The Good Doctor (2017–…): Season 4, Episode 5 - Fault - full transcript

Shaun questions his decision to give the new residents autonomy when one of his intern's misdiagnosis of a patient has dire consequences. Morgan and Park bond over failed relationships.

It's just a migraine.

until we're completely sure...

Is the pain a tight
band or pulsating?

Good question.

light bothers me, nausea.

I get these all the time.

You said you didn't feel a,

What'd you call it? A...

An aura. I know, but...

Exactly how often do
you get these symptoms?

I just ask, since your boyfriend
doesn't seem to recognize them.

Zane and I have only known
each other for eight days.

It moved fast.

did you feel your foot twitch?


Positive Babinski.

What does that mean?

It's not a migraine.

Oh, that.

I was performing due
diligence on my new roommate,

who might be a violent maniac,

and look what I
found in his closet.

It's cute.

You moved in with two suitcases.

You only have four
pairs of underwear.

How the hell did a
parrot make the cut?

I'm a Parrothead.

A Jimmy Buffett enthusiast.

The Margaritaville guy?

Well, he has other,
far better songs,

but yes, the Margaritaville guy.

It brings me luck.

Scary to think what your
life would be like without it.

Can I have it back?

It's fun getting to
know you better.

Worth every damn
bit of sacrifice.

I was demonstrating a torch
lift this morning, and, bang.

"Ballet master."

You're a dancer?

God, no. I'm like the CEO.

At my age,
I'd be the Betty White of the troupe.

Is she a dancer?

I don't know much about,
uh, culture.

I assume I just sprained something,

we will need neuro and abdominal exams,

X-rays for fractures,

CBC for infection,

cultures to rule out
a spinal abscess...

You're new, aren't you?

Uh, it's my second week here.

It's actually only my
first day seeing patients.

Am I your first?


Sorry. But, yes.


That's impressive.

Whoever's supervising
you must really trust you.

I'm not sure that's true.

They won't let me
join their stupid gym

because I had
high blood pressure.

How am I supposed to
lower it if I can't work out?

200 over 105.

That is quite high.

I just told you it was high.

Are you a smoker?

Yeah. Pack or two a day.

More if I feel crappy.


Do you have diabetes?

You're reading those
questions out of a book?

Yes. Have you ever
done this before?

I told you. You
have to trust them.

I don't.

Then act like you do.

Go away.

Nothing more romantic than
spending one of your first dates in an ER.

stressful experiences release oxytocin.

Same hormone that
creates emotional bonds.

This might actually
cement their relationship.

Next to the hippocampus.

Is that a tooth?

Dermoid cyst. Cool.

She's having a seizure.

Secure her airway. Push
two milligrams Ativan.

Thank you for
trusting us enough...

Please report.

58-year-old male dancer with back pain.

I ruled out red flags
like osteomyelitis

and kidney infection,
but I did find evidence

of a mild L2 compression
fracture with moderate wedging

and evidence of impingement
on the neural canal.

You want to start beta blockers?

Me? Yeah. I think my
patient's a stroke risk.

BP's 200 over 105.

It was the same
at her gym earlier?

Can you raise your arms?

Okay. Now try to
squeeze my hands.

I just did all these
tests with her.

I thought you were gonna give
me stuff to lower my blood pressure.

That would kill you.

Now push against my hands.

If she's in danger
of having a stroke...

She's not. She's
already having one.

Smoking on estrogen
put her at high risk.

Loss of circadian blood
pressure variation confirms it.

Stick out your tongue.

We gotta get a CTA.

No. We're treating with IV tPA.

Don't we need to locate
the clot? We just did.

Right deviation means a
right vertebral artery occlusion.

Oh. You can close
your mouth now.

Her seizure and coma
were caused by a dermoid cyst.

It's a pocket of tissue with bits of teeth,
hair, and fat.

She likely got it
before she was born.

What can you do?

The less invasive
option is to put in a drain

to release some pressure,

treat with anti-seizure
meds and steroids,

then basically watch to see
if the swelling goes down.

And the more invasive?

Surgical removal.

But the cyst is deep inside

and wrapped
around major arteries,

so it is more likely
to fix the problem,

but it carries risk of
stroke or paralysis.

We need a decision quickly.

Ellie's sister is
on the paperwork,

but we haven't been
able to reach her.

Do you know where the
parents live or any other siblings?

He might still be on a business trip,
but, uh...

you can try her husband.

If we can't reduce the swelling,

she will have
permanent brain damage.

Is that him?

we need you to make a decision.

Yeah, yeah.

I'm... I'm not sure that
I'm the right one to...

I mean, right now,

I hate her.

You don't.

You're angry.

You're hurt.

Because you love her.

58-year-old male
dancer with back pain.

Moderate vertebral wedging and
impingement on the neural canal.

Yes. I think an L2
compression fracture.

Prescribe anti-inflammatories,
a brace, and PT,

then discharge him.

Do you wanna re-check anything?


Remember to floss your
brain after every meal, people.


Do you think we
should be doing this?

I know we have to legally,

but maybe her husband isn't
the one who knows her best,

knows what she wants.

Better than the guy who
met her last weekend.

Arachnoid knife.

Mmm, that guy,
she's in love with him. Apparently.

Well, maybe she loves them both.

Aren't you a romantic!

Watch for perforators.

I've been polyamorous for years.

When I was monogamous,
I was jealous, possessive, egotistical.

Our patient wasn't
honest. That's not cool.

But other than that...

Good margins all around.

Let's dry up the field
and close her up.

I never would've guessed
I was your first patient.

Felt more like the fourth.

By the way,
did I detect an accent?


I mean, I had one,
but I worked really hard to lose it.

No one ever notices it anymore.

Eastern Europe?



I grew up Hasidic,
speaking Yiddish.

I left it a long time ago.

You left the... the religion?

The religion, the culture,

my family.

Must not have been easy,
growing up that way,

knowing you were

a doctor.

Excuse me?

My generation,
you could get bashed.

You could get thrown in jail.

We had to learn codes,

how to read each other.

You should thank
your lucky stars

you get to live your
life the way you want it.

I don't know what
you went through.

Please don't pretend to
know what I went through.


My gut...

Code blue!

The surgery seemed successful,

but we need to monitor for
seizures over the next 24 hours.

Is this high enough?

Um, a little to the left.

No. To the right. Yeah.

You never said
anything was wrong.

Can we have the
room for a moment?

I'm sorry,
but we really need to check...

You're worried about
talking in front of them?

Embarrassing me?

I didn't think
anything was wrong.

When I met Zane,

it made me realize
something was missing.

Or, at least,
I think that's what I'm feeling.

You mind tilting your chin up?

I'm sorry.

Why couldn't you
just talk to me?

Or... Or leave me?

I don't know.

Were you happy?

With him?

I guess I should go.


Who are these people?

do you know where you are?

Why am I in the hospital?

Suprarenal aortic aneurysm.

It ruptured as he
was being discharged.

Clamping aorta now.

How much blood is he down?

We suctioned out two liters

and gave six units
on the rapid infuser.

The aneurysm
caused his back pain.

Dr. Wolke missed it.

I did an abdominal exam.

Aneurysms are
very hard to catch.

Experienced doctors
miss them all the time.

Potts scissors.

The aneurysm is 6.5 centimeters.

Dr. Wolke should have felt it.

It felt like normal musculature.

I'm so sorry.

We'll never know what you felt.

There's no way to know if you,
or any doctor, for that matter,

would have detected this.

I would have.

He asked me if I
wanted to double-check.

If I had, I would've caught the
aneurysm before the rupture.

Stop it.

He made a mistake.

He might have.

But you did, too.

No. You told me to back off.

I didn't tell you to
abdicate responsibility.

When a First Year asks if
you want to re-check their work,

your answer should
always be "yes."

The fact they're
asking is a warning sign.

I didn't know that.

It's called retrograde
memory loss.

it seems to have been temporary.

She's lucid again.

We're running an
MRI and lab tests

to see what caused it.

Thank you for, uh,
telling me. I know I'm just the...

You care.

Maybe things with Ellie and I
weren't always perfect, but...

It was exciting.

When I was with her...

Never felt that way before.

I took care of her
when she was sick.

I never strayed.

It wasn't about
the things we did.

It was... It was about

being with her.

She stuck by me
when I needed her.

Last year,
I was... I was drinking way too much.

It's hard to imagine
being without her.

I just can't imagine
being without her.

She's stable.

Q-hour neuro exams and
monitor for signs of elevated ICP.

♪ * Wastin' away
again in Margaritaville

I believe you're getting a call,
Dr. Park.

♪♪ Searchin' for my
lost shaker of salt ♪♪

a Parrothead. Wear it proud.

Can we just agree
to have some limits?

Maybe not everything
I own is fair game.

Mmm, no.


Trust me,
it'll be worth every damn bit of sacrifice.

I've said that twice now.

You've said a
lot of things twice.

You have limited creativity.

Truth is,
it wasn't creative at all.

It's from Jimmy Buffett's
Cheeseburger In Paradise,

one of his Big 8. So big,
even I know it.

You, sir, are no Parrothead.

Mia does woodwork
as a side hustle.

She made it for me on
our first trip to Hawaii.


Wait, no, that's not right.


And do you toss away all
mementos of past friends and jobs?

If a job cheated on me,
I might wanna move on.

When's the last time
you dated someone?

When's the last time you
acted like a human being?

So, years?

I definitely found the right word.

See you at home.

You can't sleep?

You want some warm milk?

My mother has, like,
18 prescriptions for this.

Some of them are
actual prescriptions.

I can sleep

but need to figure out
how to supervise better.

How many of these are
you planning to read tonight?

Just the relevant
sections of each.

Tech bros are always watching
TED Talks on leadership.

That could be quicker
than those books.

How about tomorrow,
we have a date night?

Why would we need a date night

if we're in a relationship
and living together?

Because it'll be fun.

I'll schedule date
night for tomorrow.

Great. Think of
something for us to do.

There is one thing that
helps most people sleep

that my mother did
not tell me about.

What makes a great manager?

Some say it's all
about planning.

Others, charismatic leadership.

A third group...

Your temporary memory
loss was caused by some fat

that leaked from your cyst.

We can remove
it via a craniotomy,

but there is a real risk
of more memory loss.

Maybe permanently.

What will I lose?

The time prior to the surgery.

Days, weeks, possibly months.

But if we don't operate soon,

the risk of brain
damage only grows.

I can't do it.

I don't even know
what I want right now,

but I do know that I don't want
the decision about my marriage

forced on me by an operation.


find another answer.

You are not very
good at your jobs,

and I'm not very
good at teaching you,

so we are going to focus
on one step at a time.

You will master
each skill separately.

I've made a list of 400 skills.

I didn't have the time to
finish it last night because...

Dr. Wolke,
you will be focusing on physical exams.

You'll find a list of the seven
post-op tests to be conducted on Carl.

Dr. Jackson,
you will find relevant seminars

on conquering nerves
in the workplace.

What are good
activities for a date?


What does she like?

Cars, coding,
Zelda: Breath of the Wild,

Sauvignon Blanc, Skittles,
RuPaul's Drag Race,


I had a very romantic
time camping in Big Sur.

This is for tonight.

I haven't gone on many dates.

But everyone loves movies. Hmm.

Healing nicely.

No redness or swelling.

I'm gonna palpate around it now.

Look, I need to apologize.

For bringing up your
personal life the other day.


You have nothing to
apologize to me for.

So, what's next on your list?

Checking for signs of
infection inside your abdomen.

Open your eyes wider.

You have signs of jaundice.

I think your liver's failing.

The liver is being
damaged by a new aneurysm.

How? A genetic
predisposition or...

More likely,
when we fixed the first one,

we increased the
pressure upstream.

Can we stent the celiac?

Anatomy's too tricky.

Aortic to celiac bypass?

We'd just risk a new
aneurysm forming upstream.

but it solves the problem in front of us.

He'll die without
an intervention.

He'll probably die either way.

Let's all take the time to
research alternate solutions.

If we can't come up with
something better in 24 hours,

we proceed with the bypass.

She's saying no for
emotional reasons.

So the answer isn't medical.

It's emotional.

We think Zane
should talk to Ellie.


I don't want him
anywhere near her.

To convince her to
do the craniotomy.

From you, it's self-serving.

From Zane...

Wait. If she doesn't want it...

You said you can't
imagine life without her.

If you meant that,
you'd risk anything to keep her alive.

Including her memories of you.

Well done, Shaunie.

I really needed this.

The system update yesterday?

Went bananas.

I've been flooded
with complaints.

Total nightmare.

How's work? Did the videos help?


Tell me more.

One of my patients developed
a secondary aneurysm.

Now I need to find a
surgical fix by tomorrow.

Otherwise, he will probably die.

I brought Skittles.

Shouldn't you be
at the hospital?

Yes. After you go to bed,

I plan to go back
and do research.

Shaunie, go to the hospital.

No, we made this schedule.

Someone else needs you.

More than I need you.

It's a hospital.

It's filled with sick people.

But tomorrow,
will someone need you

to come up with a
way to save their life?

Mmm, maybe.

Probably not tomorrow.



I am canceling date night.

That's rude.

Oh, well.


I should

go to the hospital.


They're prepping
Ellie for surgery.

Any last-minute questions?

What should I do?

Forgive her.

Under the right circumstances,
every human will stray.

We're not hardwired
for monogamy.

I'm guessing you're not married.

I'm not saying that
it's wrong to feel angry.

She wasn't honest with you.

The alternative to forgiving her

is losing someone that you love.

Then what?

If she comes back to me
just because she forgets him,

my marriage wouldn't be honest.

I have an idea.

We could remove
more proximal aorta

and extend the graft.

And rebuild the
celiac trunk with what?


Branches are too complex.

This Lancet article
on polymer materials

doesn't work.

But thin-film nitinol?

Did we break him?

We have the material.

It's his veins.

Hey! Oh, I'm sorry.

Did we reestablish
personal boundaries?

This morning's presentation's
on who's not moving on?

Exhibit A.

Canoodling on a very
romantic hillside with...

With my gay best
friend. Can you leave?

Exhibit B.

A XXL Rob Gronkowski jersey.

Just the latest fashion style

from a woman who
hates the Patriots?

Or an ex-boyfriend's...

Not an ex. I hooked
up with Gronk.

Seemed worth preserving.

Rob? Or one of his brothers?

Props. I guess.

Exhibit infinitum.

Two ticket stubs to
Quantum of Solace.

Now, you once called
Daniel Craig "James Blonde,"

and yet, 11 years later,
these were in your drawer,

on top of an instruction
manual for a 2019 cellphone,

which means you dug
them out within the last year.

Why? I can only
assume you are currently

once again hooking up
with the James Blonde fan.

How could you possible deduce...

I also read your e-mails.

You've been sleeping with an ex

without asking for
any commitment.

It's just sex. It's not
keeping me from anything.

What's more likely to prevent
someone from moving on?

A parrot in a drawer
or an ex in your bed?

I'm at least getting something
hot from the situation.

You're just
wallowing in failure.

So, if your bag's empty,

I'm naked and have
to go to the bathroom.

It's called a
Y-shaped vein graft.

Your aorta is damaged
from the aneurysm

right where it branches off.

We're gonna find a vein in
your leg that's similar in size,

cut it out,
and use it to replace the damaged artery.

How bad is it?

This is an excellent solution.

If it works.

What are the actual
chances that it doesn't,

that I'm gonna die?

I don't want to give a number.

I mean, I can't.

I literally can't. There
are too many factors.

I can call in Dr. Murphy...

I don't need to hear numbers.

How bad is this?


Thank you.

Whatever happens,
you're gonna be an incredible doctor.

And I am honored to
have been your first patient.

I screwed up.

That first exam,

I felt something.

I should have known
it was an aneurysm.

We could have saved
you before it got bad.


You were my first patient.

I need you to do
something for me.

I need you to pray.

You must know a
prayer for the sick.

I'm not a believer anymore.

Neither am I.


Ellie, do you know these men?

Of course.



And are you a
friend of Brendan's?

Something like that.

A lot has happened
in the last week.

So before you went under,
the doctors made a video.

It's sort of, uh, a message

from your old self
to your new one.


I just want you to know

that I love you.

Tell me about the day you met.

I was in the middle of
an art exhibit in SoMa,

and I noticed this guy,
and he was

looking at all the same
paintings I had been looking at.

Need another 6-0 loaded
backhand for the arterial stump.

Graft is secure.

Take off the Satinsky clamp.

Good perfusion
to his lower body.

Heart rate's spiking.

There's no ST elevations.

BP's tanking. Did he
thrombose the graft?

Distal anastomosis is pulsatile.

But there is blood pooling
in the left lower quadrant.

The right, too.

He's bleeding
everywhere but the graft.

It's DIC.

Send a stat ROTEM
and coag profile...

Start compression,
give epinephrine, and get the defib.

Set it to 120. 120.



No response.

Go to monophasic at 360.


Why aren't you shocking again?

He's in asystole.

Dr. Lim?

Dr. Wolke.

He's dead.

Time of death, 7:23 p.m.

Take as much time as you need.

I was in love with him.

All those moments I had,

meeting at the gallery,
the conversations...

I don't remember any of them.

But they were real.

And they brought up feelings.

Ones I don't remember
having for a really long time.

But all they made me think of was you,

Hearing how I met
Zane just reminded me

how you and I met
at Chelsey's party,

and you showed up in
that ugly bomber jacket.

And Zane taking
me to the hospital

reminded me how you
nursed me for months

when I broke my femur in Aspen.

And the whole time...

I just couldn't
stop thinking about

how much I must have hurt you.

And I...

I don't know

if you can forgive me.

But I love you.

And I... I want to come home.

Well, you're wrong.

That bomber jacket
was really cool.

He died.

I tried stepping back.

I tried brainstorming.

And he died.

I don't know what people
are thinking or feeling.

I can't communicate what I need.

And more patients will die.

You don't think your ASD had anything
to do with your patient's death, do you?

Because it didn't.

It did.

Asher wasn't sure about
his abdominal exam.

I should have known that.

Shaun, you're gonna do

most things better
than anyone else,

and there are days when you're gonna fail,
like everyone else.

Today might be
one of those days.


What do you do then?

You go home,

you be with the people you love.

You take comfort in that,

and then you wake up
tomorrow and start all over again.

You can go home.

I just

don't wanna be alone right now.

I opened a Bumble account today.


I swiped right
three times today.

Gronk's jersey didn't
have a tag in the back.

It's symbolic.

You have any idea how much
the real one will be worth one day?

Fair enough.

♪♪ Wastin' away
again in Margaritaville

♪♪ Searchin' for my
lost shaker of salt

♪♪ Some people claim that
there's a woman to blame

♪♪ But I know

♪♪ It's my own damn
fault ♪♪ ♪♪ Damn fault ♪♪

I'm glad you're here with me.

So am I.