The Good Doctor (2017–…): Season 5, Episode 7 - Expired - full transcript

After visiting a possible wedding venue, Shaun and Lea happen upon a terrible car accident and discover Alma, a young pregnant mother who has been badly injured and needs immediate medical attention. Back at St. Bonaventure, Alma's condition worsens, and Shaun and Drs. Lim and Jordan are forced to deliver the baby prematurely. Meanwhile, Dr. Glassman is apprehensive when a figure from his past reaches out for help.

This might be
the first place we've visited
that feels right.

That's good.

But, Shaun,
we really need to

talk about something
non-wedding related.

Oh, it's perfect.

Yes, and it is the only venue
available on our date

that meets
all our criteria.

I'll stand
at the altar.

You walk down
the aisle.





The fireplace tile,
is that original?

I have no idea.

let's say it is.

If you want to up
the curb appeal,

maybe a fresh coat of paint,
some landscaping...

is just fine.

How soon can we
sell the place?

We'll get multiple bids
on day one.

Oh, great.

Hi, Aaron.

Shelly Carroll,
Ethan Ray Realty.

Ilana Reeves, ex-wife.

We should drop off
this agreement

with our deposit check

Once I explain the issue
to the pastor,

I'm sure he will replace
the problematic floorboards.

Shaunie, there's something
I really need to tell you.



I'll call 911.

I'm Dr. Shaun Murphy.

Where are you hurt?

It's my hand.

Your fourth and fifth
fingers are broken.

If you have
no other injuries...

Shaun! Over here!



Hello, hi,
I'm Dr. Shaun Murphy.
Are you injured?

My leg's trapped.

My chest hurts
when I breathe.

How far along
is your pregnancy?

Twenty-six weeks.

Do you think
my baby's okay?

I have no way
of knowing...

...but you have tachycardia
and your jugular is distended,

which are signs of
a cardiac tamponade.

If I don't drain it,
you'll die before
the paramedics arrive.



Sorry about the mess.

Uh, Debbie talk you into
a fresh start?

No, no.

Um, we didn't exactly
work out.

Oh, I'm sorry.

Yeah, me, too.

But I am moving to
a small town in Montana,

which, hopefully, you know,
will be good for me.

I need your help.

It's my husband,

He's dying.


What's your name?


Hi, I'm Lea.

Is there anyone
you need me to call?

Uh, um, no.
My... My boyfriend's
out of town.


What are you gonna
do with that?

A subxiphoid

An echo-guided one
would be better,

but I don't have a J-tipped wire,
or an echo machine.

Maybe we should wait
for the paramedics.

you can trust him.




Okay, hold.

You are very lucky.

We usually don't drive
to work this way.


His diagnosis is
Lewy Body Dementia.


How long has he had
the symptoms?

It began
two years ago.

Insomnia, muscle weakness,

Recently, he's started having
bouts of confusion.

We found an experimental trial
that uses deep brain stimulation

to slow cognitive

Would you look at it,
see if it's worth it?

There are so many
more doctors

with more experience in
this field than I have.

Aaron, I... I need somebody
who's gonna give me the truth,

so we don't waste
what time we have left.

How many clients
have been referred

for elective procedures
from the clinic?


Those satisfied clients
will lead to more.

And the automated intake screens
have cut labor costs by 8%.

But the nurses don't like it.
They think they're next.

Handle them right,
they'll get over it.

If you have specific
thoughts on that,

I'd love to hear them.

Maybe over lunch?

Morgan, you excel at
striking the right balance

between enthusiasm
and obsequiousness.

Thank you.

Instead of lunch,

how about you and Alex
have dinner with Marcus and me?


Marcus Andrews?

It'll be a hoot.

pregnant female,

blunt chest trauma
from a car accident.

I performed a subxiphoid

at the scene
with a gas siphon.

Cool? Is the baby...

Fetal heart rate is normal,
no signs of distress.

Mother became hemodynamically
unstable en route.

She needs surgery
for internal bleeding.

Okay, keep rolling.
Keep rolling!

DR. GLASSMAN: We're gonna do
a couple of tests

to get a sense of
your cognitive state,

and then we're gonna
throw you in the MRI,

the big donut,
very loud,

to see if you're right for
the deep brain stimulation.

Any questions?


What I know or don't know
about the medicine

will not change
the outcome.

A patient who doesn't think
they know more than their doctors

is rare these days.

Implicit social contracts
are my field of study.

They're the agreements
we make daily,

often without
even realizing.

But perhaps that's
a conversation for another...

Who are you?

Why are we here?

Sunil? Sunil?


You're right where
you're supposed to be.

Take a deep breath.

Tell me
their names.



And little Raj.


Some spells pass a little
more quickly than others.

I... I think
I'm okay now.



Do you remember
why you're here?

Because I'm dying.

Let's get started
with those tests.

DR. PARK: Sunil's MRI shows
no contraindication

to deep brain

Initial labs
look good.

He's a great

Is the coat hanging in
my closet
your "good" blazer?

It's my only blazer,
so, yes.

Get it dry-cleaned.

For our dinner with
Andrews and Salen.

As intriguing as
that pairing is,

dinner's a hard pass.

Not an option.

But compensation
is fair.

We can finally binge
The Wire.

Your first offer doesn't get
you off the couch, and...

Andrews and Salen?

Game respects game.

And sometimes
sleeps with it.

Tickets for you and Kellan
to a UFC fight in Vegas.

Still no.

But save that thought
for his birthday.

Salen and Andrews?

They may have one soul
between them.

Any sign of
motor weakness?

He's gonna have to
tolerate the head frame.

the cervical spine MRI.

We could replicate
the DBS trial on site.

I'd be happy to

Oh, that's very
kind of you.

Are you sure
you're gonna have time

while you overhaul my clinic
into an Ethicure profit center?

Oh, and by the way,
I'm gonna need my office back.

I hope
you don't mind.

Parathyroid looks off.

DR. REZNICK: Is that
an ectopic lesion?

He's had a history
of renal stones.

I don't...

What were his calcium
and PTH levels?

They were only
mildly elevated.

Nothing that triggered
for the workup.

What are you

I'm thinking this may not be
Lewy Body Dementia.

Repairing the ventricular
tear with Prolene sutures.

JORDAN: No remaining
arterial or major bleeds.

Good. I'd prefer not to
have to open her belly.

I would like both of you
to wear socks to my wedding.

No shoes.
Just socks.

Lea and I found
a nearly perfect church,
but the floor squeaks.

Should make for
some interesting pictures.


No way
you are robbing me

of a chance to show off
my new Bruno Maglis.

Also, wet and stinky feet are
not in Lea's dream wedding.

probably true.

Last suture is in.

Dr. Allen,
how's the baby?

Heart rate
is stable.

Okay. Next step,
get her down to imaging.

We need a surgical plan for
these pelvic fractures

before they cause
any more bleeding.

Aaron! Aaron!

I didn't expect a miracle,
but thank you.

He's not
out of the woods yet.

He still has
a lesion.

Okay, hopefully benign,
hopefully removable.

I heard you.

Most people stop listening
after they hear the very bad news,

or, in this case,
the very good news.

Okay, the nuclear study
this afternoon, I got it.

What happened with


Why did my impulsive,
whirlwind marriage

to a gun-toting barista
not work out?


You're hurt.
Do I look hurt?

I just saved a man.

I know how you
hold onto things.

And I know how you try
to fix things

and you try to fix

I'm okay.
Talk to me.

'Cause I doubt very much
you're talking to anybody else.


I was myself, and up close
and personal,

Debbie didn't like
what she saw.


She said I was
controlling and selfish.

Did you tell her
she was right?

Well, yeah,
'cause she was.

It didn't help.

What's in Montana?

Pine trees
and cowboy boots and

change for me.

In Montana,
no one knows me,

and I have no history,

and no one has
any expectations of me.

You've done this before.
After Maddie.

That's not fair.

I know.

But my therapist
would say you're

"pulling a geographic."

Has your therapist
met me?

I have to go prepare
for Sunil's procedure.

The safest path
is external fixation.

We'd use a metal frame to
stabilize the fractured bones

until your baby
is ready to be delivered.

You'd need three weeks
of bed rest,

and you'll likely develop
debilitating arthritis.

There's a significant chance
you will never

have full mobility
ever again, bu...

I have grad school.
A job. This baby.

That can't be the only option.
No, it's not.

I was going to tell you,
if we do a C-section now,

we could do
an internal fixation,

which would greatly
improve your chances

of walking
without assistance.

Though it does increase
the risk of complications

associated with
premature birth.

So I either never
walk right again,

or I jeopardize
my baby's life?


You have to decide.

My boyfriend,

at first, he didn't
want to keep our girl.

But then
he came around to it.

We said that we'd
figure it out together.

Then he signs up for
this month-long research trip

off the Gulf of Alaska,
and here I am.

I can't choose between
myself or my baby.

No, you have
to choose.

I can't.

Dr. Glassman,
I'm glad you're back.

Lea and I
have a problem.

I heard.

The floor squeaks.

At the church?

Is that it?

No. I also have a patient who
won't decide on a surgical plan.

Have you talked
to Lea?

She is no doctor.

No, I don't mean
about the patient.

(SIGHS) Shaun,
I am not gonna be around.

I'm... I'm moving.

I'm selling my house,
and I'm moving...

(CHUCKLES) Montana.


Will you still be
my best man?

Yeah, of course.

Then you should
give me your advice.

Shaun, you don't
need my advice.

Sometimes I do.

You don't like to
give it to me anymore.

Lea and you
are partners now.

You can...
You can talk to her,

and Lea has a whole lot
of stuff she's gotta
talk to you about.

And you'll work it out,
without me.


Sharks tickets.

Doesn't being together mean that
we have an unspoken agreement

that when I need a date,
you're it?



The lesion has
an irregular shape,

and it's extending into
the carotid sheath.

It's a malignant carcinoma,
and it's invasive.

Hey, I thought you
were working late.

I am going back,
but first,

you and I need to make
a decision about the church
and the squeaky floor

and something else

Dr. Glassman said you have
things you need to tell me.

Uh, I didn't go
on a business trip
a couple weeks ago.

I went to Montana
to find Glassman

and convince him
to come home.

Because I was really
worried about you.

What were
you worried about?

There have been so many changes
at the hospital,

and I know that's been
hard for...

Not because of my...
I know.

Not because of your ASD,
but because

change is hard.

And then
your patient reviews,

and I knew you were
struggling with them.

I was, but then I improved
my interaction techniques,

and my scores went up.


That's not what happened,

I omitted some of
the patient reviews.

Just the ones where
people said really mean stuff.

That's why your scores
went up.

I told you I didn't
want you to.

I know.
I'm so sorry.

I just got so worried,
and I wanted to protect you.

And I thought, if I could
just help you, I...

What you did
was very wrong.

I know.

I am truly so sorry.


Your apology is
not accepted.


The lesion in your neck
is cancerous,

and it has grown
very quickly.

I am suggesting
a non-surgical approach,

one with targeted therapies
and radiation.

It should give you
a few more good years

before debilitating
symptoms set in.

I'm very sorry.

There's no way of
removing it?

It's attached to
the carotid artery.

It's too dangerous.


Thank you, Aaron.

That's more than we hoped for
when we came to you.

I was here all night
with Dr. Allen.

We have not come up with
a better surgical solution.

Your choices from yesterday
remain the same.

How is she?

fetal movement.

Heart rate is 140.

That's good.



I talked to Matt.

He's making his way back,
but it'll be a couple of days.

He says whatever I decide to do,
he will support it.

Which isn't really
helpful right now.

No, it's not.

You need to
make a decision.


He shouldn't have gone,
but we needed the money,

and it was
a great opportunity.

But mostly,
I feel like it was

a reason for him
to be somewhere else.

He says one thing
but does
something different.

How do you know if
he loves you?

He does.

But someone can love you
and still let you down.

That doesn't
seem right.


No, it doesn't.

Knowing what to expect
of others is difficult.

People can be
very unreliable.

That's why I always
wanted to be a doctor.

Science and biology and
medicine are very reliable.

I like that.

She's relying
on me.


I need to do
what's best for my baby.

Go ahead with
the external fixation.

How would you rate the new
self-serve, self-pay system?

Four stars.

Not five?

I prefer to be stingy
with my top rating.

Last night was a five.

So it was
even better than

a convenient way to
buy a smoothie?

Hey, what are you doing
Thursday night?

I invited Morgan and Alex
to have dinner with us.

A double date?

I didn't realize
we were going public.

We're both
consenting adults.

What's to hide?

As the boss, you are free
to do what you like.

As a partner,
that's not the way it works.

I'm sorry.

I should have asked you
before I told anyone.

Marcus, you're smart and funny
and almost too good-looking,

and your socks don't just
match your sweaters,

they elevate your whole aesthetic.

And I told Morgan because
I'm excited about you.

About us.

I'll make the reservation.

There's a surgical solution
here, isn't there?

No, no, no.
Not a safe one.

But you've built your career
on doing surgeries

that most doctors think
are too dangerous.

Yeah, because, to quote you,
I am an insufferable egomaniac.

But that's
who we came to see,

and now I'm getting some
surgeon who's gonna
run off to Montana

in the guise of becoming
a decent human being?

Okay, uh, criticize me,
yell at me if you like.

I understand you're upset.
All those late nights

where you were tackling
the most impossible cases,

every possible angle.

You come alive in surgery,
more than you did in...

There are other surgeons.
There are other hospitals.

I have done everything
I know how to do
to help you and Sunil.

I am sorry
if that's not enough.

I think you're scared.

Of what?


Of failing me again.

Yeah, I wish
that were true.


It's Sunil.

I need to get out of here.

Don't you see
what's happening?

Sunil, Sunil.
Wait, wait, wait, wait.
Sunil, Sunil.

Stand by
with a sedative.

Ahead of you.
Just trying to get close.

You're right where you're
supposed to be, honey.

Take a deep breath.

All right, tell me...
tell me their names.

Tell... Tell me their...
Tell me the...

I don't know you!

Whoa, whoa, whoa,
whoa, whoa, whoa!


You got him?
I got him. I got him.
I got him.


I got him. I got him.

Are you hurt?

I'm okay.

My patient chose
to prioritize her baby.

We did
the external fixation.

She's resting comfortably, and
you need to correct my scores.

I can't restore
the data.

You are very smart.

You can
figure out a way.

Shaun, I apologize,

but I... I can't undo
what's been done.

Lea, the scores reflect
my work and me.

No, it didn't.

The algorithm ignored
what's best in you.

No, it should be
the same for everyone.

The data has to be

I can't, Shaun.
I'm sorry.

Then you need to
tell Salen.

That's a terrible idea.

There is
no other option.

Shaun, I could
lose my job.

You broke the rules.

Maybe you should
get fired.

I'm fine, really.

Humor me.

Pupil response
is normal.


I'm sorry
about before.

I was so frustrated.

I... I appreciate everything
that you've done.

You owe us nothing,

and you've gone
out of your way to help.

Here's some Naproxen.

It'll help with
the pain and soreness.

I don't blame you anymore.

For Maddie...
No, p...

No, don't.
Please stop.

Don't do that.
I need you to hear this.

For a long time,
I did blame you.

I could barely look at
a picture of Maddie

without being reminded
about how angry I was,

and how angry I was at you
trying to replace her with Shaun.

Shaun wasn't meant to
replace Maddie.

My God.

Nobody can.

Becoming a part of Sunil's family
has brought me peace.

They're my whole world.

And I'm so glad
you found Shaun.


You're right,
I am scared.


If I operate on Sunil
and he died,

I'd be responsible for you
losing someone you love.



I'll take another look
at the imaging.

I can't promise

Who knows, maybe this egomaniac
can come up with something.


She's having severe
abdominal pain.

BP's 73 over 49.
She's hypotensive.

There's uterine bleeding
from a placental abruption.

It's a delayed reaction
to the crash.

Her choice was moot.

Okay, page Dr. Lim to the OR
for an emergency C-section.

We're ready.

I love you.
I love you, too.



What are those for?

I know how mad you were
when these disappeared
from the vending machine.

health-conscious revamp

was not a victimless crime.

I drove 20 minutes
to a gas station to
get those for you.

This is the bribe?

it's just chips.

And a declaration

that I will respect
the boundaries you've set.

You don't have to
do dinner.

I'll survive.

I assume Salen will be
picking up the check?

I don't love
your ambitious streak,
but I do love you.

I'll be your arm candy
for the night.


How long until we have
access to start the C-section?

A few more seconds.

BP's 70 over 55.
Heart rate 109.

Fetal tones?

Present, but we saw D-cells
on the tracing.
The baby is stressed.

Once the baby is out,
we will immediately begin

an in-fix pedicle
screw rod fixation.

She'll walk fine.

We'll need a two and
a half millimeter drill bit

and titanium screws.

We're clear.
ChloraPrep and scalpel.

BP and heart rate

in the cross hairs.

"Be quick, but don't hurry,"
as John Wooden used to say.

Starting resection.


That's a lot
of bleeding.

Yeah, well, we're
poking around
the carotid.

It's to be expected.

How's he doing?

BP's 64 over 42.


Do you see
any vascular feeders
you can clip?


Tumor has completely
invaded the artery.

We're gonna have
to move fast.

Mother's BP is still dropping.
50 over 37.

Hang another two units.
Extending uterine incision.

here she comes.


Dr. Murphy, Dr. Allen,
deliver the placenta.

Check for uterine bleeding
before beginning
internal fixation.

Dr. Lim, Apgar's three.

The baby's in distress.

She's not oxygenating.
We need to intubate.

Dr. Murphy, with me.

Get a blood gas.

Bagging 100% oxygen.


Baby is acidotic with
a pH of seven.

No improvement in vitals
or oxygen sat.

Check the tube's

ET tube is in
the correct position.

Equal breath sounds
on both sides.

This doesn't
make any sense.

The baby has
a congenital heart defect.

The patent ductus arteriosus
is closing.
That is causing hypoxia.

We need to open the duct
and oxygenate her blood.

Call the pharmacy
for PGE, stat.

(Cap clatters)

Start the PGE at 0.1.

BP's 61 over 42.

Tumor's hypervascular.

I can't see
a damn thing.

There's too much

Should we stop the bleeding
and abort the resection?



Tubing... clear plastic
surgical tubing.


Baby isn't pinking up.

PGE is in.
IV looks good.


Starting compressions.

What if it's not
a heart defect?

We're gonna
occlude the carotid,

blocking the blood until we
can cut the damn thing out.

He'll stroke out.

That's what
the plastic tube is for.

I'm gonna build
a shunt bypass,

keep the blood flowing
to the brain.

(ECHOING) Suction.

Apply the clamp.

Dissecting scissors.


Ugly little thing.

Stand by with the patch.

Let's clean it up.

No obvious
metabolic disorder.

No evidence of head trauma
or pneumothorax.

No mucus plug
in ET tube.

No transient tachypnea
in the newborn.

The PGE is
the right dosage...



Shaun, what?

It's expired.


Call the pharmacy.

We need more PGE,
but from a different lot.

The PGE is expired.
We need...

The pharmacy says
we don't have another lot.

Our entire supply
is expired.

Prep for

We might be able to keep
the PDA open with a stent.



We need to run PGE
at 0.1 micrograms.

Tell the pharmacist to mix
10 vials of 50 micrograms
of Alprostadil

with 10 milliliters
of saline solution.

Mix 10 vials
of 50 micrograms
of Alprostadil.

He says that's
the wrong medication.

Where are you going?

It'll be faster
if I do it myself.


Uh, you know this is
for erectile dysfunction?


Alprostadil is
the same drug as PGE

but in a different

We need to run the IV at
0.056 milliliters per minute.

That will give the baby
0.1 micrograms per
kilogram per minute.

Pushing 0.1.





Mucous membrane's
still blue.

Oxygen saturation's
not registering.

We just need to
give it more time.

Hold compressions.


Pulse not palpable.

No, push 0.2
of the solution.



Dr. Murphy.

Push 0.2.

Dr. Murphy,
the baby is flatlining.

No. There's nothing more
we can do.

No, I can save her!




Time of death, 18:23.

Sunil's recovering
very nicely.

Just, no exercise or,
you know,

strenuous activity
for the next six weeks.

Thank you.

Don't go to Montana.

You still need Shaun.

He makes you better.

Hang up.

I need to
call you back.

We just lost a baby,
because this hospital
wasn't prepared.

The medication
we needed was expired.

All of it.
No back-up batch.

Did the money you saved
pay for your water wall?

In my 15 years here,

nothing like this has
ever been allowed to happen.

This hospital's priorities...
your priorities

are upside down, and today,
that killed someone.

How's the mother?


She won't be conscious
for a few hours.

I'll make sure and have
a grief counselor
standing by.

And call your lawyers,

When she finds out
that her baby died

because of
expired meds...

Dr. Lim, until we've done
a thorough M&M

and identified what changes
need to be made,

discretion is in
everyone's best interest.

Are you suggesting
we not tell her the truth?

I'm suggesting we all
have exposure.

You, the residents.


this is a tragic day.

But we cannot allow
a single event

to derail
everything we do here.

Salen made cuts.

We're... We're
behind on inventory.

It just...

It... it fell through
the cracks.






They're all useless!


Shaun, stop, stop, stop, stop!
They're all... No!

It wasn't your...
It wasn't your fault!
N-N... Please! Please! No!

There's nothing more
you could have done!
No, you lied to me!

I can't trust you!

And I can't marry you.




You're hyperventilating.
Hey, hey, hey, hey.

Look at me.
Look at me.

Look at me.

Take a deep breath
now, okay?

Take a deep breath.

There you go.

You can talk to me.

Dr. Glassman,

you... you are a...

An awful best man

and a terrible mentor.

You said you would never
abandon me, but that's a lie.

A lie.

That is a lie!

Why is everyone
lying to me? Why?

You should have been
running the hospital!

If you had, the baby
would not have died!




I'm here.
I'm here.


I'm right here.


I'm right here.
I got you.

I got you.

I got you.
I got you.


I got you.
I'm right here.