The Good Doctor (2017–…): Season 4, Episode 6 - Episode #4.6 - full transcript

Previously on
The Good Doctor...

The aneurysm
caused his back pain.
Dr. Wolke missed it.

I screwed up.


Dr. Wolke.

He's dead.

Take as much time
as you need.

The virus
has damaged
your mother's lungs.

We're doing
everything we can
to help her.

120 joules.

I've got hydroxychloroquine,

I'm twice the size
of SJ General.

I should have twice
the amount of tests.

** I'm over the rainbow

** No yellow brick road

** Can't seem to find home

** Over the rainbow

** Ah, ah, ah,
ah, ah, ah, ah

** Ah, ah, ah,
ah, ah, ah, ah

Oh, my God,
what happened?

Is he okay?

I'm a doctor.
What happened?

I don't know.
He was running.
I honked.

All of a sudden,
he was in front
of my car.

Pedestrian versus car,
GCS five at scene.

Rigid abdomen
with active bleeding.

Flail chest with pneumo.

He needs an ex lap. Now.

We've got
a massive

I need two large
suctions and lap pads
in all four quadrants.

There's a grade-three
liver laceration

in right
lateral segments.

Liver stitch,
number 1 chromic

on a blunt needle
and a combat gauze.

What were you doing
on your bike
at that hour?

Heading into work.

Trying to prep
for my budget meeting
with Glassman.

Mobilize the liver to
check for any associated
diaphragm injury.

It's the other side
of town.

I was taking
the scenic route.

BP's dropping.

He's got another bleed.

Add more lap pads
and run the bowel.

There's a perforation
near the terminal ileum.

Ah. Something
tore through
the intestinal wall.

It's shrapnel.

From the accident?

The coat's eroded.

It looks like
it's been in there
a while.

It must have gotten dislodged
in the accident.

How does Asher
seem to you?

He seems fine.

Too fine for someone
who's just lost
their first patient.

I don't have time to worry
about people being too fine.

He's faking it.

The brain releases serotonin
when you smile,

even if you're miserable.

I feel better already.

Denial is not
a proven strategy

for psychological

Dwelling on things you can't
change doesn't help either.

24-year-old woman
came into the ER

complaining of
abdominal pain
and headaches,

and, surprise,
she's pregnant.

Apparently not
a happy surprise.

She wants
an abortion.

Well, what's wrong
with her?

I assume you haven't
recently learned
the value of sharing,

which makes me think
there's another reason

you're unloading this
onto the surgical department.

She has a congenital
IgA deficiency

and a history of
severe infections.

She'll need
IV antibiotics

and close

I figured
one of your newbies

may as well
learn something.

** ...You'd say

** What can make me
feel this way

** My girl

Lea's birthday
is tomorrow.

There are many
cute frogs

and many
romantic songs.

I can't decide.

It is my first gift
as her boyfriend.

It needs to
be... awesome.

Well, then, maybe
singing frogs,

however cute,
might be a mistake.

Try something
more personal
or romantic.

And find a resident
who hasn't done
a suction D&C

and teach them.

Oh. No, n... no.

I'll do it myself.

I'm not going to
teach anymore.

I'm a good surgeon.
I'll do surgery.

Dr. Murphy, part of
your job as a surgeon
is to teach.

You can't opt out
because it's difficult.

I am opting out
because I'm bad at it.

Well, you can't opt out
for any reason.

But I may have given you
too much responsibility
too soon,

so I will supervise
your supervision

until you get
the hang of it.

Pick someone.

Did you two
lose something?

Our patient.

Rose Babcock.

She's post-op from
repair of a distal
radius fracture.

White hair.

Looks at you
like she's staring
into your soul.

Does she have
a limp?


Well, I think
she does now.

Uh, Ms. Babcock,
did you fall
down again?

Oh, no, I'm fine.

But... But there's
a poor man
in room 318

who's in
a lot of pain.

Let's get you
back in bed.



Apply a new Tegaderm,
not antibiotic ointment.

They breathe.

Don't make us
handcuff you
to the bed, Rose.

We charge extra
for that.

Dry the skin more
so it'll stick.

You're doing
just fine, dear.

Heart rate's
spiking in the 130s.

BP 162 over 95.

Are you feeling
any pressure
in your chest?

No, it's just anxiety.

Not mine.
It's one
of yours.

We're gonna pretend,
since it's happening
in your chest,

that it's yours.

20 milligrams
IV labetalol.

I'm fine.

I'm an empath.

I can feel
what other people
are feeling,

and one of you
is very stressed out.

Olivia, stay where you are.

And one milligram
of Ativan.

Keep away
from me!

Step back!

you were in
an accident.

We're taking care
of you.

Stop. Stop it! Now!

Get away from me!

I need you
to hold him down
while I administer Haldol.

Sir, please just...

I'm warning you.
This room
is being cleared.

No one
is gonna hurt you.



You're having
a flashback.

You're not
in Afghanistan.

You're in the hospital.

Look around.

What do you see?


Yeah, baby, it's me.

Zoe, I...
I couldn't sleep.

I... I went for a run,
and I...

I heard an explosion.

And I don't...
I don't know what
happened after that.

You were hit
by a car.

We had to do surgery,
but you're gonna be okay.

It's okay.

Take him back
to his room,

make sure
he didn't open
his wound.

I'm sorry.

Dr. Murphy?

Rose is not
your patient.

She was teaching me
about her gift.

She says
the basis of empathy
is curiosity,

which I find curious

I'm curious about the job
you're supposed to be doing.

Who are you leading
through the D&C?

None of them.

The only one
who hasn't done one
does not want to,

so I will.

Which resident?

Wanting to
is irrelevant.

It's their job.

Wanting to
is irrelevant.
It's your job.

I'm a Christian.

Performing an abortion
goes against my beliefs.


You may encounter
a situation one day

where this procedure
could save
a woman's life.

Then I hope
someone else can...

And it's my job to
make sure you can
perform all surgeries,

including abortions.

So where does that
leave us?

I'll do
the surgery.

I've only
done one.

I'm sure
there's a lot
I still can learn.

Dr. Murphy,
you have
a new student.

Get her started running
pre-surgery assessments.

Thank you,

That's the kind
of ambition
I like to see.

He did three tours.

He came home
after he was

in some kind
of explosion.

I don't really know
what happened.

He's tried to tell me
about it several times,

but he just...
He breaks down.

When was he diagnosed
with PTSD?

Two years ago.

But he hasn't
been the same
since he got back.

At first,
he was moody,

Little things
would set him off.

Then the insomnia

His mind is just...
It's never at rest.

Nights are the worst,
you know?

He, um...

He gets these
terrible nightmares.


Just... We can't sleep
in the same room

Make sure he stays
off his feet.

Would you like us
to arrange
a psych consult?

We've been
down that road.

Talk therapy,
group therapy,
exposure therapy...

endless medications.

Let us know
if you change
your mind.

** Keep diggin' up dirt

Jillian, I need those stats
on elective surgeries
for my budget meeting.

And a coffee.


She's not there.
I need approval
for this.

And this.

You said I couldn't
give her the frogs.

Oh, you can't
give her this either.

You don't know
what it is.

I know
it would mean more

if you had to
leave the building
to get it.

I would like to do
the suction
D&C surgery.

I assume your religious
convictions haven't changed
in the last few hours.


But I believe I was
put in this program
for a reason.

So, if you think
it's important for me

to learn how to do
an abortion,

then I should learn.

Take Jordan
to the skills lab.
Run the surgery steps.

You two will
handle the D&C

With you.

How are you
going to supervise
my supervision

if you're not there?

I will help you prep
and debrief afterwards.

But this patient
doesn't need
a gallery of strangers

standing around,
gawking at her most
private experience.

to interrupt.

Ben woke up
of pain.

Did you check
the incision?

The pain is in his arm.

Now test
external rotation
of the shoulder.

We're almost done.

Can you describe
the pain?


We'll call it a 10.

It's been hurting
for years, but, aah,
this is...

This is something else.

How did you injure
your shoulder before?

I was in a...

I was in a convoy
in Kandahar,

and there was a...

I dislocated my...

You don't need to
discuss it with us.

What did you find?

sensitivity to touch,

Could be CRPS.
What is that?

Well, it appears
the car accident

a prior injury.

You've developed
complex regional
pain syndrome.

We'll start you
on Gabapentin
and Dilaudid.

Opioids make me
a little insane.

We could do a stellate
ganglion block.

It's an injection
of anesthetic
near the spine

that blocks
the pain signals,

and could also help
the PTSD.

I've been treated
for PTSD for years.

Why haven't I heard
about this?

It's experimental,
but promising.

The procedure
comes with risks:

vascular injury,
major hematoma.

Dr. Lim,
I've been taking a risk
every time I go to sleep.

I want to do it.

Stellate block is
an accepted procedure
for treatment of pain.

Which you wouldn't
have suggested

if the patient didn't
also have a mental
health condition.

I hear Jordan's back
on the D&C,

in spite of her
righteous indignation.

Is something

I think
you're being unfair.

Well, if anyone's
being unfair, it's me.

I told Jordan
to do it.

I told her.

We make decisions that
are hard to live with
all the time.

We make them anyway.

And I told her
pissing off the Chief

was a very bad way
to start your residency.

Glad to hear
you're still

as surgical department
camp counselor,

but I don't mean
you were being
unfair to Jordan.

You're being unfair
to the patient.

She's facing
an emotionally
fraught procedure.

She needs the support
of her doctors.

And who she's getting
is a rookie who thinks
she's committing murder.

And Shaun.

I have a point.

I'll lead Jordan
through the D&C myself.

You're happy.

Dr. Murphy will be happy.

My cup runneth over.

Now get whatever's
in that box
out of my department.

Morning sickness.

Nurse Ella's.

Rose claims she can feel
her pregnancy.

She was right
about the guy
in Room 318.

He had a clot
in his ankle.

I'm sure she picked up
on some subtle clues,

like the guy moaning
and grasping his ankle.

Get a CT to rule out
abdominal injury
from her fall.

We're going to
insert a thin needle
into your neck

so we can inject
the anesthetic.

It may sting a bit.

Use an in-plane approach
to place the needle

between the C6 tubercle
and carotid artery.

You might feel
some discomfort.

What's wrong?

Zoe's hurt.

I'm okay.

Get some ice.

Let me take a look.

What happened?

I hit her.

I was laying
next to him.

I know I shouldn't,

but the shot
just made his pain
feel so much better.

I thought...

You didn't do
anything wrong.

There was a noise
in the hall.

I lashed out.
I know.

I didn't mean to.

I'm sorry.

Nothing's broken.

I can get you something
for the swelling.

No. I'm okay.
I'm gonna go home,
get cleaned up.

I just need some time.

I love you.

I think
we can
help Ben.

There have been
some promising

using Vagal
Nerve Stimulation
to treat PTSD.

His scarring would
make it impossible

to expose and
find the nerve
without damaging it.

Those scars
are the reason that
we need to try.

Imagine reliving
your worst nightmare
over and over again.

Why doesn't
anyone around here

want to do the job
they were hired for?

What Ben needs is
psychological help.

I've ordered
a consult.

Leave it to
the people who are
trained to do it.

It sets
a bad precedent
to force a resident

to do a procedure
they're not
comfortable with.

Wow. Does anyone
around here not
have an opinion

about who should do
that damn abortion?

Jordan had a choice,
and in my opinion,
she made the right one.

It's not a true choice
if you're coerced
by your boss.

I asked her
to do her job.

You took an opportunity
from a resident
who wants to learn

in favor of
one who doesn't.

Is this song and dance
about Jordan doing
the procedure

or your niece
not doing it?


There's a misconception that
Olivia came to St. Bonaventure
because of me.

She's here because
of your reputation.

The great Dr. Lim,

a master class in
technique, professionalism,

Lately, it doesn't seem like
that reputation holds up.

I'm giving you
an antibiotic
to prevent infection.

The vacuum aspiration
will take about
15 minutes,

and you'll be numbed
with a local anesthetic.

Conscious sedation
is also an option,

but you will need
someone to drive you
home afterwards.

Do you have
any questions
for me?

I'm scared.

Are you certain
you wanna go ahead
with the abortion?


Then you don't
have to be scared.

You're the making
the right decision
for you.

Give her another
400 micrograms
of misoprostol.

I'll be back
for the procedure.

This doesn't work.

I need these numbers
in spreadsheet format.

Thank you.
Oh, excuse me.

Dr. Park?

Rose's CT was normal.

Get an upper GI
barium study.

First quarter
supply costs
you requested.

Also, one of
your first-years
seems upset.

He's been
in the stairwell
for a while.

Everything okay
in here?

I just needed
some quiet.

Surgeons come
into the stairwell
for two reasons,

fire drills
or doctor trauma.

You having a fire drill?

I just wish we had a more
effective treatment for Ben.

His head's so messed up,
and we can't help him.

I don't think
this is about Ben.

Have you ever
lost a patient

you knew
you could have saved?

was at its worst,

we had to cancel
all non-urgent

A young mom with
a heart condition was

more urgent
than I thought.

And she died waiting
for me to put her
on the schedule.

How do you
get past that?

You get past it
that's the job.

You will always
remember it.

And you will
stop reliving it.

How can you
be so sure?

Because if you don't,
you can't be a surgeon.

And I'm pretty sure
you're a surgeon.

I should get
back to work.

Insert the speculum.

Now dilate
the cervix.

Begin suction.

Begin gentle suction
in the uterus.

Is anything wrong?

You're okay.

Dr. Allen,
I can take it from here.

Don't worry.
We're almost done.

You're gonna be
just fine.

You have no idea
what that woman
was going through,

and you made it
worse for her.

I know.
I didn't...

You had an opportunity
to opt out before you
walked into that room,

but you agreed to do
the procedure,

you took on
an obligation
to that patient,

and you failed her.

If you ever do anything
like that again,

I will have you removed
from my program.

Maybe you should be
cleaning bedpans
for a while.

Hopefully there's
no moral objection
to that.

Why are there
adult toys
on my desk?

I've heard good things
about the Llama,

but online reviews
aren't always accurate.

Do you have
a favorite?

They're for Lea.

Which one do you like
the most, Claire?



Evidence suggests
that trauma changes
the way the brain works.

An overactive amygdala
can heighten
someone's response

to emotional stimuli,
including fear.

I think we should consider
amygdala ablation for Ben.

That's crazy.

And completely outside
the scope of our care.

We're s...


We're surgeons.

We fix
physiological problems,
not mental ones.

It is
a physiological problem.

His brain isn't
functioning properly.

If it was a tumor
that was causing
these reactions,

you wouldn't hesitate
to remove it.

But there is no tumor.

You're talking about
inflicting damage
on his brain.

He could suffer a stroke
or come out in a coma

or not come out at all.

If you use
a stereotactic
laser approach

rather than
an open craniotomy,

you would greatly
reduce the risks.

This is not your case!

You cannot jump
into this one

because you don't
want to do the one
assigned to you,

which is to teach,
which you've made
my problem

just like you made
Lea's birthday gifts
my problem.

You need to grow up
and accept some

I was diagnosed
with PTSD last year.

I kept it
mainly private.

Melendez really
helped me
through it.

It was nice
to have a friend
to lean on.

So if you need one...

I feel



Like I can't
catch my breath.


it comes with the job.

I'll get over it.

It's Ben.


No one
is gonna hurt you.

You're having
a flashback.

I know where I am.

Every day
since I came home,

I've felt like there's
a monster chasing me.

I try to outrun it

but I end up hurting
the one I love the most.

I'm a threat to
everyone around me.

No, Ben,
you just need help.

Nothing helps.

I can't smile.
I can't laugh.

I can't feel anything
but pain.

I make everyone
around me



There's a surgery
that may help.

I would like to scrub in on
the amygdala ablation surgery.

Rose said you're
feeling overwhelmed
and need...

I don't wanna hear
any more things
that woman has said.

Your job
is to supervise
your residents.

Why are you here
instead of
doing that?

You said you were
going to supervise
my supervision,

but you didn't.

You took over my case.

I don't know
what I was supposed
to learn or how.

Scrub in.

Dr. Murphy,
walk Asher through
the probe placement

and trajectory
to the amygdala.

I will supervise
your supervision.

Okay, insert
the probe

to the cortical

You're off course.

On the current trajectory,

you will penetrate
a branch of
the choroidal artery

and cause
a hemorrhage.

Step away
from the probe.

Your job
is to teach,

not take over.

Adjust the probe
one millimeter

Avoid the temporal
horn on your right.

I can't see it
on the image guidance.

Tell Asher
what you see.

It should point toward
your six o'clock
on the Y axis.

You have to feel it.


The tissue plane
along the parenchyma
is smooth.

It should feel
like gliding.

You've reached
the amygdala.

Ready to begin
thermal laser ablation.

Rose's upper GI
and labs were normal.

Should we keep her
another day
to observe?

No. If she's stable,
let's send her home.

I'll have Olivia...
Open your mouth.

Pardon me?

Open your mouth.

I can, uh...
Shut your mouth.

There's this rat.
A mouse.

A little dead mouse
in the garage,

and the big, strong man
is afraid to get it out.

Not afraid,

Neither of us
wanna deal
with it,

so we are settling it
in the only responsible
way, a bet.

A dare. A series
of dares, actually.

Whoever wusses out first
has to...

Take those things
out of your mouth.

I will discharge Rose.

You two, go home.

We were just...
Being idiots at work,

while people
are sick and dying.

Go home.

All your tests
are normal.
We're discharging you.

Right, because
you're psychic.

I'm an empath,
not a psychic.

Whatever the case,
I would suggest
you take it easy.

No drinking,
no heavy lifting...

You have to
let it out, dear.

It was you.

You made
my heart rate spike.

You're about to implode.

There's nothing wrong
with you... or me.

Code blue!


Dr. Lim,
my behavior yesterday
was inexcusable

and unprofessional.

I let you down.
I let the patient down.

I am deeply sorry.

And I promise
it will not
happen again.

You let your personal
judgment get in the way
of doing your job.

You're right.
That is inexcusable.

You said I had no idea
what the patient
was going through.

The truth is I kinda do.

Scared, alone,
afraid of anyone
finding out.

I chose my career
over motherhood,

over my faith.

But I don't regret it.

And I know God forgave me
because I get to be here,

living my dream
of being a doctor.

But I purposely try
not to think about it.

You're off scut duty.

That's not why I...

Take it.

My name is
Benjamin Alan Harris.

I'm in St. Bonaventure
Hospital in San Jose.

Language and memory
appear to be intact,

and your
motor function
is normal.

But that doesn't mean
it worked, does it?


We'll have to do
an fMRI to see
how you respond

to fear-inducing

But we'll let you
rest for now.

I'm not gonna rest
until I know
I'm better.

I want you to know
how I got these scars.

No. Not now.

Just give yourself time.

I was in a convoy
in Kandahar.

I was in a Husky,
the big vehicle
at the front.

Ben, you don't
have to do this.

Ronnie was driving.

He was telling me
a story,

something about
a goat at the base,

or maybe
it was a chicken.
I don't know. But...

We were laughing.

Then the world
was on fire.

It's the Husky's job

to spot IEDs.

And I missed one.

I can't see their faces.


bodies everywhere.

Dying alone,

without their families.

All I could do
was hold their hand.

Are you okay, Ben?

** Happy birthday to you

** Happy birthday to you

** Happy birthday, dear Lea

Fun day.

What do you need?

We have a diagnosis.

I thought
I felt someone here.

You've had a long day.

You have
Prinzmetal's Angina,

A heart condition.
But it's very treatable.

It explains
all your symptoms,

and it's exacerbated
by stress,

which is likely
what caused
your heart attack.

You need to stop
seeking out
other people's pain.

It's literally
killing you.

You're the Chief
of Surgery.

You could have sent
somebody else
to tell me this.


But then I'd miss
my chance to gloat.

You're here
because you're hurting

and you don't know
where else to go.

Go ahead.
Use your magic.

Tell me
what's wrong with me.

How do I stop
feeling like this?

It doesn't work
that way.

I don't have
a magic wand.

I can only hold up
a mirror,

make you slow down,

look at the parts
of yourself

that you've been
trying to ignore

because you're afraid
if you look too closely,
you'll break.

Maybe you will.
I don't know.

Maybe breaking
is the point.

You can't outrun
your pain, Dr. Lim.

If you keep trying,
it's gonna kill you.

** Oh, oh, oh-oh-oh,
oh, oh-oh-oh

** Oh, oh, oh-oh-oh,
oh, oh-oh-oh

** Where do my hands go?

** Oh, oh, oh-oh-oh,
oh, oh-oh-oh

** Have time to play
with my mind

Time of death, 12:34.

Time of death, 7:13.

Time of death, 2:25.

Time of death,
2100 hours.

Time of death...
Time of death, 4:26.

Time of death...
Time of death, 7:13.

Time of death...

Time of death...