The Good Doctor (2017–…): Season 4, Episode 14 - Gender Reveal - full transcript

After finding out the gender of their unborn child, Lea's enthusiasm prompts Shaun to make an effort to be a more supportive partner. Meanwhile, the team treats a navy pilot whose previous doctor's misdiagnosis compromises her chances at a full recovery.

[heavy breathing]

Bet that burned some calories.

Almost as good as a
session of hot yoga.

With considerably
fewer wind chimes.

You forgot your phone charger.

Leave it for next time.

Since when did you start
counting on a next time?

Since last time we went three
rounds. But if you want to stop...

I didn't say that.

I recall you saying
quite the opposite.

I want you not to depend
on this being here for you.

Thinking you can plug
in anytime you want.

I'm aware that I need
the charger's consent.

You need to see other women.

- Why? I don't want to...
- No excuses.

If we're going to
keep hooking up,

you should start
sleeping with other people.

You are a very strange woman.

Have you seen my phone?

Oh, and remember we
have to leave the hospital

by 6:00 tonight
for birthing class.

The birthing class
that I don't need

on account of my OB
rotation in medical school.

But where I will learn how to
give you the support you need

while giving birth to our child.

That is my guy.

I got the results of
the fetal DNA test.


This will tell us
the sex of the baby.

I know, on account of my
OB rotation in medical school.

Aren't you excited?

Not by that.

There are only two outcomes
that can be detected on this test.

- And I'm fine with either.
- So am I.

I... I'm excited
to find this out.

Please come here so
we can look together.

It's a girl. We're
having a girl.

Would you like to
paint the nursery pink?

No. This isn't the '50s.

- Okay.
- Okay!


- Okay. I will see you in class.
- Okay. Okay. [laughs]

[theme music plays]

I've got bay three.

- The chest contusion?
- Uh-huh.

Why are you all bright-eyed
and bushy-tailed over a bruise?

This is Dr. Wolke,
I'm Dr. Reznick.

- Tell me how you got that contusion, Mr...
- Bradley "The Body" Vargas.

Currently top-ranked in
his MMA Weight Class.

I've seen all of your
fights, you're amazing.

So much for slipping in and out
of here without being recognized.

[groans] Sparring.
Roundhouse right to the chest.

[Morgan] That was some kick.

This is a pretty large
hematoma. We need to drain it.

You're already training for Vasquez?
That fight's not for a couple months.

A real fan.

Drain it, like, with a needle?

- We can numb you if you like.
- Get that away from me!

Not here.

[Claire] Your pre-op
tests came back normal.

So we can go ahead
with the hip replacement.

My physical therapist says I should
be walking four hours after surgery

and good to go in 10 to 12
weeks, but I'm aiming for nine.

Can you please tell my
mom that's not a good idea?

You should not
rush your recovery.

Does it matter to you whether
you are having a boy or a girl?

I'm having a boy.

We're going to name
him Ray, after my dad.

My girlfriend and I are
going have a daughter.

That's great news, Shaun.


The procedure will
take a couple of hours,

so we should be able to
get you home in a day or two.

Oh, I'm looking forward to
getting back in the air, pain-free.

No more pills or
cortisone shots or...

my internist telling me my
hips are too wide for the cockpit.

Well, sounds more like a Navy
problem than a you problem.

Clearly the cockpit
needs a redesign...

as well as a renaming.

[pagers chiming]

OR-2 is ready, it's time.

Both implants seem to be intact.


Sorry I freaked out. Too
many people back there.

If my fans found out I had pec
implants, my career would be over.

I saw you make Miguin tap in one round.
Implants had nothing to do with that.

My body's a big part of the
brand. Everything else is real.

One hundred percent
U.S. prime Bradley.

You do not need
to explain anything.

It's just...

How many guys, let alone
fighters, get plastic surgery?

I'm sure more than you think.

When I was a kid...
well, I was a big boy.

I got picked on all the time.

My mom wanted me to
be able to protect myself,

so she put me in jiu-jitsu.

I loved it. Started
training every day.

Seems to have worked.

Yeah. Well, after
the fat was gone.

Man boobs don't
look good on anyone.

They did very nice
work. I would never know.

We still need to drain it.

I'll get the procedure
room set up.

[Alex] Is that why you want
me to sleep with other people?

- So you can shamelessly flirt?
- I feel no shame.

And I'm not stopping you. So
why do I need to see other women?

This is embarrassing, for you.

What man asks that question?

- You're soft and prone to attachment.
- I promise you I will not get attached.

Empty words. You have
a Bumble profile, use it.

No need. What's going to keep
me from getting attached to you

isn't the charms of other
women, it's your utter lack of any.

Nice osteotomy of
the femoral head.

It's bone on bone in here.

I don't know how Jean
pushed through the pain.

A female fighter pilot in the Top
Gun era, she's pushed through worse.

Things are much
better for women today.

In this surgery, I
am the only man.

But until they find a way
to put uteruses in men,

biology will always force us to make
sacrifices our male colleagues don't.

Is that why you
don't have children?

Shaun, that is not something
you should ever ask a woman.

Oh, I brought it up.

I never consciously
made that decision.

But along the away, I
made a bunch of small ones

that put my job in front
of having a family and...

I don't regret it.

But it does piss me off that
most men don't have to choose.

Mobilize the proximal
femur then ream and rasp.

[monitor beeping]

- Jean's pressure just tanked, 64 over 38.
- Push fluids, start pressors.

Heart rate's low at
42. Sinus bradycardia.

Her pre-op tests were all
normal. She has no cardiac history.

If she threw a clot, she'd be
tachy. Check for any occult bleeding.

I'll get a transesophageal echo.

There is no bleeding.

Check a 12-lead,
start troponins.

- Her BP's stabilizing.
- [beeping stops]

Remove osteophytes, place
cup, direct screws posterolaterally.

Her pressure should
not have dropped.

And we don't know
why it came back up.

Was it the fluids and pressors
or spontaneous reversal or...

We need to finish
her hip arthroplasty

before she bottoms
out again and then, yes,

we need to figure
out why it happened.


[Alex] Go ahead and
advance the needle.

Are you seeing anybody?

Oh, no. Is this
about to get weird?

No. No.

Taking a fluoro shot.

Do you usually date
one person exclusively

or are you seeing a
few people at once?

Careful not to breach
the pleural space.

Define your terms, does "date" mean
have dinner with or meet up for sex?

I'm not entirely sure.

By the time there's food
involved, I prefer to be exclusive.

In the hematoma now.

I'm not able to
aspirate anything.

It's not just clotted
blood. It's a mass.

It's about five centimeters across.
Firm, nonmobile, it's very dense.

Get a biopsy. But that...

looks like breast cancer.

There might be a problem with her
heart. Should she be putting strain on it?

If I'm going to have a heart
attack, this is the best place for it.

That is exactly right.

It's very likely
your mom is fine,

that the blood pressure drop
is a reaction to the anesthesia.

You're a very successful pilot. Was
that harder because you are a woman?

For me, standing out was
a plus. It got me noticed.

That's not always a good thing.

It's the Navy. Was the bar
higher for me than the guys? Yeah.

But pressure's just an
opportunity to get better.

Your mother is very inspiring.

Yes. She is.

I can go harder
if you need me to.

Yes, please.

I don't have breasts.

How can I have breast cancer?

You have breast tissue. While
it's rare in men, it does happen.

The biopsy has identified a
particularly aggressive tumor,

but the good news
is we caught it early.

What's next?

[phone chimes]


We're recommending surgery to remove
the mass, followed by chemotherapy.

We don't believe there will be
any long term loss of strength or...

Can I keep my implants? Will
they be able to work around them?

- It's possible.
- But highly unlikely.

At the end of this, The Body
gotta look like The Body.

Otherwise, I'll lose my
sponsors. My career.

A lumpectomy makes
sense, considering...

If you want to let the patient prioritize
his appearance over his health.

- He needs a mastectomy.
- Would you be that dismissive

if our patient was a woman
choosing to preserve...

- [phone chiming]
- Someone's popular today.

They're all dating app alerts.

It's amazing what
upgrading a profile pic can do.

You should vary
your password more.

Where'd you get this photo?

I took it for personal use.

I'm happy to let it be your
introduction to the world of e-dating.

Fly, muscular sparrow. Fly.

This photo is such...

The words you're looking for are
"thirst trap," and you're welcome.

[woman] Relax. Relax.

While you are under the
soothing touch of your partner,

let's discuss birthing plans.

Okay, maybe just a
little less pressure?

Like this?

Not really.

Remember, you are in charge
of your birthing experience.

Every aspect of your
labor is your decision.

Starting with when
you head to the hospital.

Okay. Maybe just
stop. It's okay. It's okay.

I recommend what
doulas call the 4-1-1 Rule.

You wait until contractions are four
minutes apart and last for one minute

- for at least...
- Five-minute intervals is safer.

That's one opinion, Dr. Murphy,

for mothers who enjoy
waiting at the hospital.

Once you arrive, clearly instruct
your partner and your doctor

- of what you want.
- No.

The doctor needs to be in charge.
What if there's a complication?

Maybe just let her talk.


After your water breaks, fortify
yourself for the work ahead.

Be that with meditation
or a pre-selected song

that you find soothing,
or perhaps a light snack.

That is a very bad idea.

Dr. Murphy, please hold
your comments until the...

You shouldn't eat
after your water breaks.

Many women experience
bowel incontinence during labor.

[woman 1] Is that true?

- We might poop ourselves?
- Okay.

No one mentioned
involuntary pooping.

- How was the class?
- Very informative.

When's the next one?

There won't be a next
one. We were thrown out.

None of our tests showed
any issues with your heart.

You are in great shape.

Then what caused the
blood pressure drop?

Dr. Browne must have been right.
It was a reaction to the anesthesia.

So when can I get out of here?

When we know you can get
around safely on your new hip.

Oh. Let's do this.

Careful, Mom. It's not a race.

Everything's a race, dear.


Jean's hip is intact. Which
means it didn't cause her fall.

No. Her blood pressure did.

Jean was still being
monitored when she collapsed.

Her blood pressure fall
precipitously, like in surgery.

Sudden hypotensive crisis
could be a high spinal cord tumor.

Or carotid stenosis, or
carotid sinus hypersensitivity.

Endocrine deficiency?

Make a list. Start
ruling things out.

Make a list somewhere else.


Come meet Theresa.

She's a doula and we're talking
about her helping me during my labor.

Hello. Lea does not need a doula.
I will be helping her, but thank you.

- Let me know what you decide.
- Of course. Thank you.

All right.

Shaun, I am so
excited about our baby,

and I'm so scared about
delivering her. It's going to hurt.

- It could go on for hours...
- Possibly over a day.

And I need to know that I
can have whatever I need.

A massage at exactly
the right pressure.

A hand to squeeze really hard.

- A cool wet washcloth.
- Oh.

Or a warm wet washcloth.


Can you do that?

I can get better at massages.

I'm sure you can, but those aren't
really your strengths, are they?

It's... just a setup for failure and
I know neither of us wants that.

No. We don't.


Dr. Park.

Dr. Boheim.

I definitely do not know this
because it's completely confidential,

but hypothetically, if you were
treating MMA Rockstar Bradley Vargas,

and if I had a
10-year-old patient

who would go bananas
for a signed photo...

I'll see what I can do.

Thanks in advance for the
autograph. It'll make a 10-year-old's day.

- No.
- What?

She's all wrong.

She's a peds resident.

They're all kind and nurturing
and they care about things.

And she obviously wants you to
keep all your chargers at her house.

That's not what you need.
You need fun. Text the redhead.

- What redhead?
- Candace309.

Change your password
to something I can't guess.

No tumors in the
frontal or parietal lobes.

Next, we should check for a
glial-based tumor in the brain stem.

Squeeze my hand
as hard as you can.

Lea said she may need to do that
during labor. I want to be prepared.

Okay. Okay, that's enough.

We need a better look
in the high cervical cord.

Is Lea feeling
nervous about labor?

She thinks she needs a doula
to support her, but she doesn't.

You squeezed my hand
very hard. I can take it.

I think there's probably going
to be more to it than that, Shaun.

I've also looked into
antimicrobial options for washcloths

to wipe her forehead.

What else?

I don't know.

Neither do you, or Lea,
or the doctor, or the doula.

That's what's
terrifying about it.

It's the biggest
day of her life.

And the only thing
you know for sure

is that another human being is
going to force its way out of you.

High cervical cord is clear.


Good. You're almost there.

The lighting in this
room is very harsh.

We didn't call for a
surgical consult, Dr. Murphy.

I know. I'm here for research.

And this is a bad time. Next
contraction, I need you to push.

- Okay.
- I am very interested

in anything you can share
about your experience.

- What are you feeling right now?
- [woman] Like...

[breathing heavily] like he's trying
to... [grunting] rip out everything!

Do you wish you had
gotten an epidural?


It's too late now.

Please page Dr. Glassman.

[woman] Okay. Good.

Lea wants to have a doula.

Okay. And... you don't?

Research shows that doula-assisted
births have fewer complications,

decreased length of labor, and
increased breast feeding rates.

So you do want a doula.

No. I can precisely measure
the time between contractions

and get the right washcloths,
and I've mapped out

the fastest route from the OB
floor to the cafeteria for ice chips.

I don't want Lea
to have a doula.

But they are good.

I am very bad at massages.

So, you... You want Lea to
have everything that she wants,

but you don't want
her to want a doula?


- How do I do that?
- I don't know.

I just... [chuckles]
It can't be done.

It's like you want a red shirt
really badly, but it has to be green.

Why can't you just give
her what she needs?

Okay, good.

[Marcus] We need to expose
the underlying pec major.

Dr. Park, gently cut with
microdissection needle.

I really need to join a gym.

I mean, I know I'm never
going to look like The Body,

but I could try to look
like I have a body.

[Asher & Marcus chuckle]

Raise the flap and be
careful not to thin it too much.

Bradley's transformation is
impressive, but it's not real.

Strength, determination, hard
work. Those things are real.

And worth striving for.

Not to the
exclusion of all else.

The day I lost my job as chief, I
went home and drank myself to sleep

every night for a week.

Better to drown my sorrows
than to let my wife see me cry.

When your marriage fell apart,

did you tell a good friend
that you were heartbroken,

or did you just hit something
really hard for a long time?

Both are fine. But
men don't do both.

I'm guessing no one told you, you
were a real man when you came out.

But that took a lot more courage than
getting pummeled inside of an octagon.

I can't see any
clear tumor margins.

The tumor extends beyond
what was visible on imaging.

It was obscured
by the pec implant.

Close him up.

We need to wake him and get
his consent for a total mastectomy.

I can't go home yet. I still don't
know what's wrong with my patient.

- Then why did you ask me to wait?
- This is for you.

Okay, this will massage your
shoulders whenever you want

at exactly the right pressure.

There are three settings
and a pulsing option

which I think would be
irritating, but it is up to you.

When I wear this, you can
squeeze as hard as you want.

Also, I have been building
up my washcloth tolerance.

I am up to 15 seconds.

That's great, Shaun.

But I decided I want
Theresa there for the birth.

It'll make me feel safer
and more comfortable.

I can make you feel
safe and comfortable.

I am the father, I am
going to be a good father.

- I know that and I believe that.
- You don't need her.

Maybe not, but I want her there.

It's my body and
my birth experience,

and I want to have a doula there
with me, so we're going to have one.

I love you.

I'll see you at home.

[woman on TV] Less than two weeks
away, so don't get too comfortable...

The brain and spinal MRI scans
were clear. You don't have a tumor.

One less thing to
worry about. What's left?

There is still a very long list.

I need to perform a carotid sinus
massage to test for hypersensitivity.

I have been working on
my massage technique.

But you may pass out.

That's how we know
if the test worked.

Elongate your neck and turn your
head 10 degrees away from me.

Did you have a doula
when you gave birth?


No one I know had a doula
back then, or fancy birthing suites.

Or hypno breathing or the luxury
of three months off to recover.

It's not a luxury, Mom.

It's important for the
mom and the baby.

If women want to
compete, then compete.

We can't ask for special
treatment and then complain

that the playing
field isn't level.

I had a long weekend,
and then back in the plane.

I didn't have a choice.

You had a choice.

- I...
- Stop breathing, please.

You always loved to fly.

Maybe more than being stuck
on the ground with me and Dad.



I didn't like leaving
either one of you.

I just wanted you to see me be strong
so you knew you could be strong too.

I did.

Being... scared and weak, I wasn't
always sure that that was okay.

- [monitor beeping]
- Oh, my God.

Wait, is this what was
supposed to happen?

No, this is not
supposed to happen.

You need a total mastectomy
including the removal of your pec implant.

But with training, your
strength should fully re...

I can't get back in the octagon
with half of my chest caved in.

I'll lose my sponsors.

Then find new ones. Once people
know what you've been through...

Do you honestly think I'm going to
let anyone know I had breast cancer?

What about non-surgical
options? What about chemo?

Chemo alone isn't the
best way to treat this.

It doesn't have to be the
best. It just has to work.

There's no guarantee it will.

And given the tumor's invasiveness,
they'll have to use toxic...

I can take whatever
you throw at me.

But I'm not having surgery.

EEG results are normal.

You've never had
a seizure before,

but it's possible
one was missed.

There are many different types.

Does Jean ever stare off,

- become non-responsive?
- No.

No, but there was that
one bathroom episode.

When I came to stay with you.

- After Dad died.
- Oh, that was nothing.

It was late and she
fell asleep watching TV.

She got up to use the
bathroom and got light-headed

and then almost fainted.

I think I was just exhausted.

Did it happen again?

Uh, hardly ever. A couple
times over the last few years.

There is no mention of
this in your medical record.

I told my internist.

He said it happens to some
women during menopause.

Have you experienced other symptoms
that were attributed to menopause?

Of course.

Tell me what they are
and when they started.

Um, I think I had some
constipation and sleep issues.

When? How long?

I... I don't know.

I don't remember.
I... I told my doctor

and he told me
not to worry about it.

He told me to forget
about it, so... I did.

Mrs. Williams.

I have an urgent problem
I have to talk to you about.

- You'll need to wait your turn, Mr...
- I am Dr. Shaun Murphy.

I need answers
about Jean Starzak.

She was your patient,
now she is my patient.

Dr. Murphy, if you can
wait, we can talk in private.

Okay, yes.

You failed to chart many
of Jean's symptoms.

Constipation, sleep disturbances,
hot flashes, reduced libido.

She's not sure she remembers all
of her symptoms or when they began,

- so we cannot figure out what is wrong.
- Sounds to me like she's in menopause.

You're a talented
diagnostician, Mrs. Williams.

No, she's not.

Menopause doesn't explain
her recent blood pressure issues.

- Mrs. Starzak's chart, please?
- It's not in there.

And she mentioned several
episodes of nighttime dizziness,

which I believe were seizures.

What is in here is enough to remind
me that the dizziness was menopause.

Micturition syncope,
not seizures.

And the blood pressure
issue isn't new...

but also isn't a symptom

of anything besides her
anxiety about forced retirement.

It wasn't.

I know it happened
during surgery.

She wasn't anxious,
she was unconscious.

My daughter is never
coming to see you.

According to this piece
in Clinical Endocrinology,

Jean's symptoms match pretty
well with Addison's disease.

She doesn't have hyper
pigmentation or weight loss.

- Not all cases presented with...
- Cortisol levels are normal.

There have been several recent
case studies collating hypothyroidism

with low post-op EP.
Jean's TSH is borderline high.

But her thyroid hormone
is in the normal range.

What about sleep apnea?

I read about a case
involving BP crashes.

That's interesting.

Jean's body type isn't typical of
that, but we could ask about snoring.

I would like to see
that case literature.

It's not a conventional
case writeup.

I saw a post on Reddit.

What subgroup?

The Women's Health Community.

It's not scientific at all.

It's not helpful.

But neither is this.
There is nothing here.

The medical establishment
isn't looking into this stuff.

It's ignored women like Jean.

As demonstrated by her own
doctor not charting her symptoms.

That is true. But it is still a bad
idea to rely on anecdotal evidence.

Yeah, and I agree with you.

If you have a better idea,
I am happy to go with it.

Keep checking Reddit.

Claire, can you look at
social media postings?

I'll check out the blogs.

You changed your
profile picture. It sucks.

It looks like me.

It's not like I photoshopped your
head on someone else's body.

If I'm going to sell myself, I at
least want to sell who I actually am.

The women who answer your
post don't care who you actually are.

And based on this photo, I
don't think you know who you are.

You're reading Proust?

[Bradley retching]

Once the Ondansetron sets in,
you should start feeling better.

Just in time for your
next chemo session.


I'll get through it.

I know you will.

Doesn't mean you should.

It's dumb.

You're acting like an idiot
because you're less afraid of months

of pain and nausea
than being exposed.

You've constructed
a perfect facade,

and you're going to kill
yourself trying to preserve it.

But being strong has nothing
to do with being The Body.

Tell that to my
fans, my sponsors.

I think you should.

Tell them none of
this makes you a man.

You were just as brave and strong
back when you were a fat, bullied,

little kid that decided
to make a change.

That kid didn't let other
people tell him who he could be

or what he was capable of.

Don't let him down now.

Schedule the surgery.

This woman says she had
chronic low blood pressure.

And her doctors blamed it
on her weight-loss obsession.

Turned out she had
congestive heart failure.

This woman's seizures were
attributed to her pregnancy.

She was on her fourth doctor

before they correctly
diagnosed her epilepsy.

[Claire] I've got something.

This woman spent years with
the same symptoms as Jean

before she was diagnosed.

Parkinson's disease.

You're healing well. The pathology
results show clean margins.

You should regain full strength

and be back in the
octagon in a few months.

Thank you.

There's something
I want to show you.

[Morgan] "My next
fight is Breast Cancer."

Over a million views, with some
very encouraging comments.

A few you will want to mute.


And a bunch of women
who are really into scars.

The test confirms you
have Parkinson's disease.

[Claire] We believe it has
been progressing for a few years.

Your hip pain may well
have been the first indicator.

Can I still fly?

I'm afraid not.

How do we treat it?

Unfortunately, the
delay in diagnosis

has allowed the
symptoms to intensify,

and there is nothing we
can do to reverse that.

You should still have several
more years of decent mobility.

And we can help manage
the symptoms with medication.

We'll let you two
have some time alone.

I'd like to go home.

Can you, uh...?

Can you see about
getting me discharged?

Tori, please go.

No, Mom.

It's okay.


How's your phone battery?
'Cause there's a charger at my place.

It's time to retire
that metaphor.

I'm busy.

You were right. I'm attachment prone
and there's nothing wrong with that.

As long as I'm with someone
who feels the same way.

[Dr. Boheim] I found the place.

Flanagan's. Oysters, overpriced
IPAs, the game on three big screens.


See you tomorrow.

I'd want our daughter to have the
chance to have everything she wants.

And I want you to have the
chance to have everything you want.

And I can't.

Not by myself.

It's okay that I am bad at
massages. She will handle them.

Thank you.

How do you two feel
about frankincense oil?


No, thanks.


The world is harder for women.

I want to change that,
but I don't know how.

By being an amazing
dad to our daughter.

By letting her know that
she's loved and supported.

We'll raise her to be strong.

Like you.

[inaudible dialogue]

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