The Good Doctor (2017–…): Season 1, Episode 4 - Pipes - full transcript

Dr. Neil Melendez and the team have to wade through legal waters when a husband and wife have to make a life-changing decision about their unborn child. Meanwhile, Dr. Shaun Murphy ...

Previously on "The Good Doctor"...
I'm your neighbor. I'm in the middle of "Uncharted," and I'm dead.
Can I borrow some triple A's?
It's kind of silly, isn't it?
Our relationship... that we're hiding it.
We don't have a relationship.
We have sex.
- You're late. - No, the bus was late.
I did nothing wrong. The bus...
Yeah. This is gonna work out great.
So you're treating him like anybody else?
You have any idea how many patients
he's scared the crap out of today?
So teach him.
I'm teaching you both that he doesn't belong.
I hear you got Shaun off scut
and back into surgery.
You figure you'll give him a little authority,
he'll screw something up.
ANDREWS: Either way, if he succeeds,
I'm the guy who just backed him.
And if he fails, I'm the president.
[WATER DRIPPING]

[DRIPPING CONTINUES]


[KNOCK ON DOOR]
Hello. I've looked everywhere.
All right, I'm here now. We'll...
[SIGHS]
We'll just keep looking until you find it.
Why is the furniture in the middle of the room?
I know I packed it.
I made a list. "Star-tip screwdriver."
Look, it's checked.
It's checked.
[BREATHING HEAVILY]

Maybe you... you threw it out with the newspapers
you used to pack the dishes?
I packed with bubble wrap.
It's safer. And you can see through it.
Of course you did.
Shaun, there's a hardware store up the road.
You can buy a new one.
I don't want a new screwdriver!
I want my screwdriver!
Stop it!

It's the middle of the... I'm sorry.
I just shouldn't have yelled. J-Just...
Let's just take a moment. Sit down, please.
Uh, you know what?
We can use this for now, okay?
[STAMMERS]
I can't stay here.
Of course you can.
- It'll be fine. - I can't stay here.
The... dishwasher doesn't dry,
the shower drain has someone else's hair in it.
And the crisper drawer keeps coming off the track?
I assume that's what you were fixing.
I forgot.
Of course you forgot.
It's understandable.
You've been working your ass off.
You're exhausted. You're under a lot of stress.
There's a super in the building.
You can... [CHUCKLES] call him anytime.
Just make a list of the things you need repaired.
Later, Shaun. Later.
Later, Shaun!
Go to bed now.
Go to bed.
36 years old, 22 weeks pregnant.
Ultrasound at 16 weeks
revealed a tumor on the fetus' tailbone.
Mom's got antiphospholipid syndrome.
- Makes surgery high risk. - Also makes pregnancy high risk.
She's had three miscarriages.
We need to do an ultrasound and MRI
to measure the tumor's growth rate.
Late bus doesn't explain why you're showing up tired
after you just had 12 hours off.
We're all tired.
Our last shift was 36 hours.
I'm not interested in debating the shift schedule with you.
But I am curious why you always feel the need to defend him.
Well, we're all on the same team.
Yes.
But you're all quarterbacks.
And when training camp is over,
there's only gonna be one starter.

[ULTRASOUND WHOOSHING]
JARED: The crown-rump length of the fetus
is 21.5 centimeters.
[MOUSE CLICKING]
And the diameter of the tumor is...
[MOUSE CLICKING]
...10.6 centimeters.
Half the size of the fetus.
The tumor's grown.
It's not cancer, but it is monopolizing the blood supply,
which is weakening the fetus' heart.
I'm sorry, but there's no chance it would survive
long enough to be viable.
The safest course is to terminate the pregnancy.
If we were interested in the "safest course,"
we wouldn't be on our third "second opinion."
Please, Dr. Melendez,
we want whatever will save our baby.
Dr. Wright told us you've done fetal surgery
to remove this type of tumor before.
And without the tumor, our baby would be healthy.
Your antiphospholipid syndrome
makes a long surgery extremely dangerous.
There's a high chance for blood clots,
which could have fatal consequences for you.
We're willing to take that risk.
Saving the fetus doesn't do any good
if the mother dies in the process.
I've had three miscarriages.
If I have to go through that again, I might as well be dead.
- Barb. - It's true.
No, it's not.
You're the strongest woman I've ever met.
We'll get through this.
We will. And... And then we'll try again.
We could manage clotting risk pre-operatively
with an infusion of unfractionated heparin.

[SIGHS]
Never contradict me in front of a patient again.
I didn't.
I agree with your assessment of the risks.
I suggested a way we could mitigate them.
Not in front of the patient.
We're not in front of the patient now.
I was just reading about a new technique
for transesophageal echocardiography monitoring.
If there's a cardiac issue,
it would give us an early warning.

Let's get her prepped. ASAP.

Synced & corrected by kinglouisxx www.addic7ed.com

I want J.L. on anesthesia.
And let the neo-natal nursing supervisor
know that I want to do a full run-through.
[CELLPHONE VIBRATING]
Yes?
Well, we're a little busy up here, too.
All right. I'll send someone.
Andrews is covering for Lim in the ER.
He has a patient who needs a boil lanced.
A plastic surgeon can't lance a boil?
Plastic surgeons can. Chief surgeons don't.
You and Murphy.
What?
It was our ideas that convinced you to do the fetal surgery,
and now you're punishing us with Andrews' scut work?
You're not getting punished.
He is.
For being late. Again.
But I don't trust him alone with a patient.
And since you like to defend him
and seem to know how to communicate with him...
Hurry back.

Olivia Hartman?
Yes, ma'am. I mean Doctor.
You're 18?
- Yes, ma'am. - Where's the boil?
It's, um... It's down there.
Down where?
Shaun. It's, um, on her labia.
Hmm. Is it painful?
Like I used a bowling ball for a tampon.
Okay. Boils shouldn't hurt that much.
Okay if we take a look?
[BREATHES SHARPLY]
Okay.
If you just scoot down,
put your feet in the stirrups...

Great.
The swelling is fairly localized.
Extreme pain that's out of proportion to the visible injury
could mean you have necrotizing flesh-eating bacteria.
What?!

I'm gonna use the heparin pre-operatively
and a T.E.E. monitor.
Still not enough.
The risk of a heart attack or stroke...
Was thoroughly explained.
The patient still wants the surgery.
She wants it? Or you want it?
Yes, saving a fetus' life would be good news for me.
Any other questions?
Or insults?
Relax. I'm not insulting you.
Of course you want to do the surgery.
But you do surgeries like this,
some patients are going to die.
And then our department's success rate goes down,
and then our funding goes down,
and then you can't do surgeries like this.
So if your judgment is clouded in any way, just...
It's not.
Okay.
[Groans]
I'm sorry. I know this hurts,
but I really do need to insert a speculum
for this part of the exam.
If I really have what he says,
does that mean you have to cut off my...
No. No, as I said, the abscess
is most likely the result
of an untreated chlamydia infection.
[ECHOING] We'll drain the abscess,
give you antibiotics.
[NORMAL VOICE] You'll be fine.
Ow!
I'm... I'm sorry.
The inflamed Bartholin gland
is causing the ischiocavernosus muscle
to spasm and pinch the labial nerve.
You need to start with a more upward angle.
Can I try?
I think it's better if I do this.
Ow!
[SIGHS]
Yeah, okay. Fine.
Can we, uh, call your parents? Let them know...
No.
I'm 18. I'm an adult.
Even adults need emotional support.
Someone to drive them home after surgery.
Uh, I'm gonna take a taxi.
I have money.
There's nothing to be embarrassed about.
25% of college students contract an STD before graduation.
I'm not embarrassed.
And I know all about STDs.
I get tested every 30 days.
There's no necrosis on the vaginal wall or cervix.
You got it in already?
Yes. It's definitely not flesh-eating bacteria.
- I was wrong. - Thank God.
You do need surgery to drain the Bartholin gland abscess.
Why do you get an STD test every 30 days?
I have to. For work.
I do porn.
The umbilical is 19 inches,
which will allow us to remove the fetus via Caesarean
and rest it in its mother's lap while I excise the tumor.
Now, the hart part
will be reinserting the fetus afterwards.
We can't overstretch the uterine wall,
and we must be certain that every suture is tight enough
to handle four more months of kicks and thrown elbows.
Do you have a minute?
Can it wait?
No.

I don't want to do it.
Have you talked to your wife?
Yes, but she's not thinking rationally.
You heard her say she'd rather die than lose this baby.
I'm sorry, but husbands don't have veto power
over their wife's medical decisions.

A husband can't stop you from operating on his wife.
But a father can stop you from operating on his child.


[CHUCKLES] What kind of porn?
[SCOFFS] I'm sorry.
I was too busy doing all the labs and imaging
she needed for surgery.
I forgot to ask for her résumé.
I just mean, is she an actual actress,
like in stuff with a story, or...
Do they even make porn with stories anymore?
Sometimes.