The Good Doctor (2017) s06e09 Episode Script
Broken or Not
After six other houses
I am sure that
"fixer-upper" means decrepit.
Well, part of the fun is imagining
what something could be.
It could be expensive
and messy and loud and even dangerous.
Hey, why don't you do
your thing with the real estate agent?
I'm gonna go wander.
Hi.
Tori Vargas. Any questions?
Oh, yes, I have many.
About school districts,
drought-tolerant landscaping,
seismic retrofitting
Someone came prepared.
Does that include loan pre-approval?
- If not, I can help.
- Oh, no.
Going to open houses out of
our price range is our new hobby,
and sometimes, there are cookies.
How fun! Uh, excuse me just a sec.
Hi, there.
I grew up with a reading nook
just like this one.
I'd lay in a pile of pillows,
watch the falling snow.
That sounds uncomfortable.
A lot of the work is just cosmetic.
I could do most of it myself.
Make it a perfect family home.
Like, these window frames
are just painted shut,
but all you have to do is
- Ow! Damn it.
- See?
Dangerous.
Forks and knives?
Hands only.
And don't you drown
my shao bing in hot sauce.
Yes, ma'am.
A scallion omelet and sesame flatbread.
Mm! Did I forget an anniversary?
This is a thank-you for
planning our first road trip.
Mm!
I'm planning more road trips.
I can't wait to head south on PCH.
Last trip was a solo one on my Ducati.
Hold on.
You're a biker chick?
Was. In another life.
You miss it?
The other life?
Motorcycles are too dangerous.
You could end up paralyzed.
Nice deflection.
I didn't know you in the other life.
I like this one.
Still feel that way
if I go get the hot sauce?
We haven't had a chance to talk about
You kissing me.
Thereby crossing a line
you said we shouldn't cross,
right as I was headed on a date.
How'd that go?
Great.
I barely heard a word he said,
because the whole time,
I was thinking about our kiss.
It was It was amazing.
Yes, it was.
Look, I like you,
but I need some clarity here.
Right.
Let me be clear.
How about I make you dinner
tomorrow, my place,
and we talk about where we're headed?
Sounds good.
It's a date then.
A date.
Oh.
Good morning, Dr. Lim.
Did Clay stay over last night?
- He did.
- Excellent.
That means you are likely
in a good mood and amenable
because of the sex.
Amenable to what?
I think you will like it.
There was movement,
flexion, and lateral rotation,
which means that there was
engagement with the psoas
and the glutes, and I saw it twice.
Signals are getting through
to your spinal column.
This deformity is not just scar tissue.
It's a compressive syrinx.
We can enter from a midline myelotomy
and drain the fluid
after we De-tether your cord.
I could
You could walk again.
Audrey, this approach is much safer
than the one we discussed last time.
I need time to think it over.
Of course.
Okay, today is the first day I will
be implementing my new system.
I'm sure you agree
it is a major improvement.
I don't know what the hell
you're talking about.
My new rating system
for first-year residents?
I e-mailed you multiple drafts.
You never responded.
Once all the data is in,
I will share the completed version.
Well, can't wait.
Whoa!
When I asked to see where you worked,
I didn't mean it as a challenge.
I had to get you on the mat to see
if you exaggerated on your profile.
I'm I'm not really a fan
of walks on the beach.
Whoa!
Sunsets are overrated.
All right.
Whoa!
Nice.
What happens on a third date?
Lily?
Lily?
Are you okay?
My new system has over 50 unique metrics
that go into your scores.
Everything you do will be assessed.
Everything? Uh, could you be
a bit more specific?
No.
Is this like a head-to-head competition?
It's designed to make you aware
of your individual
strengths and weaknesses.
Residents with more strengths
are more likely
to get invited back
for a full residency.
Hi, Teddy. Dr. Powell.
What happened to your head?
I idiotically smacked myself
with a 20-pound kettlebell.
Kettlebell injuries
are surprisingly common.
My gym has a printout
of ten different ways
you can hurt yourself.
Did you witness the accident?
Yeah. I'm there for all his workouts.
Oh, so you're his trainer.
His brother.
My baby brother.
He's got a real knack
for making me suffer.
All right.
We're gonna run a full
concussion protocol
and get a CT as a precaution.
Not until we take care of this gash.
You're also experiencing abdominal pain.
- Did that pain start
- Aah!
before or after you hit your head?
Uh, kind of simultaneous?
Do you mind lifting your shirt?
Teddy, you've recently
lost a lot of weight.
Seventy pounds.
In five months.
Getting that summer beach bod ready.
Keeping the T-shirt on for now.
Teddy, do you mind if we laid you back
just to get a better look?
Oh, got a lump.
An inguinal hernia. It's not reducible.
I think it's also strangulated.
Hmm, Dr. Perez is right.
The blood flow to your herniated
intestine has been cut off.
You need immediate surgery. Okay.
This is Lily. 37, dizziness, epistaxis,
purulent nasal discharge.
Let's get full labs
including blood cultures.
I guess the upside of dating a doctor
is no waiting in the ER.
I dated a guy at the DMV
for that very reason.
Do you have a history of nosebleeds?
Yes.
Part of my perpetual sinus infection.
I've been on and off
antibiotics for a year.
I figured it's because
I teach Kung Fu to kids.
Mm, adorable.
Do you feel any sinus pressure?
Also, how'd you two meet?
Yes, and Bumble?
Thank you, Dr. Reznick. I got this.
He's worried this will be
awkward because I'm his ex.
Don't worry. We're friends now.
Any other recent symptoms?
I've had a few migraines
and bad taste in my mouth recently.
Temp's elevated, and she's hypertensive.
Acute-on-chronic
bacterial rhinosinusitis?
Probably, but given the headaches,
I want a stat brain and sinus C
with and without contrast.
Hernia is reduced.
Next step in the tension-free
hernioplasty?
Use mesh to cover the fascial defect.
By strengthening the inguinal floor,
we hope to prevent further hernias.
No extra credit will be given
for statements of the obvious.
It's impressive how much
weight Teddy's lost.
I just hope he's doing it
for the right reasons.
Hard to see a wrong reason.
He was clearly pretty overweight.
I agree.
Obesity increases
health risks for diabetes,
heart disease, and some cancers.
Fair. But our culture can really
go overboard on the fat-shaming,
which can lead to
low self-esteem, depression,
none of which is healthy.
Trying to change to please
someone else rarely works.
Getting someone you love
to do what is best for them
is a good thing.
There's ectopy in the EKG.
QT looks prolonged.
Push 2 grams IV of magnesium.
He's going into torsades.
Proper response?
Yes. Prepare to shock him.
Charging 200 joules. Clear.
Good catch, Dr. Powell.
I caught the strangulated hernia.
Teddy's arrhythmia is likely a
sign of an underlying condition.
It could be quite dangerous.
Next, you will be assessed on
how quickly and accurately
you can determine what's causing it.
Suture scissors.
I'll start with the sinuses.
Hey, I found you a new prospect.
Unless your last date was a
love connection for the ages.
- That's a no.
- Oh. Hmm.
How terrible for him.
How exciting for me.
Berkeley law grad, former fitness model,
just moved back
to the valley from Paris.
Thanks, but I'll pass.
That's severe opacification.
Sinus mucosa's thickened.
There's already bony erosion.
Lily needs endoscopic
sinonasal debridement.
He's smart, he's ripped, he's worldly,
and unlike Perez, he's available.
- We kissed.
- What?
You and Perez?
Yeah.
What about his
recovery-related boundaries?
I haven't figured that out yet,
but he did invite me
to dinner at his place.
I'm exploring.
Just be careful, okay?
Okay.
Her sinus infection spread
through her skull base.
That's a massive 6x4 centimeter abscess.
Page Park.
If that thing ruptures, she'll die.
Lily needs sinus and brain surgery.
Sinus debridement
looks very good, Dr. Allen.
Pulling the scope.
Bacitracin-coated Telfa.
And we use two burr holes
to drain the abscess
using ultrasound guidance.
So, how'd you get approval
to operate on your new girlfriend?
Two dates does not equal a girlfriend.
No approval necessary.
Trajectories look good.
Drainage tool.
Plus or minus that you got to
parade her in front of Morgan?
Definitely not parading,
and Morgan and I are
friends, so neither.
Uh-huh.
Mm, this is as much as I can get
without risking rupture
into the ventricle.
Eh, the rest is up to the antibiotics.
Leave the drain and close.
Would you say
you loved, liked, or hated
the last house we saw?
Are those the only options?
I should examine your hand.
Oh, it's fine.
I can't stop thinking
about the crown molding
and the reading nook,
so as long as you don't hate it,
I'm thinking we should
talk to a mortgage broker
about making an offer.
You said going to open houses
was only for fun.
I've looked at our finances,
and we can swing it.
Rent is spent.
A mortgage payment is
whatever rhymes with payment
and and means good investment.
My research shows we should adhere
to the 28/36 rule with regards
to monthly pre-tax income.
You have swelling around
your second digit's metacarpal
and the proximal phalanx of your thumb.
Okay, I've done worse on engine blocks.
Shaun, we can be homeowners.
Doesn't that excite you even a little?
Hmm.
I am a little excited
that you are excited.
Good, because I made an appointment
with a mortgage broker.
And you guys can talk 25/36.
Twenty-eight.
You know, it's silly
for us to be competitive.
Said the loser while losing.
Olive branch.
I don't know what's
causing the arrhythmia. Do you?
I have ideas.
O-kay.
So you can present them
and land the knockout blow
if you're confident that you're right.
- Or?
- Or we can bounce ideas off each other,
get the right answer, and help this guy.
For all we know,
one of Dr. Murphy's metrics
is cooperation amongst colleagues.
Fine.
But I present.
Do you have any idea how often women
get zero credit for their ideas,
even when they come out of their mouths?
Fine.
Blood sample showed critically
low potassium and sodium,
which makes no sense
given the power-food diet
that his brother's got him on.
There's plenty of nutrients. So
- maybe celiac.
- Mm.
IgA and IgG antibody tests were normal.
I'm thinking primary aldosteronism.
That's interesting.
Please present your ideas on what
is causing our patient's arrhythmia.
We think that Teddy
has primary aldosteronism.
Explains initial
electrolyte levels and
That doesn't align with urine
studies or lack of hypertension.
This was your idea.
Congenital long QT syndrome.
Teddy's QT levels
have returned to normal,
and he has no family history.
He has critically low levels of
potassium, sodium, and magnesium.
I noticed that. Despite a good diet.
It suggests absorption and
What happened to cooperation
amongst colleagues?
I didn't realize
you were gonna be wrong.
Slight enamel erosion on the molars
and trauma to the oral mucosa.
And these tiny abrasions on
his knuckles are from his teeth.
Self-induced vomiting
led to malnutrition,
which caused the arrhythmia.
Teddy, you are bulimic.
That's quite the cocktail.
Not the kind I was hoping
we'd share, but here we are.
Not exactly what I would
have worn either.
We're hoping the antibiotics will
clear the remaining infected areas
of your sinuses and brain.
I feel like I'm already getting
the VIP treatment from you.
Dr. Reznick was right.
She said your flower game
was very solid.
She stopped by?
Yes.
Ostensibly to check on me,
but mostly to sing your praises.
Not many guys have an ex as a hype man.
Lucky me.
I think it's too soon
to discharge Teddy.
He has responded well
to electrolyte replacement,
there are no signs
of recurrent arrhythmia,
and the hernioplasty only
requires simple wound care.
- He's bulimic.
- I know.
I diagnosed him, thank you,
after you and Dr. Powell failed to.
Eating disorders have the highest
mortality rate of any mental illness.
I referred him for a psych consult
and provided a list of clinics
for eating disorders.
He needs help now, not in a few weeks.
Give me some time.
Maybe I can get psych to talk to him
before he leaves.
Points are given
for passion and commitment
and taken away for arguing
with an attending.
I don't care about the points.
We can't keep him hospitalized
without a clear surgical indication.
Stop hounding me.
I'm having a coffee.
Can I have a coffee?
You're hovering.
I'm excited about the prospect
of getting you back on your feet.
This surgery is not an easy decision.
The surgical plan is a very good one.
Yes, it's a solid plan.
But?
But my life is good right now,
really good.
Better than it's been in a while.
And the idea of that changing is
Lea said we would go to
open houses as a fun hobby,
but now she wants to buy one.
- Shaun, I'm in the middle of a
- No, you're not.
A house? Okay, well, congratulations.
Look at you two, grown-up-ing.
No, it's a fixer-upper.
Dr. Glassman, I don't like it.
Did you tell Lea that?
No, she is excited when she talks
about the house. It makes her happy.
And I think she has been sad lately.
Why has she been sad?
I told you,
we have to wait to get pregnant
because of her Asherman's syndrome.
Well, maybe Lea is looking for
a way to move you two forward.
You think if we buy that house,
Lea will be less sad?
I don't know, but, you know,
buying a house can be exciting.
It's a distraction.
Distractions can be useful.
No, no, no. I do not like distractions.
Shaun
you've been rating residents
for quite a while now,
and now all of a sudden,
you revamp your entire system?
When did you decide to do that?
Mm, after the sextuplets were born.
Wasn't that around the same time
you found out about Lea's Asherman's?
Yes.
We were both very sad.
You think my new system
was a distraction?
Yeah, and and now
maybe Lea needs one.
Oh, excellent idea.
Thank you, Dr. Glassman.
Brought your ride outta here
and your discharge papers.
Pulled some strings,
got you a psych consult
at an eating-disorder clinic
day after tomorrow.
Thanks, but I'm good.
This hospital stay
was the wake-up call I needed.
You don't have to go through this alone.
Discharge party. I brought drinks.
Special Potassium Powerhouse
for my big bro.
So, um, Teddy tells me
he has some, like,
freak electrolyte deficiency?
Do you know what caused it?
Teddy's got all the information.
Do I need to make
any adjustments to his diet?
It might be a good time to dial
back on the weight-loss goals.
Uh, why?
Simon, uh, let's just go.
Is it dangerous for him to diet now?
For how long?
Um, I-I-I can't really say.
Simon, forget it.
It's on me to make sure you're okay.
No, it's actually not. It's my life.
Why are you getting mad at me?
I'm just being supportive.
Otherwise known as
micromanaging everything I do.
You were miserable and a mess, okay?
I'm the one getting you healthy.
What am I missing?
Tell him.
It wasn't your workouts
that took off the weight.
I've been
purging.
Making myself puke.
Is that what caused your heart thing?
Why would you do something so stupid?
Maybe because you're so obsessed
with me not being a fat embarrassment.
- I never said that.
- You didn't have to.
You've never been so excited
as when I mentioned
maybe losing some weight.
- Because I'm worried about you?
- You're ashamed of me.
It's been years since we've hung out,
and now every day,
you're all over me
to meet you at the gym.
You're killing yourself,
but this is my fault?
Get your own ride home.
I don't want to micromanage.
Sim
Teddy, I am so sorry.
It's fine.
I can Uber.
- You sent her flowers from me?
- You're welcome.
Have you considered that I may
not even want to keep seeing Lily?
She's clearly a keeper,
and you need a girlfriend.
How is that your business?
Because I need you and I not to make
the same mistake all over again.
We both know we've been teetering
on the edge of falling back into us.
You're out of your mind.
Like you haven't thought about it?
You read too much
into my friendly gestures.
Like offering me your sperm?
For IVF.
Could the symbolism
be any more heavy-handed?
We can't go back.
You made it very clear
that I'm not what you wanted,
and I haven't changed.
So I need you to move on.
- How long?
- It's just over a minute.
We pushed 2 milligram IV lorazepam.
And the antibiotics
clearly aren't working.
Push another 2 lorazepam.
Why do you look like you just
watched the first two minutes of Up?
I thought Teddy wasn't gonna get
the help he needed for his bulimia.
I thought maybe his meddling
brother might make sure he did.
Not a bad plan.
The execution was flawed.
So congratulations on your
upcoming blowout victory.
Help! Someone call the RRT.
I got it.
Teddy.
He's ruptured his esophagus.
Page Dr. Murphy and prep an OR.
Chest tube placed.
The lung drainage is orange?
What's left of the smoothie.
Advance the endoscope.
He is fortunate that you
responded so quickly, Dr. Perez.
I pushed Teddy to admit
his bulimia to his brother.
They fought, and then he did this.
Oh. That was
not helpful.
And there is too much damage
for a primary esophageal repair.
We can place an endoscopic stent,
wait until edema improves.
It will leak.
What about using omentum as a patch?
The tissue is too friable.
It's usually for kids,
but what about gastric transposition?
We could resect the damaged esophagus
and reconstruct it using stomach tissue.
Good idea, Dr. Perez.
This will improve your score.
We need to open him up.
The abscess is not responding
to the antibiotics.
The sinus infection
is still seeding to the brain.
We could drill an additional burr hole,
get more aggressive with the drainage.
The same approach
will get you the same results.
Thanks for the unhelpful cliche.
Lily needs a bifrontal craniotomy
with sinus exenteration.
Remove the skull base on both sides,
then rebuild it to stop bacterial entry.
I'm not taking off Lily's
forehead and consigning her
to years of reconstructive surgeries.
You want to save her life
or protect her pretty face?
Are you seriously accusing me
of acting unethically
because I've been on two dates with her,
after your move with the flowers?
- What move with the flowers?
- Shut up.
I'm accusing you of letting your
medical judgment be clouded
because you don't want to agree with me.
I'm making the right call
for the patient.
Disagreeing with you
is an unrelated bonus.
Get Lily and the OR prepped.
Removing the devitalized
segment of the esophagus.
We've got a good plane
of healthy tissue.
Dr. Perez,
you may perform the two-layered,
inverted, hand-sewn anastomosis.
I had a l-late night
on a research project.
My hands aren't stable enough.
Dr. Powell should take this.
Starting to suture.
I am ready to go home.
I am not, thanks to Andrews dumping
reconfiguring
the remote interface in my lap.
It's weeks, if not months,
of debugging code.
Well, that was fast.
When I asked Dr. Andrews
to assign you a new project,
he could not think of any.
How is your hand?
Annoy Annoyed, along with the
rest of me. Why would you do that?
Because you have been sad
that we have to wait to have a baby.
Work will be a much better
distraction than restoring an old house.
That's not a judgment
for you to make, Shaun.
I'll pick my own distractions.
And I have been sad.
And that house is just a chance
to make something broken
beautiful again.
So is reconfiguring
the remote interface.
The house feels like a step forward.
I can really see us being happy
in that home, Shaun.
I just wish you would
try to see that, too.
Okay.
Okay we can make an offer?
No, I meant, okay, I will try.
Thanks.
I'll see you at home later.
Sorry I'm late.
I had an impulse.
NBA 2K.
Prepare to get smoked.
Mm. Tip-off will have to wait.
I'm buried.
Maybe I could help?
Trouble with a case?
Yeah.
My own.
What's happened?
Glassman found movement
in my psoas and glutes.
He and Murphy found
an endoscopic solution.
They'll De-tether your spinal cord.
That's great.
Is there a problem
with the surgical plan?
It's quite elegant.
Then what's holding you back?
I feel like we've been
living in this bubble,
this perfect bubble,
and if I step outside of it,
it will pop.
This surgery
would change you,
not us.
What we have isn't going to disappear
if you walk again.
You need to believe that.
I want to.
Please. I can't be the reason
you say no.
We successfully repaired
Teddy's distal esophagus
with reconstructed stomach tissue.
Teddy will be able to eat
and swallow normally,
but any further purging
will cause irreparable damage.
I thought we were finally close again.
He's been hurting, and I
I had no idea.
How do I fix this?
Sometimes trying to fix
the problem is the problem.
I went through some tough times, too,
and plenty of people
had ideas about how to fix me.
See, I didn't I didn't need that.
I just needed them
to love me, broken or not.
Even though I don't like sanding
and paint is sticky and smells terrible
and power tools are loud and dangerous,
I am positive that we, mostly you,
can make that fixer-upper
into a beautiful home for us
and the family we will have.
Are you saying we should buy the house?
If it will make you happy.
I bulldozed you, didn't I?
Yes. But I do not mind.
But I do.
I'm being selfish.
Thank you for letting me.
But the only step forward
I need right now
is one we make together.
Let's find a place we both love.
That is a good approach.
And, also, let's get my hand
checked out. It does really hurt.
Advancing into the abscess.
Couldn't stay away?
Lily is my patient. I admitted her.
Resecting last bits of capsule
from the abscess cavity.
Got it. Pulling the scope.
Heart rate's 32. BP, 210/122.
Her brain is starting to
herniate out of the burr holes.
Give 100 grams mannitol,
burst suppress high-dose propofol.
That won't be enough.
Get her CO2 below 30.
I'm aware. Place an EVD.
Should we pivot to
the bifrontal craniotomy?
- No time.
- Can you connect the burr holes
and run a small craniotomy flap?
No, but a hemicraniectomy
will reduce the brain pressure.
And then you can debride
the skull-base infection.
- Good.
- Good.
Mm, that was hot.
Doing this surgery is a good decision.
- I hope so.
- Doubts?
No. I'm a little nervous, but no doubts.
Thank you both for not giving up.
You're welcome.
We'll see you in recovery.
Welcome back.
You've got a visitor.
You're okay?
Getting there.
No gym for a while.
You need time to heal.
I'm on it, doc.
Remember when we were kids,
you made me watch Alien vs. Predator?
I had to let you sleep
in my room for three months.
Turns out the combined
Alien/Predator canon includes 13 movies.
You and I are gonna watch them together.
If that's cool with you.
Sounds stupid.
But fun.
Looks like both brothers
are on the mend.
Take video. Maybe Murphy
will give you some points.
I'm good.
What happened in the OR when
you handed over the anastomosis?
Just didn't feel like my day.
I devised my
first-year-resident rating system
as a distraction.
It was very complicated and
encouraged too much competition.
So I have decided to retire it.
You okay?
Easily the worst date I've ever been on.
Well, the next one,
I'll put the rest of your skull back on.
We have to wait until the swelling
in your brain has gone down.
Am I gonna be okay?
You've got a long road ahead, but yes.
And you won't be alone.
That's a lot of commitment
especially when you and
Dr. Reznick don't really seem done.
Thanks for everything
Dr. Park.
I'm glad you didn't move on
from the case.
Glad you listened.
I'm working on it.
Lily will be lucky to have you
through her recovery,
unless you decided
not to see her anymore.
You were right. She's a keeper.
Then I'm happy for you two.
Visiting hours still open?
They don't usually
let visitors into pre-op.
Well, nobody says no
to a guy in a wheelchair.
I had to see you.
I recognize this is terrible
timing and kind of bonkers,
but I couldn't let you
go in before asking.
Audrey
will you marry me?
Definitely bonkers.
I don't expect an answer now.
This?
This is me telling you that I am all in.
Thank you.
That's my cue.
I'll be waiting.
Do I look as silly as this feels?
Ms. DiLallo?
We're gonna have to postpone your CT.
I brought ice cream.
Better let me in before it melts.
Danny?
Danny!
No. No, no, no, no, no.
No, no. Danny.
Danny.
Shaun.
W-What's wrong?
I'm I'm pregnant.
My OB told us it isn't safe
for me, or the baby.
And, um
And I'm really scared.
Okay.
You told me to imagine what could be.
Yeah.
Let's do that
together.
I am sure that
"fixer-upper" means decrepit.
Well, part of the fun is imagining
what something could be.
It could be expensive
and messy and loud and even dangerous.
Hey, why don't you do
your thing with the real estate agent?
I'm gonna go wander.
Hi.
Tori Vargas. Any questions?
Oh, yes, I have many.
About school districts,
drought-tolerant landscaping,
seismic retrofitting
Someone came prepared.
Does that include loan pre-approval?
- If not, I can help.
- Oh, no.
Going to open houses out of
our price range is our new hobby,
and sometimes, there are cookies.
How fun! Uh, excuse me just a sec.
Hi, there.
I grew up with a reading nook
just like this one.
I'd lay in a pile of pillows,
watch the falling snow.
That sounds uncomfortable.
A lot of the work is just cosmetic.
I could do most of it myself.
Make it a perfect family home.
Like, these window frames
are just painted shut,
but all you have to do is
- Ow! Damn it.
- See?
Dangerous.
Forks and knives?
Hands only.
And don't you drown
my shao bing in hot sauce.
Yes, ma'am.
A scallion omelet and sesame flatbread.
Mm! Did I forget an anniversary?
This is a thank-you for
planning our first road trip.
Mm!
I'm planning more road trips.
I can't wait to head south on PCH.
Last trip was a solo one on my Ducati.
Hold on.
You're a biker chick?
Was. In another life.
You miss it?
The other life?
Motorcycles are too dangerous.
You could end up paralyzed.
Nice deflection.
I didn't know you in the other life.
I like this one.
Still feel that way
if I go get the hot sauce?
We haven't had a chance to talk about
You kissing me.
Thereby crossing a line
you said we shouldn't cross,
right as I was headed on a date.
How'd that go?
Great.
I barely heard a word he said,
because the whole time,
I was thinking about our kiss.
It was It was amazing.
Yes, it was.
Look, I like you,
but I need some clarity here.
Right.
Let me be clear.
How about I make you dinner
tomorrow, my place,
and we talk about where we're headed?
Sounds good.
It's a date then.
A date.
Oh.
Good morning, Dr. Lim.
Did Clay stay over last night?
- He did.
- Excellent.
That means you are likely
in a good mood and amenable
because of the sex.
Amenable to what?
I think you will like it.
There was movement,
flexion, and lateral rotation,
which means that there was
engagement with the psoas
and the glutes, and I saw it twice.
Signals are getting through
to your spinal column.
This deformity is not just scar tissue.
It's a compressive syrinx.
We can enter from a midline myelotomy
and drain the fluid
after we De-tether your cord.
I could
You could walk again.
Audrey, this approach is much safer
than the one we discussed last time.
I need time to think it over.
Of course.
Okay, today is the first day I will
be implementing my new system.
I'm sure you agree
it is a major improvement.
I don't know what the hell
you're talking about.
My new rating system
for first-year residents?
I e-mailed you multiple drafts.
You never responded.
Once all the data is in,
I will share the completed version.
Well, can't wait.
Whoa!
When I asked to see where you worked,
I didn't mean it as a challenge.
I had to get you on the mat to see
if you exaggerated on your profile.
I'm I'm not really a fan
of walks on the beach.
Whoa!
Sunsets are overrated.
All right.
Whoa!
Nice.
What happens on a third date?
Lily?
Lily?
Are you okay?
My new system has over 50 unique metrics
that go into your scores.
Everything you do will be assessed.
Everything? Uh, could you be
a bit more specific?
No.
Is this like a head-to-head competition?
It's designed to make you aware
of your individual
strengths and weaknesses.
Residents with more strengths
are more likely
to get invited back
for a full residency.
Hi, Teddy. Dr. Powell.
What happened to your head?
I idiotically smacked myself
with a 20-pound kettlebell.
Kettlebell injuries
are surprisingly common.
My gym has a printout
of ten different ways
you can hurt yourself.
Did you witness the accident?
Yeah. I'm there for all his workouts.
Oh, so you're his trainer.
His brother.
My baby brother.
He's got a real knack
for making me suffer.
All right.
We're gonna run a full
concussion protocol
and get a CT as a precaution.
Not until we take care of this gash.
You're also experiencing abdominal pain.
- Did that pain start
- Aah!
before or after you hit your head?
Uh, kind of simultaneous?
Do you mind lifting your shirt?
Teddy, you've recently
lost a lot of weight.
Seventy pounds.
In five months.
Getting that summer beach bod ready.
Keeping the T-shirt on for now.
Teddy, do you mind if we laid you back
just to get a better look?
Oh, got a lump.
An inguinal hernia. It's not reducible.
I think it's also strangulated.
Hmm, Dr. Perez is right.
The blood flow to your herniated
intestine has been cut off.
You need immediate surgery. Okay.
This is Lily. 37, dizziness, epistaxis,
purulent nasal discharge.
Let's get full labs
including blood cultures.
I guess the upside of dating a doctor
is no waiting in the ER.
I dated a guy at the DMV
for that very reason.
Do you have a history of nosebleeds?
Yes.
Part of my perpetual sinus infection.
I've been on and off
antibiotics for a year.
I figured it's because
I teach Kung Fu to kids.
Mm, adorable.
Do you feel any sinus pressure?
Also, how'd you two meet?
Yes, and Bumble?
Thank you, Dr. Reznick. I got this.
He's worried this will be
awkward because I'm his ex.
Don't worry. We're friends now.
Any other recent symptoms?
I've had a few migraines
and bad taste in my mouth recently.
Temp's elevated, and she's hypertensive.
Acute-on-chronic
bacterial rhinosinusitis?
Probably, but given the headaches,
I want a stat brain and sinus C
with and without contrast.
Hernia is reduced.
Next step in the tension-free
hernioplasty?
Use mesh to cover the fascial defect.
By strengthening the inguinal floor,
we hope to prevent further hernias.
No extra credit will be given
for statements of the obvious.
It's impressive how much
weight Teddy's lost.
I just hope he's doing it
for the right reasons.
Hard to see a wrong reason.
He was clearly pretty overweight.
I agree.
Obesity increases
health risks for diabetes,
heart disease, and some cancers.
Fair. But our culture can really
go overboard on the fat-shaming,
which can lead to
low self-esteem, depression,
none of which is healthy.
Trying to change to please
someone else rarely works.
Getting someone you love
to do what is best for them
is a good thing.
There's ectopy in the EKG.
QT looks prolonged.
Push 2 grams IV of magnesium.
He's going into torsades.
Proper response?
Yes. Prepare to shock him.
Charging 200 joules. Clear.
Good catch, Dr. Powell.
I caught the strangulated hernia.
Teddy's arrhythmia is likely a
sign of an underlying condition.
It could be quite dangerous.
Next, you will be assessed on
how quickly and accurately
you can determine what's causing it.
Suture scissors.
I'll start with the sinuses.
Hey, I found you a new prospect.
Unless your last date was a
love connection for the ages.
- That's a no.
- Oh. Hmm.
How terrible for him.
How exciting for me.
Berkeley law grad, former fitness model,
just moved back
to the valley from Paris.
Thanks, but I'll pass.
That's severe opacification.
Sinus mucosa's thickened.
There's already bony erosion.
Lily needs endoscopic
sinonasal debridement.
He's smart, he's ripped, he's worldly,
and unlike Perez, he's available.
- We kissed.
- What?
You and Perez?
Yeah.
What about his
recovery-related boundaries?
I haven't figured that out yet,
but he did invite me
to dinner at his place.
I'm exploring.
Just be careful, okay?
Okay.
Her sinus infection spread
through her skull base.
That's a massive 6x4 centimeter abscess.
Page Park.
If that thing ruptures, she'll die.
Lily needs sinus and brain surgery.
Sinus debridement
looks very good, Dr. Allen.
Pulling the scope.
Bacitracin-coated Telfa.
And we use two burr holes
to drain the abscess
using ultrasound guidance.
So, how'd you get approval
to operate on your new girlfriend?
Two dates does not equal a girlfriend.
No approval necessary.
Trajectories look good.
Drainage tool.
Plus or minus that you got to
parade her in front of Morgan?
Definitely not parading,
and Morgan and I are
friends, so neither.
Uh-huh.
Mm, this is as much as I can get
without risking rupture
into the ventricle.
Eh, the rest is up to the antibiotics.
Leave the drain and close.
Would you say
you loved, liked, or hated
the last house we saw?
Are those the only options?
I should examine your hand.
Oh, it's fine.
I can't stop thinking
about the crown molding
and the reading nook,
so as long as you don't hate it,
I'm thinking we should
talk to a mortgage broker
about making an offer.
You said going to open houses
was only for fun.
I've looked at our finances,
and we can swing it.
Rent is spent.
A mortgage payment is
whatever rhymes with payment
and and means good investment.
My research shows we should adhere
to the 28/36 rule with regards
to monthly pre-tax income.
You have swelling around
your second digit's metacarpal
and the proximal phalanx of your thumb.
Okay, I've done worse on engine blocks.
Shaun, we can be homeowners.
Doesn't that excite you even a little?
Hmm.
I am a little excited
that you are excited.
Good, because I made an appointment
with a mortgage broker.
And you guys can talk 25/36.
Twenty-eight.
You know, it's silly
for us to be competitive.
Said the loser while losing.
Olive branch.
I don't know what's
causing the arrhythmia. Do you?
I have ideas.
O-kay.
So you can present them
and land the knockout blow
if you're confident that you're right.
- Or?
- Or we can bounce ideas off each other,
get the right answer, and help this guy.
For all we know,
one of Dr. Murphy's metrics
is cooperation amongst colleagues.
Fine.
But I present.
Do you have any idea how often women
get zero credit for their ideas,
even when they come out of their mouths?
Fine.
Blood sample showed critically
low potassium and sodium,
which makes no sense
given the power-food diet
that his brother's got him on.
There's plenty of nutrients. So
- maybe celiac.
- Mm.
IgA and IgG antibody tests were normal.
I'm thinking primary aldosteronism.
That's interesting.
Please present your ideas on what
is causing our patient's arrhythmia.
We think that Teddy
has primary aldosteronism.
Explains initial
electrolyte levels and
That doesn't align with urine
studies or lack of hypertension.
This was your idea.
Congenital long QT syndrome.
Teddy's QT levels
have returned to normal,
and he has no family history.
He has critically low levels of
potassium, sodium, and magnesium.
I noticed that. Despite a good diet.
It suggests absorption and
What happened to cooperation
amongst colleagues?
I didn't realize
you were gonna be wrong.
Slight enamel erosion on the molars
and trauma to the oral mucosa.
And these tiny abrasions on
his knuckles are from his teeth.
Self-induced vomiting
led to malnutrition,
which caused the arrhythmia.
Teddy, you are bulimic.
That's quite the cocktail.
Not the kind I was hoping
we'd share, but here we are.
Not exactly what I would
have worn either.
We're hoping the antibiotics will
clear the remaining infected areas
of your sinuses and brain.
I feel like I'm already getting
the VIP treatment from you.
Dr. Reznick was right.
She said your flower game
was very solid.
She stopped by?
Yes.
Ostensibly to check on me,
but mostly to sing your praises.
Not many guys have an ex as a hype man.
Lucky me.
I think it's too soon
to discharge Teddy.
He has responded well
to electrolyte replacement,
there are no signs
of recurrent arrhythmia,
and the hernioplasty only
requires simple wound care.
- He's bulimic.
- I know.
I diagnosed him, thank you,
after you and Dr. Powell failed to.
Eating disorders have the highest
mortality rate of any mental illness.
I referred him for a psych consult
and provided a list of clinics
for eating disorders.
He needs help now, not in a few weeks.
Give me some time.
Maybe I can get psych to talk to him
before he leaves.
Points are given
for passion and commitment
and taken away for arguing
with an attending.
I don't care about the points.
We can't keep him hospitalized
without a clear surgical indication.
Stop hounding me.
I'm having a coffee.
Can I have a coffee?
You're hovering.
I'm excited about the prospect
of getting you back on your feet.
This surgery is not an easy decision.
The surgical plan is a very good one.
Yes, it's a solid plan.
But?
But my life is good right now,
really good.
Better than it's been in a while.
And the idea of that changing is
Lea said we would go to
open houses as a fun hobby,
but now she wants to buy one.
- Shaun, I'm in the middle of a
- No, you're not.
A house? Okay, well, congratulations.
Look at you two, grown-up-ing.
No, it's a fixer-upper.
Dr. Glassman, I don't like it.
Did you tell Lea that?
No, she is excited when she talks
about the house. It makes her happy.
And I think she has been sad lately.
Why has she been sad?
I told you,
we have to wait to get pregnant
because of her Asherman's syndrome.
Well, maybe Lea is looking for
a way to move you two forward.
You think if we buy that house,
Lea will be less sad?
I don't know, but, you know,
buying a house can be exciting.
It's a distraction.
Distractions can be useful.
No, no, no. I do not like distractions.
Shaun
you've been rating residents
for quite a while now,
and now all of a sudden,
you revamp your entire system?
When did you decide to do that?
Mm, after the sextuplets were born.
Wasn't that around the same time
you found out about Lea's Asherman's?
Yes.
We were both very sad.
You think my new system
was a distraction?
Yeah, and and now
maybe Lea needs one.
Oh, excellent idea.
Thank you, Dr. Glassman.
Brought your ride outta here
and your discharge papers.
Pulled some strings,
got you a psych consult
at an eating-disorder clinic
day after tomorrow.
Thanks, but I'm good.
This hospital stay
was the wake-up call I needed.
You don't have to go through this alone.
Discharge party. I brought drinks.
Special Potassium Powerhouse
for my big bro.
So, um, Teddy tells me
he has some, like,
freak electrolyte deficiency?
Do you know what caused it?
Teddy's got all the information.
Do I need to make
any adjustments to his diet?
It might be a good time to dial
back on the weight-loss goals.
Uh, why?
Simon, uh, let's just go.
Is it dangerous for him to diet now?
For how long?
Um, I-I-I can't really say.
Simon, forget it.
It's on me to make sure you're okay.
No, it's actually not. It's my life.
Why are you getting mad at me?
I'm just being supportive.
Otherwise known as
micromanaging everything I do.
You were miserable and a mess, okay?
I'm the one getting you healthy.
What am I missing?
Tell him.
It wasn't your workouts
that took off the weight.
I've been
purging.
Making myself puke.
Is that what caused your heart thing?
Why would you do something so stupid?
Maybe because you're so obsessed
with me not being a fat embarrassment.
- I never said that.
- You didn't have to.
You've never been so excited
as when I mentioned
maybe losing some weight.
- Because I'm worried about you?
- You're ashamed of me.
It's been years since we've hung out,
and now every day,
you're all over me
to meet you at the gym.
You're killing yourself,
but this is my fault?
Get your own ride home.
I don't want to micromanage.
Sim
Teddy, I am so sorry.
It's fine.
I can Uber.
- You sent her flowers from me?
- You're welcome.
Have you considered that I may
not even want to keep seeing Lily?
She's clearly a keeper,
and you need a girlfriend.
How is that your business?
Because I need you and I not to make
the same mistake all over again.
We both know we've been teetering
on the edge of falling back into us.
You're out of your mind.
Like you haven't thought about it?
You read too much
into my friendly gestures.
Like offering me your sperm?
For IVF.
Could the symbolism
be any more heavy-handed?
We can't go back.
You made it very clear
that I'm not what you wanted,
and I haven't changed.
So I need you to move on.
- How long?
- It's just over a minute.
We pushed 2 milligram IV lorazepam.
And the antibiotics
clearly aren't working.
Push another 2 lorazepam.
Why do you look like you just
watched the first two minutes of Up?
I thought Teddy wasn't gonna get
the help he needed for his bulimia.
I thought maybe his meddling
brother might make sure he did.
Not a bad plan.
The execution was flawed.
So congratulations on your
upcoming blowout victory.
Help! Someone call the RRT.
I got it.
Teddy.
He's ruptured his esophagus.
Page Dr. Murphy and prep an OR.
Chest tube placed.
The lung drainage is orange?
What's left of the smoothie.
Advance the endoscope.
He is fortunate that you
responded so quickly, Dr. Perez.
I pushed Teddy to admit
his bulimia to his brother.
They fought, and then he did this.
Oh. That was
not helpful.
And there is too much damage
for a primary esophageal repair.
We can place an endoscopic stent,
wait until edema improves.
It will leak.
What about using omentum as a patch?
The tissue is too friable.
It's usually for kids,
but what about gastric transposition?
We could resect the damaged esophagus
and reconstruct it using stomach tissue.
Good idea, Dr. Perez.
This will improve your score.
We need to open him up.
The abscess is not responding
to the antibiotics.
The sinus infection
is still seeding to the brain.
We could drill an additional burr hole,
get more aggressive with the drainage.
The same approach
will get you the same results.
Thanks for the unhelpful cliche.
Lily needs a bifrontal craniotomy
with sinus exenteration.
Remove the skull base on both sides,
then rebuild it to stop bacterial entry.
I'm not taking off Lily's
forehead and consigning her
to years of reconstructive surgeries.
You want to save her life
or protect her pretty face?
Are you seriously accusing me
of acting unethically
because I've been on two dates with her,
after your move with the flowers?
- What move with the flowers?
- Shut up.
I'm accusing you of letting your
medical judgment be clouded
because you don't want to agree with me.
I'm making the right call
for the patient.
Disagreeing with you
is an unrelated bonus.
Get Lily and the OR prepped.
Removing the devitalized
segment of the esophagus.
We've got a good plane
of healthy tissue.
Dr. Perez,
you may perform the two-layered,
inverted, hand-sewn anastomosis.
I had a l-late night
on a research project.
My hands aren't stable enough.
Dr. Powell should take this.
Starting to suture.
I am ready to go home.
I am not, thanks to Andrews dumping
reconfiguring
the remote interface in my lap.
It's weeks, if not months,
of debugging code.
Well, that was fast.
When I asked Dr. Andrews
to assign you a new project,
he could not think of any.
How is your hand?
Annoy Annoyed, along with the
rest of me. Why would you do that?
Because you have been sad
that we have to wait to have a baby.
Work will be a much better
distraction than restoring an old house.
That's not a judgment
for you to make, Shaun.
I'll pick my own distractions.
And I have been sad.
And that house is just a chance
to make something broken
beautiful again.
So is reconfiguring
the remote interface.
The house feels like a step forward.
I can really see us being happy
in that home, Shaun.
I just wish you would
try to see that, too.
Okay.
Okay we can make an offer?
No, I meant, okay, I will try.
Thanks.
I'll see you at home later.
Sorry I'm late.
I had an impulse.
NBA 2K.
Prepare to get smoked.
Mm. Tip-off will have to wait.
I'm buried.
Maybe I could help?
Trouble with a case?
Yeah.
My own.
What's happened?
Glassman found movement
in my psoas and glutes.
He and Murphy found
an endoscopic solution.
They'll De-tether your spinal cord.
That's great.
Is there a problem
with the surgical plan?
It's quite elegant.
Then what's holding you back?
I feel like we've been
living in this bubble,
this perfect bubble,
and if I step outside of it,
it will pop.
This surgery
would change you,
not us.
What we have isn't going to disappear
if you walk again.
You need to believe that.
I want to.
Please. I can't be the reason
you say no.
We successfully repaired
Teddy's distal esophagus
with reconstructed stomach tissue.
Teddy will be able to eat
and swallow normally,
but any further purging
will cause irreparable damage.
I thought we were finally close again.
He's been hurting, and I
I had no idea.
How do I fix this?
Sometimes trying to fix
the problem is the problem.
I went through some tough times, too,
and plenty of people
had ideas about how to fix me.
See, I didn't I didn't need that.
I just needed them
to love me, broken or not.
Even though I don't like sanding
and paint is sticky and smells terrible
and power tools are loud and dangerous,
I am positive that we, mostly you,
can make that fixer-upper
into a beautiful home for us
and the family we will have.
Are you saying we should buy the house?
If it will make you happy.
I bulldozed you, didn't I?
Yes. But I do not mind.
But I do.
I'm being selfish.
Thank you for letting me.
But the only step forward
I need right now
is one we make together.
Let's find a place we both love.
That is a good approach.
And, also, let's get my hand
checked out. It does really hurt.
Advancing into the abscess.
Couldn't stay away?
Lily is my patient. I admitted her.
Resecting last bits of capsule
from the abscess cavity.
Got it. Pulling the scope.
Heart rate's 32. BP, 210/122.
Her brain is starting to
herniate out of the burr holes.
Give 100 grams mannitol,
burst suppress high-dose propofol.
That won't be enough.
Get her CO2 below 30.
I'm aware. Place an EVD.
Should we pivot to
the bifrontal craniotomy?
- No time.
- Can you connect the burr holes
and run a small craniotomy flap?
No, but a hemicraniectomy
will reduce the brain pressure.
And then you can debride
the skull-base infection.
- Good.
- Good.
Mm, that was hot.
Doing this surgery is a good decision.
- I hope so.
- Doubts?
No. I'm a little nervous, but no doubts.
Thank you both for not giving up.
You're welcome.
We'll see you in recovery.
Welcome back.
You've got a visitor.
You're okay?
Getting there.
No gym for a while.
You need time to heal.
I'm on it, doc.
Remember when we were kids,
you made me watch Alien vs. Predator?
I had to let you sleep
in my room for three months.
Turns out the combined
Alien/Predator canon includes 13 movies.
You and I are gonna watch them together.
If that's cool with you.
Sounds stupid.
But fun.
Looks like both brothers
are on the mend.
Take video. Maybe Murphy
will give you some points.
I'm good.
What happened in the OR when
you handed over the anastomosis?
Just didn't feel like my day.
I devised my
first-year-resident rating system
as a distraction.
It was very complicated and
encouraged too much competition.
So I have decided to retire it.
You okay?
Easily the worst date I've ever been on.
Well, the next one,
I'll put the rest of your skull back on.
We have to wait until the swelling
in your brain has gone down.
Am I gonna be okay?
You've got a long road ahead, but yes.
And you won't be alone.
That's a lot of commitment
especially when you and
Dr. Reznick don't really seem done.
Thanks for everything
Dr. Park.
I'm glad you didn't move on
from the case.
Glad you listened.
I'm working on it.
Lily will be lucky to have you
through her recovery,
unless you decided
not to see her anymore.
You were right. She's a keeper.
Then I'm happy for you two.
Visiting hours still open?
They don't usually
let visitors into pre-op.
Well, nobody says no
to a guy in a wheelchair.
I had to see you.
I recognize this is terrible
timing and kind of bonkers,
but I couldn't let you
go in before asking.
Audrey
will you marry me?
Definitely bonkers.
I don't expect an answer now.
This?
This is me telling you that I am all in.
Thank you.
That's my cue.
I'll be waiting.
Do I look as silly as this feels?
Ms. DiLallo?
We're gonna have to postpone your CT.
I brought ice cream.
Better let me in before it melts.
Danny?
Danny!
No. No, no, no, no, no.
No, no. Danny.
Danny.
Shaun.
W-What's wrong?
I'm I'm pregnant.
My OB told us it isn't safe
for me, or the baby.
And, um
And I'm really scared.
Okay.
You told me to imagine what could be.
Yeah.
Let's do that
together.