is rapidly deteriorating
Stop. You're now an attending.
You need to learn how to make
tough decisions on your own.
- Good job.
- Mm.
Now breathe.
Two-minute rest and we'll do one more.
Hey.
What are you doing here?
Oh, looking for a heating pad.
Or is it ice? I never know which one.
Ah, nobody does.
Judging from your walk,
I'd say you need a lot more than that.
She's right. And the real
problem's not your back.
It's your shoulders.
Your posture's all slumped.
I see that a lot in my older clients.
Oh. Well, thank you.
I fell into a trench during World War I.
I'm gonna get you a bolster.
How you doing?
Other than having to tap out
of a hernia repair?
Fantastic.
Standing's a lot harder than it looks.
So don't.
Do the surgery from your chair.
Well, unlike Murphy,
I have to be over the patient
to see inside.
So lower the patient.
That would throw a bunch
of things out of sync,
the staff, the table.
You're the chief.
Let them sync up with you, Chief.
The doctor's password is irrelevant.
The patients have their own
separate login ID.
You say irrelevant,
yet the patients can't log in.
They have to reset their
password every time they try.
Damn it.
I need some advice.
And I need an epidural.
And I need a new tech.
This guy's coding is a total mess.
I'm doing a xenotransplant,
but my new resident
refuses to participate.
She think it's immoral.
Dr. Andrews said
I have the power to fire her,
but I am not sure if I should.
Mm, if she's this defiant on day one,
it's only gonna get worse.
You have been defiant
to your attendings, right?
Surgery you did on Lim as an example.
That's different.
My decision
in Dr. Lim's surgery was right.
Dr. Powell, clearly wrong.
Your decision left her paralyzed.
He's not here to discuss Lim.
Your newbie is trouble
in all caps. Fire her.
I'd like to remind you
it's her first day.
It's also your first day.
Take a minute, think about it.
Thank you for your help.
You have much more leadership
experience than Lea does.
But I trust her more.
I'm going to fire Dr. Powell.
It's a pig.
It's a life.
Animals feel pain and fear.
They have emotions, just like humans.
Every drug we take
gets tested on animals first.
Are you against that too?
Call me a hypocrite,
but I believe that there is a
difference between a rat and a pig.
And as soon as the tech advances,
we should stop using rats, too.
Didn't you fight in a war?
You're okay
with killing for your country,
but won't sacrifice a pig
for your patient?
I was never okay with killing.
And only somebody who's never
been in the military
or known somebody who has been
would say something so idiotic.
I'm sorry. I didn't mean to
I need to speak with Dr. Powell.
The pig heart's here. We need to go.
We will finish this later.
Pull it back a little.
You went past the cords.
Wish there was a way
we could reach this guy.
At least get him to go outside
and stop trying to fill his loneliness
with electronic junk.
When my grandma died,
I saved her sweaters
because they smelled
like her pipe tobacco.
That's interesting,
on a number of levels.
But your grandma's sweaters
are obviously different
than a stack of broken TVs
and receivers.
And you're handsome enough.
You don't need to go on about
how much you love your grandma.
Already flirting.
He's only been here a few hours.
Have you at least finished
the scope first?
Finishing up.
I'll export the images to his chart.
And we were definitely not flirting.
Absolutely not.
I usually wait till the second
day on the job for that.
Needle nose.
Oh.
I always thought the needle nose
was the unsung hero of the toolbox.
Got it.
Awesome.
Actually, not awesome.
Even with all the covers off,
your knees won't fit under.
Damn it.
What if you took the motor out totally?
OR nurses can manually raise
and lower the table without the motor.
It's not the motor. It's the frame,
which is welded to the table.
Which means I'm screwed.
We can figure this out.
I gotta go.
Thanks for your efforts,
but this isn't happening.
- Where is the cooler?
- Cooler?
We thought you were bringing the heart.
I am.
We've found that patient
outcomes were much better
if the heart remained in vivo
until the last possible moment.
Sign here, please.
For specimen A71923?
We're not supposed
to name the specimens,
but we call him Wilbur.
Okay.
Come along, Wilbur.
We need a pre-op ECHO.
How? He's covered in hair.
How do you think?
Is it okay? They want to see him.
I'm sorry. We have to
prep him for surgery.
It is okay.
You can do that while they pet him.
Why does he need an operation?
Well, he is giving his heart
to another one of our patients.
But how will he live
if he gives his heart away?
No.
He can't.
He is going to die.
Mm.
Dr. Lim.
Dr. Lim.
- This better be fast.
- It will be.
I thought I should let you know
that I am firing Dr. Powell.
- Okay.
- Okay.
Uh, mind if I ask why?
Oh.
She refused to participate
in the xenotransplant.
She thinks using animals for medical
procedures or research is immoral.
That's an odd opinion for someone
who wants a career in medicine.
But it's not your job as an attending
to weed out the bad residents.
It's to mentor and mold them into
It's okay.
Wilbur is very friendly.
Good talk. I gotta go.
We finally figured out
how to lower the light.
Still haven't solved the table issue.
I have. Scrap the whole thing.
And do surgery sitting on the floor?
No. On a sturdy, stainless-steel
table that sits on four legs
instead of a bulky pedestal.
Like they have at my butcher shop.
And in our morgue.
Your beliefs are misguided
and very wrong.
Dr. Andrews and Dr. Lim confirmed
that your insubordination
is just cause for termination.
I'm sorry you feel that way.
But I understand.
I'll clean out my locker.
You don't have to do that.
My job is to mentor and teach
you how to be a good doctor.
So I want you to watch the
xenotransplant from the OR gallery.
Just because you think it's immoral
doesn't mean you shouldn't
learn how it's done.
Are you willing to do that?
Yeah. Yes.
Good.
You can go now.
There's a lot of blood
from the tumor surface.
I need gauze.
It's not stopping.
You need to cut off
the tumor blood supply.
Thank you, Dr. Reznick.
Actually, I think the bleeding
might be coming
from the superior laryngeal artery.
Adding additional clamp and a silk tie.
The bleeding stopped.
Good catch.
Thanks.
Looks like you're
more than just a pretty face.
My grandma, who I loved
and cherished, would agree.
There's a minor tear in
the inferior epigastric artery.
No, I've got this.
I need to get more light
and a ten blade.
I'll open over the entry site.
Thank you.
Come on. Where are you?
There it is.
Bipolar forceps.
And we're back on track.
Nice work.
It's kind of a big deal.
Maybe you want to say something?
Mm. Why?
Never mind.
You're our hero, Wilbur.
Ten blade.
Sternal saw.
Oh.
This is harder
than I thought it would be.
- You want me to do it?
- No. I am the attending.
I will do it.
Okay.
Stop!
Motorcyclist just declared
brain dead in the ER.
He's a match, and his family consented.
Heart's on the way.
Oh.
Oh. That felt inappropriate.
It was.
We need to close Wilbur chest
and waking him up.
Your surgery was very successful,
and, thankfully, not innovative at all.
You're gonna be fine.
Thanks to Dr. Murphy.
It was a team effort.
Except for Dr. Powell.
Ah.
I thought I was supposed to rest.
Movement post-surgery helps
the blood flow and recovery.
What's a pig doing in here?
His name's Wilbur.
He was gonna donate his heart,
but turns out they didn't need him.
Want to meet him? He's super nice.
Pigs are actually
one of the smartest animals.
I grew up on a farm.
We once had a pig
who could do long division.
Mm.
What's gonna happen to him now?
He'll have to be euthanized.
He's been genetically modified.
Can't be around other pigs.
Use you once
and throw you away.
You are brilliant.
- It worked?
- Perfectly.
Wilbur's got a new parent,
and Jeremiah's got a reason to
step outside at least twice a day.
Mm.
I'm impressed. Seriously.
You should be. Because I'm awesome.
Jeremiah just needed a
little push in the right direction.
I'm glad you didn't just make a snap
judgment based on his appearance.
I thought I knew your type.
I'm sorry.
Mm.
Wanna grab a drink,
let me make it up to you?
We're good.
And I'm beat.
Gonna go home, do some restorative yoga,
and, uh, hit the hay.
Yeah, me too.
No, I'm kidding.
I'm gonna drink.
But mad respect.
Namaste.
So, he wasn't your type, but now he is?
- I never said that.
- Ooh.
You absolutely said it.
You just used your flirty voice.
You were like, "Mad respect. Namaste."
Can we continue this argument
over Negronis?
I paid last time.
I paid last time.
- No, I paid last time.
- Oh, really?
Yeah, 'cause I had to leave
the tip, too.
Kick.
Toes up.
Good.
Down.
How was the appy?
Fine.
Fine, but what?
I'll, uh, get you set up
with the E-stim.
I feel like a racehorse that's
been relegated to the carousel.
I used to tell people
that it took me two years
to get back to being
the surgeon that I was,
you know, before
the brain cancer and all that.
I lied.
I never got back to being
the surgeon I was.
You're never going to be
the doctor you were.
That's a fact.
But you have no idea
the doctor you're gonna become.
And I am here for you.
Anytime.
Thanks.
I've been told you two have
been sniping at each other.
- No, we
- This is not a conversation.
You two need to sort your stuff out,
because I don't ever want
to have to deal with it again.
- Yes.
- It won't happen again.
Good.
So, how was your first day?
Tequila stat!
Are we commiserating or celebrating?
We are definitely celebrating.
Ugh.
Come on!
- Hey. Tough day?
- Oh.
I know you said you don't want any
No, I I'm I can do this.
Thank you.
Ah!
Come on!
You okay?
No, I am not okay.
I'm so sick of this chair.
I'm sick of having to drive
with my hands.
I'm sick of not being able to get around
because there are stairs everywhere.
And I hate that my body
won't do what I want.
I hate having to train
like an Olympic gymnast
just so I can get off the damn toilet.
And I hate Shaun Murphy.
This is all his fault.