The Good Doctor (2017) s06e17 Episode Script

I made you blueberry pancakes.
Would you prefer cauliflower?
Nope. Shaun, that's our baby.
I'm 36 weeks.
The baby is the size
of a head of cauliflower.
Our baby will not be this bumpy.
I am very happy.
Me, too.
We're having a baby,
I have an amazing job,
you're an attending.
We have a new family car.
Dr. Glassman has moved down the hall.
Jared is coming back
to work at the hospital.
It is great that he's back.
But, you know, the dynamic
might be a little different.
Research has shown
that when working with friends,
you get more done in less time
and have fun on the job.
But Jared will be working
for you, not with you.
It can be different when
you have to manage a friend.
Lines can get blurred,
and that can be hard.
Hmm
The lines are not blurred.
They are very clear.
Hey, there, Loverboy.
Give me the details.
Are you and Jerome exchanging keys,
or are you getting
a whole-new place together?
Yeah, no. He did not ask me to move in.
Then what did he want
to talk to you about?
I I don't want to talk about it.
Okay, now I want to know even more,
and my interrogation
will continue until
You going to the club or work?
Yeah, these early calls are
gonna take some getting used to.
- Hmm.
- A little Kendrick's
the perfect pick-me-up.
Never mad at Kendrick.
Yes.
Nice shirt. Tom Ford?
Yeah, my good luck charm.
Figured it couldn't hurt
on my first day back.
For $700, it should give you
more than luck.
On occasion, it has.
See you guys in there.
The car is a bit much,
but the fashion is lit.
Now, Mr. Grumpy,
what's going on with you?
Goodbye.
Dr. Kalu is not your peer,
not your friend.
He is your employee
and you are his boss.
I am confident that Jared
will do a good job.
That's exactly what I'm talking about.
He is not "Jared." He is "Dr. Kalu."
I do not always call people
by their professional titles.
- Sometimes I call Dr. Allen
- Dr. Murphy.
An informal communication style
with Dr. Kalu
can create a perception of
special treatment and favoritism.
I do not plan to give Jared
special treatment.
That doesn't mean
Dr. Kalu isn't expecting it.
And if I see it, it won't
be good for either of you.
She has bruising and pain even
with passive range of motion.
Some bullies at school chased her.
She fell down the stairs
trying to get away.
That's not even how it happened.
I knew we should have stuck
with homeschooling.
She insisted, and look what happened.
You need to be still.
Your shoulder is fractured.
Ultrasound the patient.
Why are you laughing?
Sh-She can't help it.
Yara has Tourette syndrome.
It's why she got
into the fight at school.
Mom, he was asking me.
You never let me speak for myself.
It wasn't a fight.
Some kids thought it would be
funny to point and stare at me,
and I thought it would be funny
to egg their lockers.
Then my stupid tics
messed up my getaway.
There's significant tissue swelling
and massive hematoma
at the proximal humerus.
The fracture has caused
an acute compartment syndrome.
You need surgery right away.
What were you doing
when you started getting dizzy?
I was sitting in gym class,
and then the room started to spin.
And then I threw up.
But I wasn't doing it.
I just introduced Carter
to the Wonder Woman comics.
He's been trying to learn the twirl.
I don't blame you. The twirl is awesome.
Where's my little guy?
- Hey, Mama E.
- Hey, Carter G.
You should have called me immediately.
Elaine's my mom.
And I don't need your permission
to bring my son to the hospital.
Actually, you do.
I'm his legal guardian.
What's wrong with him?
Uh, his heart rate is is quite low.
What does that mean?
It looks like Carter has an abnormality
of the electrical signals
controlling his heartbeat.
We need to run some tests.
Echo and electrophysiology study.
The prodigal resident returns.
Aha. Lovely to see you as well,
Dr. Reznick.
Will the hospital be getting a new wing
in the Kalu family name?
My family are doing well.
Thanks for asking.
And I was recruited to return
based on my training,
breadth of experience,
and willingness to take
a demotion back to a first year.
Ooh, it's gonna be hellish
being bossed around by newbies
and people who used to be your peers.
Grab me that box on the top shelf.
I missed you, too.
You know, while I was away,
I learned how to read emotional energy.
And sniping at people's
your love language.
Happy to know you still care.
Good luck, newbie.
Thanks.
I, uh
I gotta get to surgery. Enjoy.
Your control of the shaft segment
is very precise.
Thank you.
Brown retractor.
No brown retractor.
I thought I put it on your tray
from the supply room.
All of my tools must be
individually selected,
sterilized, and placed in my tray
before I begin the surgery.
Understood. Got it.
That will do.
Further expose the proximal humerus.
Place sutures in rotator cuff
to mobilize humeral head.
Sorry for dropping the ball
with your tools.
Rookie mistake.
Don't sweat it.
You're BFFs with the boss, right?
I treat every resident the same.
Dr. Allen,
place Steinmann pins
proximal to biceps tendon.
Dr. Kalu, you are on suction.
Oh.
Catheter placed in the axillary vein.
I feel bad for Carter's mom.
I can't imagine trying to raise a kid
with my mother backseat driving
my every move.
Well, maybe if Bianca told Elaine
that she was taking Carter
to the hospital,
she would trust her more.
Pacing wire.
Bianca was probably doing
what she thought was best.
Withholding information
is never for the best.
Advancing to the right ventricle.
Everything okay between you two?
We're fine.
That can't be right.
I need contrast to clear up
what I'm seeing on fluoroscopy.
L-transposition of the great arteries.
The ventricles are
inverted.
His heart is backward.
Your surgery went well.
We were able to decompress and release
your compartment syndrome
and stabilize your humerus fracture.
Great. When can I go back to school?
You'll only be out a few days.
Just be sure to wear your sling.
You're not going back to school.
- Why not?
- It's not safe.
I'm not sending you back
so they can hurt you again.
I'm not a baby.
I can take care of myself.
I just need to take your vitals.
If you could take care of yourself,
we wouldn't have ended up
in the hospital.
Going to school is literally the
only thing that I do that is normal.
I don't want to be
I don't want to be
stuck at home with you.
You never let me do anything by mys
Yara?
She's having a seizure.
We need 2 milligrams
of lorazepam and MRI, stat!
She's sleeping like a baby.
You should've used propofol
instead of Versed to sedate her.
Versed is old school.
Same effects, none of the overshooting.
Why are you changing my settings?
Peds case.
Shorter duration imaging
sequences cuts the time in half.
It's your first day, remember?
You could probably use a
refresher before trying a shortcut.
I'm a little out of practice,
but I've still got
a few tricks up my sleeve.
Says the guy who has to repeat a year.
- Ow.
- Mm-hmm.
Shaun will appreciate getting
Yara's results back faster.
Trust me.
You know him better than me.
Was the patient properly sedated
before you began this MRI?
Yeah, of course. I used the standard
pediatric protocol with Versed.
Did Dr. Allen tell you about
our revised propofol protocol?
Yeah. But in my experience,
Versed provides better
You should have listened to Dr. Allen.
I know how to perform an MRI, Shaun.
You apparently do not.
There is too much motion degradation.
These images are unusable.
Dr. Allen, please go redo the MRI.
Dr. Kalu, we need to speak privately.
You cannot take shortcuts.
You're right. I'm sorry.
You cannot expect special
treatment because you are my friend.
I'm not expecting
special treatment, Shaun.
But I don't appreciate being
treated like an intern, either.
I know, technically, I'm a first year,
but I've been a doctor
for as long as you have.
We are not peers.
I am your boss,
and you have a lot to learn.
Dr. Andrews said he is judging my
performance off of your performance,
and your performance is not good.
Okay?
Okay.
Good. You need
to go practice basic skills
and observe our current
standardized MRI process.
Heart block plus
inverted cardiac anatomy.
What's your plan?
Intravenous pacemaker is out,
but we could open him up,
place it surgically.
That doesn't address
the underlying anatomy issue.
The defect could lead to
heart failure as he gets older.
It could, but he might be fine
with just the pacemaker.
But if he's already developed
arrhythmia, not a great sign.
I'd recommend
the double switch reconstruction,
redirect blood flow
to the right ventricle.
I have Carter's BMP and cardiac labs.
Yeah, I already received them digitally.
But the hard copies
are always appreciated.
- Trouble in paradise?
- Everything's fine.
They've been in this
passive-aggressive fight all day.
We're not fighting.
No,
that would require you talking to me.
You don't have to share,
but you do have two divorcees
with a sadly ample amount
of experience between us.
Was one of you secretly
in contact with an ex?
Took a job out of state without
including you in the process?
Jerome lied to me,
about something very important.
- I didn't lie.
- A lie of omission is still a lie.
- It's not that simple.
- You should have told me.
- I wanted to.
- Yes, but you didn't.
Because I was afraid of how you'd react.
But you're right.
It should never have been a secret,
because there's nothing to hide.
I'm HIV positive.
Thanks to my meds, my viral load
has been undetectable for years.
I'm poz undetectable.
I can't transmit the virus.
You should go talk to him.
I have work to do.
Present the double switch
surgery to the family.
If they agree, I'll scrub in.
On it.
No. How did we get from a
pacemaker to reconstructing his heart?
The procedure may sound drastic,
but it will greatly reduce his
risk of developing heart failure.
Can't we just give him
the pacemaker now,
and do the bigger surgery
if the problem gets worse?
At the point he starts showing
signs of heart failure,
it'll be too late
to do the reconstruction.
We should fix it now.
This isn't your decision.
You are still making me pay for
mistakes I made when I was 17.
And 18, 19, 20
I've been back for two years.
How can I be a mother when
you won't even give me a chance?
Mama?
Mama E?
I don't feel good.
It's okay, baby. I'm here.
Honey, what's wrong?
My chest hurts.
The heart rate's 40 BPM.
BP 73/45.
We need a decision soon
before his condition deteriorates.
I wanted to apologize for earlier.
It was unprofessional.
You have nothing to apologize for,
and no duty to disclose.
Undetectable equals untransmittable.
I appreciate you saying that.
Give Asher some time.
He's a doctor.
He knows there was
never any risk to him.
What people know
and how it makes them feel
are often two very different things.
You've had years to process your status.
Allow Asher to process it, too.
Please do not say, "I told you so."
I won't. But I'm gonna think it.
You seem a little spoiled.
You don't know me.
You come from money,
and you haven't had to
work hard for anything.
You made it through med school.
Bravo to that.
You got kicked out of this program,
but landed on your feet
taking care of a billionaire.
And when you got tired of that,
you were welcomed back here
with open arms.
You come in with your fancy car
and your old tricks, and think,
"Ta-da, I'm a surgeon,"
but you're not. Yet.
You're the new kid.
Shaun is the boss, and I have seniority.
You should listen to Kendrick.
Be humble.
I just want to prove that I belong here.
To Shaun, to everyone.
But you're right.
I know.
The image is still not
high enough resolution.
Have you finished redoing the imaging?
Yes, and I followed all the protocols,
but the image still doesn't look clear.
The image is clear,
but Yara's diagnosis was incorrect.
She does not have Tourette's.
She has a brain tumor.
I don't have Tourette's?
No, you have a hypothalamic hamartoma.
Your tics aren't tics.
They are gelastic seizures
caused by the tumor in your brain.
Tumor? Does that mean cancer?
The tumor is not cancerous.
But a Gamma Knife radiosurgery
should stop it from growing
and treat the seizures.
Will it stop this?
Not immediately.
And possibly not at all.
There are other options you can consider
in the future
if you don't see improvement.
Or we could consider them now.
A successful resection
could stop the seizures immediately.
That procedure is very risky.
But that means I can go back to school.
I could learn how to drive.
I could take care of myself.
Mommy, please.
I just want to be normal.
Tumor resection can cause stroke,
partial paralysis,
learning deficits, meningitis.
The Gamma Knife is much safer.
- Yara, I'm sorry. I can't.
- You can.
You just won't let me.
Please go ahead
and schedule the Gamma Knife procedure.
Have you made a decision?
I'm afraid of exposing Carter
to any more trauma.
What trauma?
He was left by his mother.
- I left him with you.
- Expecting me to pick up all the pieces
and fix everything, like always.
I knew he was safer with you
than with me.
But I didn't know that.
I gave you too much freedom,
wasn't involved enough,
and look what happened.
My mistakes were mine, not yours.
I was supposed to protect you.
And we lost you.
I have to do better for Carter.
Well, the surgery is what's
best for Carter, long-term.
That kid is my heart.
I'm gonna trust you to fix his.
Lunchtime!
I'm starved.
I am not hungry.
Well, it's not good to deprive
your pregnant wife her lunch.
I thought it would be fun
working with a friend.
It is not fun. It is difficult.
I do not want people to think
I am giving Dr. Kalu special treatment,
because I am not
giving him special treatment.
In fact, I am being very firm
because he has already
made several errors,
and I do not understand why.
Well, he's a new resident
on his first day.
There has to be
a bit of a learning curve.
Mm, he is not acting
like a new resident.
Well, he's your friend.
And he knows you expect a lot of him.
No one can follow the rules
if they don't know what they are.
Atrial septum excised.
Starting venous reconstruction.
There may not be enough
tissue for redirection of flow
to the tricuspid valve.
We can use pericardium
to create a baffle. Metz.
You make up with Jerome yet?
He betrayed my trust.
All right, securing edge
to atrial septum.
You've never hidden anything from him?
I'd never hide something like this.
Congratulations.
You win the virtue contest.
Possible prizes include
the end of your relationship.
Or you could just talk it out.
Dividing the aorta.
He is the one who changed things.
I mean, why is it on me to figure out?
The question is,
do you love Jerome enough
to change with him?
Suturing distal aorta
to pulmonary valve.
Coronary arteries are patent.
Anastomosis looks great.
I never met a teenager who wanted
to go to school as much as you.
I hate school.
But I hate not being able to control
anything in my life even more.
Egging those lockers
made you feel in control?
- Kinda.
- Hmm.
Those bullies messed with me,
I messed with them back.
Like normal kids do.
I was bullied a lot in high school, too.
I was scrawny with braces, a lisp
basically a target on my back.
But my mom helped me.
Gave me her credit card to buy
them off with pizza and candy.
My mom is too helpful.
She won't even let me
make my own PB and J.
She thinks I'll tic out
and hurt myself with the knife.
When my body
isn't controlling me, she is.
When you said you can cut
this tumor out of my head,
for 30 seconds
I could imagine only laughing
when something was funny.
Think I found a solution.
Oh. I have found a solution, as well.
I have made a list
of boundaries and rules
to make our working relationship better.
You need to study them.
What have you found a solution for?
I think I found a better
resection technique.
Has a lower risk profile,
closer to that
of the Gamma Knife radiation.
And it offers a better outcome for Yara.
I presented the safest option
to the patient,
which she agreed to.
And you should not have presented the
tumor resection
without consulting me.
That is an important boundary.
Number two on the list.
I thought you'd be happy I was
thinking outside the box, like you.
You are not me. You are here to learn.
Yes. I'm also here
to help people like Yara.
You need to respect
that I am your attending.
Number six on the list.
I don't have to be an attending
to know that she's sad,
lonely, and depressed.
We cannot make medical decisions
based off of the patient's emotions.
Well, sometimes the emotions
are just as important as the medical.
You are making my job very hard!
Number ten:
At work,
follow my instructions precisely.
If you cannot comply,
you will be out of the program.
I really messed up.
I should have trusted you
and been upfront about everything.
Yeah, you should have.
After my diagnosis,
it took a long time for me
to feel comfortable dating,
or even being around people.
I spent so much time alone,
and when I finally put myself
back out there,
there was a lot of rejection.
Guys just didn't want to deal
with my status.
So, when this adorable,
brilliant doctor popped into my life,
and I liked him so much
I was too scared to tell him the truth.
I'm sorry.
This doctor sounds pretty great.
He is.
I made sure we always used protection,
encouraged you to stay on PrEP.
All to make sure that you were safe.
That was a decision that
you made for the both of us.
You did all those things
to make yourself feel better
while you took away my choice.
How could you have known me and loved me
and think that this is something
that I-I couldn't accept?
When I first had to make this decision,
I didn't love you.
I barely knew you.
And I'm not sure I know you now.
I made a mistake.
That doesn't change who I am.
No, but maybe it changes how I feel.
I'm sorry that I put you through this,
but I'm still the one
living with this disease,
and it's not easy.
It's Carter. I have to go.
He woke up from the surgery,
and he was laughing
about his comic book,
then he started to turn blue.
Oxygen saturation at 80%. 120 BPM.
Blood pressure's dropping.
All right, administering oxygen
and 250cc normal saline bolus.
Why can't he breathe?
I thought the surgery
was supposed to prevent this.
Normal lead impedance.
The pacemaker is functioning properly.
Something else is going on.
We need a cardiac echo, stat.
A kink in Carter's reconstructed
atria caused the clot in his heart.
He's stable, but he needs
another operation
to remove the clot
and repair the conduit.
Are there other alternatives?
We could use a catheter to
dissolve the blockage with medication,
but that still leaves the risk of a
clot forming again down the line.
I knew doing this
was the wrong decision.
We both want what's best for Carter.
But I'm the one
who is responsible for him.
And I'm sorry I put that on you.
I will never forgive myself
for losing
out on those years of Carter's life,
but I've realized that I need
to try to let go of that.
Let go of my regret
and focus on what I know,
that leaving him with you
was the best decision for him.
That will never change.
And this surgery is the
right decision for him, too.
You're his mother.
You know what's best for Carter.
I want my son to have the surgery.
You were right.
I usually am.
What was I right about, exactly?
I came out of the gate too hot,
annoyed Shaun,
screwed things up for Yara.
Agree.
I gotta figure out my next move.
Listen.
This whole case,
you've been pitching and shortcutting
and trying to be Mr. Fix-it
for everything.
Stop flexing and listen.
Mom, let me try the tumor
resection surgery. Please.
I'm sorry. No.
We're ready for you.
All right, baby.
But first, I, um
want you to tell your mom
what you told me,
about what you're dealing with.
What this surgery means to you.
I know what she's dealing with.
I see it every day.
But have you listened
to how it feels to her?
She doesn't care.
Of course I do.
You just want to boss me around.
I'm just trying to help,
but no matter what I do,
you're always so angry at me.
I'm angry
I'm angry at everything.
I'm angry at my body for
not doing what I want it to do.
I'm angry at other kids for being jerks.
And I'm angry at you
for acting like the only way
for me to survive in this world
is by you protecting me.
I feel like I'm a puppet
and somebody else is
constantly pulling the strings,
yanking me all around.
Getting this tumor removed
is the only way for me
to cut the strings.
Okay, don't don't
don't take her yet.
We need to talk.
I need you to scrub in
on a hypothalamic hamartoma surgery.
Okay.
I had planned to use
Gamma Knife radiation,
but Dr. Kalu violated rule number two,
and now we have to do
his tumor resection.
You're upset with Jared
because he changed your surgical plan?
He overstepped with me
and the patient and her mother.
Well, a tumor resection
seems like a pretty good idea.
Are you planning on letting
Jared scrub in?
Yes, he will be on suction.
That's an insult.
He has to learn to follow rules.
He has made my job very difficult.
Shaun, sit down.
When you were a resident,
you did things completely your own way.
You still do.
You rubbed everybody the wrong way.
You made everybody's job more difficult,
especially mine.
You were a pain in the ass.
But we gave you the space to learn,
and we learned from you.
And you turned yourself into an asset.
Give Jared the same opportunity.
Okay, he overstepped.
Give him a chance to learn
and to prove himself to be an asset.
Even if you think
he's a pain in the ass.
I will take it into consideration.
Okay.
Please scrub in for that surgery.
Advance the catheter and
endoscope gently into the ventricle.
Suction and irrigate more aggressively
so she can see what she is doing.
Proceed along the midline posteroinferior
floor of the third ventricle.
Oh, there's the tumor.
We can begin excision.
Bipolar scissors.
Micro forceps.
I'll take the specimen to pathology.
No.
You are going to close.
Are you sure?
This was your surgical plan.
You will become a better surgeon
by getting a fair shot to be an asset.
I will take the specimen.
Dr. Glassman will supervise.
I'm hungry.
That's a very good sign.
I'll run down to the cafe
and grab him some food.
Any restrictions?
He can have as many
chicken nuggets as he wants.
I'll go down.
I'll get something for you to eat, too.
You haven't left his side
since we got here.
Comes with being a good mom.
I had a great teacher.
You know, a little birdie told me
that the gift shop
just got in the latest volume
of Wonder Woman.
Really? Can we get it?
If your mom is okay with it.
Of course.
But no twirling just yet, okay?
Dr. Murphy was able
to remove all of the tumor.
Yara?
Dr. Kalu.
Memory is intact.
The light didn't provoke a seizure.
And your tics are gone.
Thank you, Dr. Kalu.
Thank you, Yara.
Dr. Andrews.
I heard about your work
on the Fields case. Good job.
Thank you.
I just came in to ask you for a favor.
Please judge me for my work,
and not Shaun.
Shaun's part of the reason
you're back here.
And I appreciate him for that.
But I want to stand on my own.
And if I sink, I don't want
to take my friend down with me.
I'm ready to prove myself
as an asset to this hospital.
I'll be watching.
Thank you.
I'm sorry for being such a jerk.
You opened yourself up, and I shut down.
And I should've trusted you
that we could figure this out together.
Yesterday, you said you didn't know me.
That adorable doctor can be
kind of an ass sometimes.
I've never been in love before you.
When I was 16,
I'm pretty sure I ran over a raccoon,
but I didn't stop to check
because I
was running late to a baseball game.
Also
I love a pumpkin spice latte.
- Ugh.
- Even though I know it's basic.
You know those cufflinks I wore
to Shaun and Lea's wedding?
Yeah.
I bought them for you, but I liked
them so much,
I kept them for myself.
That explains so much.
But you can totally borrow them
sometime, probably not.
I love you.
I need you to believe that.
Just, uh, came to say good night.
And thank you.
Why are you thanking me?
For not going easy on me.
I was wrong to expect that,
even if we are friends.
You are a good doctor.
And I would like to continue
to be your friend
and your boss
with boundaries.
You're right.
And I'm studying your list.
Oh, there is one rule
that is not on the list.
It is a rule for me.
I will refer to you
as "Dr. Kalu"
when I am being your boss
and as "Jared"
when we are in friend mode.
Yeah, that works for me, Shaun.
Good.
Jared, I would like
to take you out for drinks
to celebrate you
being back at Saint Bon's,
but Dr. Kalu,
when I checked on Yara postoperatively,
I noticed you only used eight sutures
when you closed and
she had a small bleed.
You should have used ten.
You need to go work
on your suturing technique.
Happy to to practice,
but I only replaced the small bone flap.
Dr. Glassman closed the galea and skin.
Dr. Glassman skipped two sutures?
I guess so.
Um, meet you for drinks in an hour?
- Okay.
- Okay.