The Good Doctor (2017) s06e05 Episode Script

1
Previously on The Good Doctor
You put me here,
and I'm really angry about that.
I am sitting in this chair
because of that surgery.
- I enjoyed our field trip.
- I had a good time, too.
I'm sorry. I just
I can't.
I know how to fix everything.
There's a surgery
that will cure Lim's paralysis.
It's not the cord.
It's a deformity of the spinal column.
Even if there's kyphosis,
that doesn't mean
She used to have a 10-degree curve.
Now it's 15.
So, what do you propose?
We go through the abdomen
and chest, fix the deformity,
and stabilize the column
with cage, plate, and screws.
With the tension in the cord
relaxed, her body can heal.
It will fix the paralysis.
- That might work.
- Might.
Might work. Might doesn't cut it,
especially with the amount of
instrumentation around the spinal cord.
You could poke a hole
in the gut or in the lung.
Sepsis is a very real possibility.
I won't poke a hole in anything.
Do I need to remind you how
confident you were the last time?
I'm sorry, but the odds
aren't good enough, not for me.
Then better the odds.
You two see if you can find
a surgery in our comfort zone.
Any objections?
No.
Then I need to get started.
I will be very busy this week.
And you never fainted before today?
No, never.
Actually, I guess I fainted last week.
I was at recess.
I just sort of woke up on the ground.
I thought you wouldn't let me
do the Halloween pageant.
- I'm sorry.
- It's okay.
We just want you to get better.
So, you're Cinderella.
I have the main solo.
I'm singing "No One Is Alone."
Sondheim. I love it.
What's your favorite?
For what's the sound
Of the world out there? ♪
What, Mr. Todd? What, Mr. Todd? ♪
What is that sound? ♪
The crunching noises
Pervading the air ♪
Yes, Mr. Todd! Yes, Mr. Todd! ♪
Yes, all around! ♪
It's man devouring man My dear! ♪
And who are we To deny it in here! ♪
Why is there singing?
And why are you green?
It's Halloween.
Heart rate's still 38 BPM.
Hopefully, we can get you back
in time for your solo.
We can't.
The electrical system
in your heart is malfunctioning
and you risk cardiac arrest.
We can easily implant a pacemaker today
to keep it functioning normally.
Once it's in, a pacemaker is very safe.
W-Why is this happening to her?
We will do blood work
and electrophysiologic studies
to find out.
Plus, genetic workups
on all three of you.
If it's inherited,
you might be at risk, too.
Happy Halloween.
I get dizzy a lot
'cause I banged my head
when I was a kid.
They know, buddy.
Oh, yeah.
Sometimes I forget stuff, too.
Chris is always looking out for me.
He picks me up from day care every day.
He cooks me dinner,
and he lets me play video games.
Sounds like a good brother.
Tell them what we say to each other.
I say, "I got your back, little bro."
And then I go,
"I got your back, big bro."
Nice approximation of the wound edges.
You're good to go, Ollie.
Back's been bugging me.
Joys of aging.
Your pants are pretty loose.
Lost a little weight recently.
When did you see a doctor last?
I don't know.
Between Ollie and looking for work
Mind lifting up your shirt?
We're gonna order lab tests
and a CT for you,
just to be safe.
That potential assistant
I liked, with the septum ring?
Mm-hmm.
Well, I watched her TikTok,
and now I'm looking for another one.
You reading your tablet?
Yes, but I'm also listening to you.
With the Dr. Lim surgery,
I have to do two jobs.
Well, how about you start
after our lunch?
This is a growth opportunity.
As a boss, you need to delegate.
You think I write
every line of code myself?
I am a surgeon.
I cannot delegate surgery.
So, figure out the elements of your job
that only you can do
and delegate the rest.
That is a good idea.
The Force is with me.
Nice. Love it.
Ooh. Gorgeous.
So, the navy blue dress
or the black skirt?
They're all great.
Your date's gonna be blown away.
Not necessarily my date.
My neighbors aren't taking me
to romantic restaurants.
Your neighbors are a 90-year-old couple
and that hermit who likes
to talk to his geodes.
It's a date, right?
This is my floor.
Wise answer, Matey.
Date.
Date. Definitely a date.
Which is a problem
'cause those outfits suck.
What else you got?
Trashy, frumpy, slutty,
not slutty enough.
God, no. Anything else?
In my closet.
We'll meet there. 8:00 p.m.
Try to hold still, Chris.
This will just take a few minutes.
Okay.
I would have thought that you
had more Halloween spirit.
Oh, I have a lot.
But as a professional woman,
I express it after work.
- Interesting.
- Mm-hmm.
What are you up to?
There's a big pub crawl
around San Pedro Square.
A bunch of us are going.
That sounds fun.
Want to join?
I think I'll skip. But thanks.
No problem.
I think I made things weird
between us last night.
It's fine.
A three-centimeter mass
partially compressing the bile duct.
Pancreatic cancer.
Hey.
You wearing that in the OR?
I got the genetic testing back.
Skyler has hemochromatosis.
Explains the heart problems.
Yes, but look at her parents' results.
Mom carries the recessive gene.
But not her dad.
Which means he's not her dad.
And given how he let us test him,
he doesn't know it.
What are we gonna tell her parents?
The genetic testing results.
Placing the generator
in the infraclavicular pocket.
Any thoughts on how?
Without destroying
their marriage, I mean?
I will delegate that task to you two.
It will be a growth opportunity.
You also need to inform
Skyler's biological father
that he's the carrier.
Well, we don't know who he is.
Then it will be an even bigger
growth opportunity.
Adsons and 3-0 vicryl.
You have stage three pancreatic cancer.
That means it hasn't metastasized yet,
but it's spread to your lymph nodes.
So, I'll I'll do chemo?
Chemo, radiation, molecular therapy
would give you about eight months.
There is a very extensive surgery
called the Whipple procedure.
It involves removing your gallbladder
as well as parts of your bile duct,
pancreas, and intestines.
Okay. When can we do it?
It only has a small chance of success,
and if it fails, you'll have
less time and more pain.
When Ollie was a kid,
my mom worked from home a lot.
She always had me looking
after him, which I hated.
One day, I was reading comics
and he fell down the stairs.
You were just a kid yourself.
Ollie's injury isn't your fault.
I will do anything to be there for him.
We'll order the pre-op testing
for the Whipple procedure.
I'm busy.
No, you are waiting on your
patient's ear wax to soften.
We can use a thoracoscopic
and laparoscopic approach
with endoscopic decompression.
I want to present it to Dr. Lim.
No.
This approach has been used
for tumor surgery.
Did you say "surgery"?
We're not talking about you!
It's less invasive than my initial idea,
with a lower risk of vascular injury.
I said no, Shaun.
This is wild. It's like Rice
Krispies popping in my ear.
I did what Dr. Andrews said.
I lowered the risk of injury.
You didn't do what Dr. Andrews said.
You didn't raise the chance
- that we're gonna fix her paralysis.
- Paralysis?
- I am not talking about you.
- We're not talking about you!
Tilt your head.
Not good enough.
Jacob will be back soon.
Let's start with us.
The pacemaker is working great.
Thank God.
But she has a genetic disease
called hemochromatosis.
Um, excess iron
is building up in her body.
That's why she was having heart issues?
Yeah.
And there's a small amount
of damage to her liver,
but it looks like
we caught that in time.
Iron is carried in red blood cells,
so the main treatment
is just regular blood draws.
That's it? Great.
Because of the forms you signed,
we're supposed to tell you and
your husband these results together
and explain that hemochromatosis
is a recessive genetic disorder,
which means that for Skyler
to have the condition,
the gene needs to be carried
by both parents.
And then we'd explain that you carry it,
but your husband doesn't.
But that doesn't
Oh, God.
Oh, God.
Jacob's old college roommate.
We were really close
with him and his wife.
Jacob suspected, but I denied it.
He was just so amazing,
and I was in a rut.
Jacob and I are good now.
Skyler is his daughter.
I don't want that to change.
We can't avoid your husband
finding out his test results.
Can you give us
the biological dad's info?
He needs to know he's a carrier.
I don't want him involved.
We can't tell him anything
about you or Skyler.
Privacy laws.
But if he has other children,
they could be in danger.
Mick Kang.
I better go talk to my husband now.
Are you trying to look
like a stalk of celery?
- Oh.
- Ohh!
My go-to in the before times.
Pair it with
The Louis Vuitton blouse?
- Mm-hmm.
- Yes.
And these.
Hot, classic.
Well done.
Only issue
They could be hard to get off.
A feature or a bug, depending.
Let's take a break.
What's going on?
I'm a different person now,
with a different body.
That he apparently finds attractive.
You'll figure it out.
It's not only sex.
I worry I'm just racing
to start my life again.
How much do I even like him?
Is he a nice guy?
Definitely.
Cute?
Pretty cute.
Having just lost a nice
and pretty cute guy,
it goes a long way.
This'll work.
Doesn't look like
we can preserve the pylorus.
We can reassess early in the surgery.
I was an idiot the other night.
When I almost kissed you.
Obviously, I like you.
But it's a line I can't cross.
If this is because we work together
It's not.
I can't date anyone right now.
But I really hope
we can keep being friends.
Okay.
If we don't do a distal,
we run the risk of
Hold up.
We clearly both like each other,
but nothing can happen
for some reason you won't share.
But you still want to hang out?
Yeah.
Let's look at the common hepatic artery.
Our other growth opportunity's
waiting in the cafeteria.
You think I carry a gene for this
Hemochromatosis.
So, if you have kids
Yeah, two boys. Six-year-old twins.
The warning signs would be bronzed skin,
liver problems,
lack of energy, joint pain.
No.
As far as I know,
they're totally healthy.
How did you find out I'm a carrier?
I've never even been to this hospital.
I'm sorry.
We're limited by privacy laws.
But as long as you and your kids
get checked out, you'll be fine.
Privacy laws? Who Whose privacy?
I'm sorry. We can't say anything more.
Jacob?
Daisy had a kid?
Hey, look, man, um, they just
they called me in here.
- I didn't
- No!
No, no, no, no, no. Don't!
Ah!
Ow.
Okay, residents,
that did not work at all.
You chose a very bad place to meet Mick,
and then Mick got his nose broken,
and then Mick complained
that you got his nose broken,
and then Dr. Andrews berated
me for not being a good attending
when all I did was delegate
to the two of you.
She suggested meeting him
in the cafeteria.
And you didn't object.
As a feminist, it's not my place to
You both did terrible jobs.
I have to work on Dr. Lim's surgery.
Go check on Skyler's pacemaker.
I can see the common hepatic artery.
Resecting the
large lymph node anterior to it.
Dr. Park, the abdominal wall.
That's not local spread.
Metastasis. We can't finish.
We have to close him up,
reverse what we can.
We will go in posteriorly at T9-L1.
With no anterior instrumentation,
she'll be at a lower risk
of postsurgical complications,
and her prognosis will be improved
by completing posterior osteotomies
to release tension on the cord.
Still too risky.
Have you even apologized to Lim yet?
I have nothing to apologize for.
Oh, my God. Shaun.
Oh, you are still mad at me
for not following orders.
That's why you keep
shooting down my ideas.
You didn't listen to me,
and you're refusing
to accept responsibility,
so yeah, I'm a little mad,
but I'm shooting down your ideas
because they're too risky.
I don't believe that.
Okay, fine, don't believe it, then.
I want you to stop being mad at me
so you will like my ideas again.
Doesn't work that way.
Then how does it work?
How long are you going to be mad at me?
I don't know.
I'm gonna go finish my clinic hours.
Is there something wrong
with her pacemaker?
Her heart is fine.
She has jaundice. Her liver is failing.
Hypotension from the heart block
caused unexpected shock liver.
She has been listed
for a transplant on UNOS.
I've asked for an exception
to speed it up,
but at this rate, she will die
before a donor liver becomes available.
We tested her mom.
She's not a good match,
and her dad isn't either,
since he's not her dad.
What about her biological father?
The mom's been calling him,
but apparently he blocked her.
We could try.
You got him punched in the face.
I will talk with him instead.
No. Y-You said before
that I might have eight months.
We didn't know it had metastasized.
I always said I wouldn't do this to him.
You're not doing
anything to him. You're sick.
He's gonna wind up in a group home.
There are good ones.
Patient Services can advise you.
Should we get your brother
so you two can talk?
Yeah.
- Got a minute?
- Not really.
Patient of mine
he's devoted his life
to taking care of his brother,
who's got a traumatic brain injury,
but he's dying of pancreatic
cancer and he's terrified.
The Whipple procedure is the only
This isn't a surgical question.
I was hoping you'd talk to them.
About your experiences with Steve,
and after he died.
Why?
It would be great for them to
see how well you've turned out.
I don't know his brother
will turn out well.
I have ASD, but he has a brain injury.
- I know, but
- I lived in a bus.
I don't know where they live,
but it is almost certainly not a bus
or you would have already mentioned it.
I still think it could help.
It's much more likely I can help
with fixing Dr. Lim's paralysis.
Your patient is dying anyway.
Why are you in this office?
I have a meeting.
You're making this worse with Shaun.
You do realize that, don't you?
You're making him more upset.
He's got to take responsibility
for what he did.
He's trying.
And you staying pissed at him
isn't going to help that process.
Which is exactly why
I'm gonna stay away.
Well, you can't avoid him forever.
- Yes, I can.
- Stop it!
You're mad at him.
He's not going to apologize.
Someone's got to make the first move.
And that has got to be me?
Yeah, of course it does.
He's a grown man, and he's your husband.
He has ASD, and he's your son.
Your daughter is in liver failure.
None of her relatives are
suitable donors, but you might be.
You want me to give my liver?
Just one lobe.
The full liver would kill you.
I've never met her.
I mean, I
I only heard about her
a couple days ago.
Okay, you're
you're biologically linked.
That gives you responsibility.
I have two little boys who need me,
a wife I'm already
in couples therapy with.
I feel sorry for this girl.
I really do.
But I cannot destroy my family for her.
My brother's going to be okay.
We're going on a trip.
Ollie,
how about Nurse Hawks here
takes you to the cafeteria
to get some ice cream, hmm?
Sundae?
Go for it.
I found a website for a clinic in Mexico
that offers a cure
for pancreatic cancer.
Immunotherapy, stem cells, supplements.
I know these clinics.
They're scams
preying on desperate people.
What do I have to lose?
Your money, for one thing.
Your brother will need it
after you're gone.
If he loses me
he'll never make it.
He will.
You don't understand.
Growing up, um,
my family was really close.
We worked the farm together.
My brother
My brother was my best friend.
One day, the tractor rolled,
and my brother herniated a disk
getting it back up.
Doctor gave him Oxy,
and 18 months later
he moved on to heroin.
Counselors, they, um
they told me, my mom,
my dad to cut him off,
that he needed to hit rock bottom.
So we did.
And he did.
For a while there,
it felt like he was gone.
My brother tells me now
that our family's love,
everything my parents taught him,
that's what got him through.
We saved him,
even when we weren't there.
Last month, he actually, um
he marked five years sober.
Ollie can handle this.
Tell him the truth.
- Don't argue with me.
- I'm not!
Stop acting like a brat.
Let's go now.
That was school.
You hit Susan Dawkins again?
She was being mean to me,
like she always is.
Well, we talked about this, Maddie.
All you got to do is is stay away.
Why do I have to change what I do
when she's the one who's mean?
Because hitting people
isn't acceptable, Maddie.
Sometimes in life,
people are gonna be mean.
You always make everything my fault.
No, I don't.
You're supposed to be on my side.
I'm trying to be on your side,
but you make it damn near impossible
because you never listen to me!
You don't listen.
You just boss me around.
Oh, my God. Okay. You know what?
- Just go to your room.
- No.
What did you say to me? Go to your room.
I hate you.
I said go to your room!
Hepatic encephalopathy.
Without a new liver,
she'll be dead by tomorrow.
Did you get the exception from UNOS?
No.
Then it's over.
It's not.
Her biological father
could still be a match.
First, you two failed with Mick,
then I failed with Mick.
We need to figure it out
together this time.
Ollie
we're not gonna go to Mexico.
Are you better?
No.
Are you dying?
Yeah.
But we are gonna spend
every minute together.
And I'm gonna find you
a great group home.
And I know that's hard.
Ollie, I am so sorry.
Rajan's in a group home.
Rajan.
From my day group.
He says he's got his own bedroom
and the people are nice.
He's okay.
I got your back, big bro.
I got your back, little bro.
Can I come in?
I am mad at you.
And for good reason.
But no matter how mad I get,
I never stop loving you.
I didn't tell that to Maddie enough.
I don't know what you want me
to take away from that.
That I love you.
I do too.
And that I had good reasons,
non-emotional reasons,
for shooting down your earlier ideas.
But I think there might be something
to that endoscopic plan, maybe.
Do you have any of her CT scans?
I have many of them.
Well, let's start with one.
Today might be the day ♪
Everything turns around ♪
Thanks for coming out, guys.
That was beautiful.
Thanks.
- I'm Lea.
- Mick.
- First time at the show?
- Yeah.
Yeah.
Uh, can I can I show you something?
Sure.
Mother cannot guide you ♪
Now you're on your own ♪
Wow. She's incredible.
Your daughter?
N-No.
No one is alone ♪
Yours.
Truly, no one is alone ♪
Mother isn't here now ♪
Who knows what she'd say? ♪
We'll go in posteriorly with minimally
invasive percutaneous screws
and do a complete
vertebral column resection
at the maximally kyphosed segments,
then reconstruct the vertebral
bodies with an expandable cage.
You're building
a whole new spinal column.
It's the safest way to remove
the tension in your cord
and let your body do its work.
You came around?
I wouldn't say I came around exactly,
but I don't think it's crazy to say yes.
At this point,
it's not a medical question.
It's an emotional one.
You got to ask yourself,
how bad do you want out of that chair?
I'll think on it.
You look
I'm gonna use
a highly precise term here
snazzy.
Well, I spent hours applying
very expensive snazz.
You look great, too.
Thanks.
Reservation for two under Joseph.
One moment.
Is this the only entrance
into the dining room?
It's an old building. I'm so sorry.
A couple of waiters
are coming down right now.
They'll carry you
and the chair upstairs.
It's no problem.
Um
You know, I have always loved
this little courtyard area out here.
Could you possibly bring down
one of those corner tables
and a couple of chairs?
Uh, just one, actually. I come equipped.
I'll make it happen.
Thank you.
A New Hope is,
of course, a perfect movie.
Correct.
But, talking about the recent ones,
ah, there's one that,
for me, really stands out.
Rogue One.
Yes! Oh!
Oh, that ending!
Genuinely a stunner.
Oh, not just for the franchise,
but for any Hollywood blockbuster.
So, what are we watching?
I'm sorry.
I didn't think that, uh
Should I go?
Yeah.
W,
I'm guessing it wasn't a date?
If it would help, I could tell you about
what I thought was a
romantic trip to Acapulco
right after my accident.
It wouldn't.
It never even occurred to him
that I would think it was a date.
Don't do the surgery.
Whatever Dr. Murphy is proposing
I'm sure sounds pretty good right now.
Do you even know what he's proposing?
This is about you wanting
your old life back at any cost.
I've been where you are.
The first year after I lost my leg,
I would have risked anything
to get it back.
But I like my life now.
I like who I am now.
Give yourself time.
Skyler? Can you hear us?
Mommy?
Oh, careful.
You've got a lot of stitches.
What happened?
You got really sick,
but these doctors fixed you up.
This man gave you part of his liver.
He saved your life.
Who are you?
I'm Mick.
See you on Monday.
Five years sober, huh?
Do you even have a brother?
I do.
But, um, he's not the addict.
And
your addiction,
is that the reason
why you and I can't
Yeah.
About six months ago, I had a setback.
Bought some heroin.
Flushed it before I took it, but still.
My first priority is making it
to midnight without using.
My second is becoming a surgeon.
And I don't know how to add a
third without risking the others.
Thank you for trusting me.
I really hope we can be friends.
Yeah.
We're friends.
I have reserved an OR for
tomorrow afternoon in case
I've decided against the surgery.
Thank you for your work.
Why?
She doesn't owe us
an explanation, Shaun.
Yes, she does.
I revised my plan, like you told me.
Shaun.
I can look for less invasive methods.
- Shaun, stop.
- I-It's not fair.
Shaun, stop.
- If your concern is recovery time
- You know what?
- You don't have to stay for this.
- I can show
Stop!
It's not fair.
Tell me the reasons
why you think it's not fair,
and I'll try to explain it.
I'm sorry.
I heard Lim said no to the surgery.
You did the right thing trying.
It accomplished nothing.
When I went back to Hershey
to help my family's company,
I thought it would fix the business,
fix things with my brother,
fix things with my parents.
Failed on all three.
But I'm glad I did it.
That makes no sense.
I'd rather do my best and fail
than always regret not trying.
When people are in pain,
try to help them.
Even if you think
it won't change anything?
That only makes it braver.
Thanks for coming.
I am Dr. Shaun Murphy.
Dr. Park wants me to talk
to you about my life.
I don't know if I can help.
But I am going to try.