The Good Doctor (2017–…): Season 5, Episode 1 - New Beginnings - full transcript

Shaun and Lea's upcoming engagement party has everyone in a festive mood after their return from Guatemala. Meanwhile, a young single mother learns her son may have contracted his cancer from a surprising source, and Mateo finds o...

Shaun Robert Murphy,

do you take
Lea Abigail Dilallo

to be your wife...

[ORCHESTRAL MUSIC PLAYS] live together...






We got this.



We're prepared.



To keep her
in sickness and health,

forsaking all others,

for as long as you
both shall live?









We are not having
an outdoor wedding.





- I had a great time
last night.
- Me too.

Want to go grab
some breakfast?

[SIGHS] I got to get
to the hospital.


I'm a surgeon.





You look beautiful as always.

One plus of only
having video chats...

No morning breath.

I remember it being
like a summer breeze.

What's on your agenda
for the day?

Ugh, budget hell.

Our department's
way in the red,
so I don't see a way to...

Perhaps I should
let you go.

No, no. I was, uh...

Hoping for a little excitement
this morning,

but it looks like you're
out and about, so...

I can make myself



Just give me two minutes
to make this go away, yeah?



I can go away,
but not in two minutes.


So, my lawyer
called me last night

to tell me I'm no longer
a wanted man,

which, hopefully, only applies
to law enforcement.




LIM: Nice exposure
of the right tonsil.

Visibility can be tough
with kids.

PARK: Someone's
in a good mood.

That's your third compliment
this morning.

Mateo flew up from Guatemala
last night.

Oh, she's in a good mood
because she had sex.

the superior pole.

Mateo can come
to the engagement party

this Saturday
if he wants.

Also the wedding,

depending on how long
he is staying.

We don't know
when it will be,

but I do know
it will not be outdoors.

the tonsillar pillar

and dissect
around the capsule.

Lea is making all
of the arrangements

because she wants it
to be perfect,

but all that matters to me
is marrying Lea,

and any day that happens
will be a perfect day.

Oh, that's very sweet.

But planning a wedding's
a big undertaking.

Mia got pretty overwhelmed
planning ours.

Better keep
checking in.

Oh, there's a firm,
irregular mass

in this tonsil.

Get that to pathology.


Some, uh,
shortness of breath,

occasional blurred vision
and headaches,

and this morning,
my urine was foamy.

How many exam rooms
in this clinic?

Any blood in your urine?

A little.
I love that blouse.

- Chloe?
- Cushnie.


You take 20 milligrams
of Ritalin L.A. a day?

For my ADHD.

Just three?
I hardly had to wait at all.

JORDAN: Blurred vision
and headaches

can be side effects
from Ritalin.

Would you be willing
to stop your medication
for a couple of days,

see if they're causing
any of your symptoms?

I'll refer any complaints
about my behavior to you.

Foamy urine concerns me.

Could be kidney stones,
so we should do a CT...

I see by your ID badges
you're both residents,

but you seem to be
more in charge.

Is that official,
or are you just bossy?


Tell me if I'm asking
too many questions.

You're asking
too many questions.

We're gonna run some labs
and do a CT of your kidneys.


Are you overwhelmed
planning the wedding?

Because Park and Lim thought
you might be overwhelmed.

Nope, not at all.

I've got it.
It's gonna be great.

[SIGHS] Oh, great.

That's why
they're divorced.

I'm also great,
because my tonsillectomy

may have found something worse
than an infection,

which may be interesting...
Or may still be very boring.

I won't know for sure
until the path results...

Maybe let me know once
it's definitely interesting?




This is a very
small office.

it feels a lot larger

when I'm the only one
in it.

- Who are you?
- I'm Salen.

Are you really
the president of the hospital?

Uh, it says so
on the sign on your door.

Pretty small office
for such a big title.

[CHUCKLES] Nicole?

You used to be a neurosurgeon,
but now you...

- Actually, I still am.
- You do both.

But do you identify more

as a "doctor"
or an executive?

Actually, I identify
more as someone

who wants to get back to work
as soon as possible.


I'm sorry, Dr. Glassman.
I'm so sorry.

We'll be out of here
right away.

Ms. Morrison,
you can't just wander off.

It's time for
your CT scan.

Oh. Fantastic.


Ms. Morrison,
please try to hold still.

You're the one
who wanted me off my meds.


Renal pelvis looks clean.

You sound disappointed.

Morgan made me a deal.

I do all the scut work.

If the patient needs
anything surgical,

she'll put in a good word
with the attending.

Even if there's
a kidney stone,

I mean,
surgery's pretty unlikely.

But what's that,
on the right kidney?


That's a significant

Could be a mass.
She needs a kidney biopsy.

That is a legit
ultrasound-guided procedure.

And it's mine.
All mine!


Riley's throat...

It's still really
bothering him.

We had to remove
additional tissue

because your son's
tonsils showed signs
of cancerous cells.


Riley has cancer.

The margins were clear,
which means that

we were able to remove
all the cancer.

His prognosis
is excellent.

SHAUN: But right now,
he's not our main concern.

The cancer
on your son's tonsil
is cervical cancer.


That makes no sense.

He got it from you.

He was exposed
to your cancerous cells
in the birth canal,

which he likely inhaled.

Jackson may also have been
exposed during birth.

We need to scan
both you and...

- Hey!
- NICK: Hey, boys.

- How you feeling, Riley?
- Hey, Uncle Nick.

Why are you here?


I texted Uncle Nick
that Riley was sick.

Everything is fine.

Thank you for the gift,
but if you could please...

Sarah, I'm better.

All right? I swear.

And if you need anything,
I can help.

is gonna be fine.

It was very nice
of Uncle Nick to visit,

but he needs to leave.

Say goodbye.



I love you, guys.

Bye, Riley.


Hey, uh...

I need to talk to you.

I'm sorry. I just...No. No, no, no.

You did nothing wrong, honey.
Nothing at all.

But, um...


The doctors and I...

We need to talk to you.


Imaging found
an abnormal lesion
in your kidney.

Now, it could be
a benign growth,

but given your symptoms,

it could be
renal-cell carcinoma.


We'll need to biopsy the mass
to be sure.

- Who will be doing
the procedure?
- Dr. Allen.

She's an excellent
surgical resident,
right, Dr. Andrews?


And she'll be under
my supervision every
step of the way.

If that's acceptable to you,
Ms. Morrison.

Of course.


No eating or drinking
anything besides water

between now and when
I do the procedure.


Why did you lie
to your brother?

You said
everything was fine.

It's not.

He just never grew up.

When I decided
to become a single mom,

Nick wanted to help.

He got on great
with the kids.

He also drank...

Like our dad.

One day
about four years ago,

I had a job interview
and no sitter.

Nick insisted he'd help.

He took the boys
to the beach...

And got drunk.

Started chattin' up
some girl,

then turned around.


Boys were gone.

The cops found them
about a mile down the beach.


That's a good answer.




I heard about
you and Isabel.


Sorry to hear that.

Appreciate the sympathy.

No need for us
to have a heart-to-heart.

I've been there.

Not recently.

Breakup's a breakup.
How different can they be?

I'm doing great.

Taking this cute dietician
to Shaun and Lea's party.


Or Annabelle or... Lydia.

You don't remember
her name?

I don't know
which one to take.

- They're all dieticians?
- Two of them are.

I got to check my notes.


- How you doing?
- Good. Good. Really good.

Good. Really good.[ELEVATOR BELL DINGS,


[SOFTLY] I'm thinking
of going on a diet.


This one or this one?

Wear whatever you want.
I don't care.

I've got work.

Oh, you do care.

Who are you on
the phone with now?
Caterer? Flowers?

I'm on hold with
our cloud-backup people.

They're just... Oh.


Um, three more trays
of the bruschetta,

two more chicken satay for
Murphy/ Dilallo tomorrow night.
Thank you.


This one or this one?

Number two.
Morgan's wearing green.

- Excellent.
- Mmm-hmm.


If you're too busy
to answer the door,

I assume lunch
is out of the question?

[GROANS] I ate at my desk
half an hour ago.

The hospital's bleeding
more money than actual blood.

I'll be quick.

I applied for a provisional
California medical license.

My request was approved.

An old medical-school friend
is a surgeon

at San Francisco General.

He's, uh...

Offered me a job.

As promised, very quick.

I'll let you think.

No, I just didn't know

you were thinking
of leaving Guatemala.

It is a bit fast,
isn't it?


If we'd met here,

San Francisco would seem
far away, right?

That is very true.

So if I take this job,
we'll just have to deal

with being so far away
from each other, am I right?


I'm glad you are
no longer a fugitive

from government

The PET scan shows
increased metabolic activity

in the mother's uterus
and the son's trachea.

They both have cancer.


I'm doing a biopsy today.

Are you doing
a biopsy today?

'Cause I'm doing
a biopsy today.

Not many second-year residents
are doing biopsies today.


I'm not doing
a biopsy today.

Are you?





No. No, no.

The flowers need
to be there by 5:00.

If it's impossible,

then why did you commit
to that time two weeks ago?

I need to talk to my fiance.

He's a lawyer,
and he gets really worked up

when businesses
don't honor their agreements.

It's actually kind of
a turn-on for him,

making people pay, uh...

Oh. That's great.

Thank you so much.

Was any of that true?


Either way, well done.

What kind of flowers
are you getting?


Are you a patient?

I love gardenias.

What's your P.U.E. ratio?


You're not supposed
to be in here. Uh...

Put down
that sandwich!

Hi, Dr. Allen.
Is it time for my biopsy?

I told you not to eat.

I forgot.

That tends to happen
when I'm off my meds.

Please tell me
that was going to be

your first bite
of that sandwich.

My first bite.

Of this half.


LIM: Your cancer
appears to be

primarily localized
to the cervix and uterus.

You will need
a radical hysterectomy.

If the cancer's spread
to the lymph nodes,

you would also
need those removed

and post-radiation
and possibly chemotherapy.

And Jackson?

When was the last time
you had a Pap smear?

Your cancer
is quite advanced.

Most cervical cancers
are detected early

with regular Pap smears.

I'm a single mom.

Things sometimes fall
through the cracks.

How's my son?

Jackson has a tumor
in his trachea.

There appears to be
just one lesion,

no lymph-node involvement
or metastasis.

Surgery will hopefully
be curative.

And how soon
can you do that?

There's no rush to do it.
It's slow-growing.

But there is a rush
to do your surgery.

Waiting increases
your risk

of serious bowel injury
and metastasis.

How long will
my recovery take?

If all goes well...

A month.


I can't.

Who will look
after the boys?

I... I can't afford
a full-time sitter.

There's no one
that I can ask.

Jackson's surgery
should go first.

And once he's better,
you can do mine.

Jackson's recovery
won't be quick either.

He may need
to remain intubated
while his trachea heals.

He won't be able to eat.

We'll need to put
a tube in his belly.

You can help me in a month.
Right now...

You help my son.


Thank you.




Are you okay?

The engagement party
is off.

Another bad dream?

Another reminder that chaos
follows me everywhere.

Is the wedding
still on?



LIM: Stupid choice.

It's not stupid to
sacrifice yourself
for your child.

It's being a parent.

Call it
whatever you want.

We can't force her
to do the surgery.

So we're gonna have
to do Jackson's surgery first

and hope
for a smooth recovery.

You're wrong.


Endoscopic mucosal
tracheal resection.


If Jackson's tumor was seeded
via exposure during birth,

which is a very
reasonable assumption,

then we can reasonably assume
that it is localized.

Endoscopic resection
should allow

for a recovery of days
instead of weeks.

Talk to the mother.


ASHER: We have rescheduled
your kidney biopsy

for 6:00 this evening.

Nothing to eat or drink
between now and then.

Ms. Morrison, could
you stop doing that
while we're talking?

This helps me relax.

I don't care
if you're relaxed.

I care about the wandering,
the eating,

and the not listening.

- I'm listening.
- Repeat what
he just said.

You've rescheduled my biopsy
for 6:00.

[SIGHS] Nothing to eat
or drink until then.

Is your relationship primarily
cooperative or competitive?

- Cooperative.
- Competitive.


He said that because
he doesn't want to appear
competitive in front...

Have you always
had fat ankles?


ASHER: Only if the answer
is "yes."

If the answer is "no,"
it's a symptom.


This endoscopic approach,

it's, um, not
the normal surgery?

There is no normal surgery
for removing

cervical cancer
from a child's trachea.

Is it just as safe?




It's slightly more dangerous
for Jackson,

but much less dangerous
for you.

We would need emergent ECMO,
but we can prep for that,

and his recovery
should be shorter.



I'm sorry.

I'm sorry
for giving a hard time
with Uncle Nick.


I'm sorry
for giving a hard time

with cleaning up
after dinner,

fighting with Riley.

I know how much
you do for us.

And I know after
the surgery,

you won't be able
to do all of those things.


I can help.



I love you.


I love you, too.


And if anything
ever happened to you...







Swollen ankles could indicate
an infectious abscess,

which could be the lesion
we saw on her kidney imaging.

In which case, poking the mass
with a biopsy needle

is a terrible idea.

Could seed
the infection.

So no biopsy.

You'll be relieved to know
that even if there was
a biopsy,

you wouldn't
be doing it.

Second-year residents who have
to reschedule procedures

because they allow
their patients

to wander off
to eat sandwiches

don't get dibs.

Let's recheck C.B.C., E.S.R.,
blood and urine cultures,

and then start her
on broad-spectrum antibiotics.

If her symptoms improve,
then it's an infection,

which would be good news.


How cooperative
you feeling right now?

I'm really...sorry.



You're at the mass.

It has a wide base.

No easy way to loop
my snare around it.

Is it...pulsating?

It has a major arterial feeder
from his aorta.

We can't remove it
from this angle

without risking
a massive bleed.


It was a good idea
that won't work.


Abort the surgery.



You look amazing!

But wait.

You shouldn't look amazing.
The party's canceled.

I do not accept that,
not today.

I look amazing,
and people need to see that.

And unless
you caught Shaun cheating,

no way you should
be here sulking

instead of having a party
where I look amazing.

Did you catch
Shaun cheating?

No! Of course not.

Are you worried
about marrying Shaun?

No, not at all.

I just want this wedding
to be perfect.

And the party was going
to be a trial run.

It wasn't going
to be perfect.

It was going
to be a disaster.

No. It just wasn't
going to be perfect.

The first time
I got married...

I was all about
it being spontaneous

and romantic and fun.

The deejay
was an hour late.

We ran out of booze,
the food was cold,

and, somehow,
there were no napkins,

not a single one.

It was a disaster,
and so was the marriage.

So I-I really need
to get this one right.


If you aren't
willing to risk

little things going wrong,

you'll never get
the chance

to have the big things
go right.

E-mail everyone

and tell them
the party's back on.

Then I'm doing
your hair.


PARK: If we avoid
an abdominal incision,

that'd reduce
Sarah's recovery time,

which might convince her
to let us do
her procedure first.

There may be uterine adhesions
to the bladder.

That makes a laparoscopic
removal difficult.

You two, get changed.

Engagement party's
back on.

We are working
on a case.

Your fiancEe is working
on a celebration

of your future together.

Is someone going to die

if you don't figure
this out tonight?



Not good enough.
See you at the party.

Talk some sense into him.


We will solve
this problem

and then go
to the party.

It won't take very long.
We are both quite clever.



The food is happening,

bubbly is flowing,

flower arrangements
are in position.

The deejay
wouldn't uncancel,

so we're streaming chill jazz
on your phone.

- You're amazing.
- Oh.

Congratulations, Lea.
Hi, Jordan.

Thank you.

So, where's the man
of the hour?


Shaun's getting into
his party duds as we speak.

Got to make sure he
measures up to this beauty.



I got it. I know how
to do Jackson's surgery

without cracking
his chest.


It's complicated.

I've seen journal articles
that support it,

and I need to pull them.

You go ahead.
I'll put everything together.

Are you lying
about having a solution?


Is your future with Lea

more important
than this one case?

Much more.

Then do you really
want me to answer?



Well, where's Shaun?
I'd like to toast
the two of you.

I've got to take this.



- Shaun?
- This is not a little thing.

Dr. Shaun Murphy!


Stop yelling.

We are all
so happy for you.

The first time
Shaun mentioned Lea,

she was the girl
who borrowed his batteries.

I told him not to ask
for them back,

but clearly,
it worked out.

These two have a love
that can move...



What if we embolize
the blood supply to the tumor

and then do
the endoscopic surgery?

If Shaun couldn't
figure this out,

you really think
you're going to?

I was hoping you might help,
you know,

instead of just
throwing insults.

Even if you come up
with a brilliant idea,

it still won't work.

If medical logic
was gonna persuade her,

she'd have changed
her mind already.






This is perfect.

Yes, it is.


NICK: Uh...


Look, I know you don't
want me here.

I have something for you.


This is
my 90-day chip.

I haven't had a drink
in 106 days, and...

Not my first time
getting sober, but...

...I want to be the man
I know I can be.

I want to be
your brother again.


You keep it.


And whatever you all
are going through,

it'll be here, just like
I'll be here for you...

And for the boys...

If you'll let me.



Glad you're doing better.



But how do I know
I can trust you?


No, you don't.


Sarah, you need
to trust someone.



♪♪ You've got me right
where you want ♪♪

♪♪ I've got... ♪♪

You couldn't decide,
so you ended up
with two dates?

I got Marie and Maria confused
in my text threads

and inadvertently

Well, it seems like
it's going okay so far.

Oh, yeah. They're talking
about moving on to a club...

Without me.

They do have
real chemistry.

How about a double?


Yes, please.

♪♪ Tell me, tell me ♪♪

♪♪ Tell me what can I do ♪♪


Excuse me.

That was SF General.

Once the hospital board
found out

that my original charges
included assault,

they decided I was
too big of an insurance risk.

Maybe another hospital
in the Bay Area.



Uh, I would like to, um...
Make a toast.



I have known Shaun

since he was...


And, Shaun,

I have never, ever seen you

as happy as you are

right now with Lea.

Well, not that you've
always been happy.


There have been
some ups and downs,

a little bit like
a roller coaster.

But you guys have
managed it so well.

A whole lot better
than I have.


Is that funny?


Anyway, um...

But here's to
many, many, many years of...

...of happiness.

At least two, maybe three.


That was funny.

I'm divorced, so that's funny.

but you're married now,

so let's give it up
for Shaun...

Debbie left me
like two months ago,

but that's not
the point.
The point is...

You guys have built
a-a platform

and you've taken off.

And that's...


I mean, who knows?


And, so...










- [SIGHS] That was fun
last night.
- Yeah.

You want
to grab some breakfast?

I should get going.







What's on your mind,


Radical hysterectomy
with lymph-node resection

on a mom of two boys.

I'm just worried
about incontinence

and fistula

Can you preserve
the superior vesical artery?

That will ensure blood supply
to the distal ureter.


Is that all
you're thinking about?




It's still swollen,

but blood and urine cultures
are negative.

Rules out infection.

Well, it rules out
bacterial infection.

It could still
be fungal or viral.

We're better off with
an endovascular renal biopsy.

Ms. Morrison,
we'd like to insert a catheter

through your jugular vein
to your kidney.

That way, we can biopsy
the mass safely.


Will you
be doing it?

Dr. Wolke will
be doing the honors,

under my guidance.



Who's the chief of surgery

Dr. Audrey Lim.

A woman.
That's fantastic.

Can I meet her?

She's a little busy.

Dr. Murphy, can you identify
the superior vesical arteries?



Salvage them.
It will ensure blood supply
to the distal ureter.

That will reduce the risk
of incontinence or fistula.

Very clever.

It is, isn't it?

SALEN: Dr. Lim!

Excuse me.
Who are you?

And what are you doing
in my operating room?

I'm Salen Morrison.

Dr. Andrews thinks I should
have an endovascular
kidney biopsy.

What do you think?

It's absolutely
the best next step.

But what about
the possibility of...

Ms. Morrison, I don't know
anything about your case.

But if Dr. Andrews
recommends you get a biopsy,

then get a biopsy.

I have complete faith in him
and all of my attendings.

Please page Dr. Andrews

and have him
come get his patient.


Oh, I feel...


Something's wrong.



What causes kidney lesions,
shortness of breath,

swollen ankles,
and heart irregularities?

Early polycystic
kidney disease?

See, we're just guessing.
We need to sample the lesion.

Every time we get close
to doing the biopsy
on this woman,

doc-blocks us.

It's like she's messing
with us.

DR. ANDREWS: Whatever's
in her kidney is very real,

and she didn't intentionally
make her heart rate

- go through the roof.
- Unless...

Look at
her blood work.

She said
she'd stop her meds,

but her Ritalin level today
is over double
when she came in.

That could cause
her heart irregularities.

She is messing with us.




You look great.


Yeah, Jackson's asleep,
but, um, he's doing good.


Your surgery
went well.

Your prognosis
is good.

You'll receive
chemo-radiation treatment.

The radiation therapy
both external beam...

Thank you.

You're welcome.

I think
she was talking to me.

Because you
brought Nick.


Your brother
is not perfect.


But sometimes,

we need people
who aren't perfect.




I forgot.

You do that a lot.

This is silly.

You must have patients
all the time who screw up,

don't do what they're told.

Do you accuse all of them
of being liars?

- I didn't think
you're a liar.
- Thank you.

I think
you are insane.

There's a lesion
on your kidney,

and you're actively
preventing us

from finding out
what it is.

Or she already knows.


Or at least
she knows enough

to put concealing makeup
on her fingers.


To hide
her Raynaud's syndrome.

You have scleroderma?

So your kidney...

That's a benign lesion,
not a mass.

I got diagnosed
seven years ago,

after having symptoms
for three years.

Lots of bad doctors
out there.

I went off my scleroderma meds
a couple weeks ago,

see if you doctors
were more of the same.



I was curious.


How do I look?

You look like someone

about to make a presentation
to a hospital board.


I'm gonna go
to my hotel room.

No, no.
Don't you dare.

Either the board
is gonna make this

a very good night
or a very bad night.

But, either way,

I want you here
when I get home.


You know, we have
been down an attending

for over a year.

And I do know
a very qualified candidate.

If the board
gives me the money,

I'm gonna
offer you a job.

And if they don't,
screw 'em.

I'm gonna
offer you a job.





The party was
a disaster.


Yeah, it was.

I'm sorry.

I screwed up.

Shaun, that was
not your fault.

Oh, no, I know.

It wasn't my fault at all.
It was yours.

It was your party,

your responsibility,

but that's the problem.

When things
go wrong for us,

they should go wrong
for both of us.


So I'm going to help you
plan our wedding.


This way...

When it goes
terribly wrong,

it will be
both our faults.


And it'll be because
of the both of us

when everything
goes right.



What happened?
The meeting's over?

But my presentation...
I haven't had a chance...No one has.

There was only one item
on the agenda.

The hospital
is being purchased.

What? By who?


I'm looking forward to working
with both of you.