The Good Doctor (2017–…): Season 1, Episode 10 - Sacrifice - full transcript

Good news. I have a VIP
who needs a multiple ligament

reconstruction on his elbow,
and I've got room

for a couple residents
to assist me and Dr. Melendez.

Awesome.

I've never assisted
on one of those before.

Dr. Andrews knows that.

That's why he's acting
like it's Christmas morning.

I'm guessing you've never operated

on a pro athlete, either.

Um, last time I checked,

a "couple" means "two,"
and there's three of us.



More good news.

Whoever isn't with us
will be assisting Dr. Coyle

on a double-leg fasciotomy.

Feeling lucky?

Murphy.

VIP elbow. Sweet.

Fasciotomy.

Whoo.

Bobby Ato?
Don't think I've heard of him.

He's a pro athlete?

He's a pro.
I don't know if I'd call him in athlete.

E-sports.

Video games?

He's one of the best in the world.



Last year, he won enough prize money

to buy his mom a beach house
in Monterey.

Paid cash.

Is he considered a very important person

because he's an athlete or
because he has a lot of money?

Both.Both.

Mm.

I have to go.

Morning, Shaun.

This is Melissa Bourne,

the therapist that we talked about.

That you agreed to meet with,
right, Shaun?

Hi, Shaun. It's nice to meet you.

H-H-Hi.

Dr. Glassman thought
it would be a good idea

for us to meet before
our first in-home session.

Just to make sure you're comfortable.

I am not comfortable.

Shaun

It's gonna be fine.

You two are going to like each other.

Dr. Bourne has a PhD
in cognitive psychology.

She can really help you,
but you have to give her a chance.

Okay?

'Kay. Okay.

I'm proud of you, Shaun.

I'm already proud of you.

Notice the separation at zero degrees.

It's indicative of complete
tears of the LCL and the UCL.

A perfect candidate for surgery.

How's your mom? Still beating cancer?

Oh, she's good, bro.

She said she gets checked out
at the beach all the time

ever since you did
her breast reconstruction.

So, uh, thanks. I guess.

We're gonna take good care of you.

See you in the O.R. Thank you.

Which part of the UCL is the
principal secondary restraint

to excessive valgus movement?

Anterior.
Everything okay?

Yes, I'm fine.

I'm fine.

Squeeze my hands.

There is a paradoxical loss
of grip strength on the left.

There are many possible
explanations for that,

one of which i-One of which is...

he has ligament tears in his left arm.

The anesthesiologist will be up in a few

to get you ready for surgery.

Dope. Thank you.

Uh, Dr. Murphy.

What's wrong with you?
N-Nothing.

I have a condition called...

You're autistic.
Yeah, yeah, yeah. Mm, I get it.

But what is wrong with you, bro?

You gotta be legit smart
to land a gig as a surgeon

and he just shut you down like a noob.

I'll bring the idea up again. I do that.

They don't respect you.

And they should listen to you
the first time.

I can't control what they do.
Of course you can.

That's what playing the game
is all about.

It's about controlling your opponent.

You gotta find the right strategy.

It is not a game.

Everything's a game, man.
Everything's a game.

Just sometimes the stakes are higher,

and this time it's my arm.

So,
I'm guessing you drew the short straw.

I beg your pardon? Well, you're here

and your co-residents
are on the VIP case.

I'm awesome and I'd still rather
be with Melendez and Andrews.

No, it's fine...
Relax. It's cool.

Tell me about our patient.

Uh, 34-year-old female,
software engineer

and entrepreneur presenting
with Compartment Syndrome

caused by extreme overexertion
at a spin class.

The condition has caused
the muscles in her legs to...

Okay. Great.
I wasn't finished.

Finished enough to show me
you're smart and thorough.

You know the treatment plan?

We need to make incisions on...

Good.

You take lead.

We need to make a number
of long incisions

down both sides of each leg
to relieve the tension

and return healthy circulation.

It's important we act quickly.

If we don't get the swelling
under control,

the damage could be irreparable.

What does that mean?
I could lose my legs?

From working out too hard
in a spin class?

No, don't worry.
Your sister's gonna be just fine.

Look, I'm very confident
we caught this in time.

If you could lean forward?

I just need to check your
kidneys haven't been affected.

Let me know if you have any tenderness.

Extracting the palmaris now.

Dr. Andrews,
I read your op-ed in Gen Surge News.

Brilliant piece.

Never realized the lack
of continuity of care

was such a severe problem.

Dr. Melendez...

you have very beautiful hair.

Thank you.

Given the patient's grip weakness,

we could do a nerve conduction test

to rule out any concurrent nerve damage.

No.

Okay,
that looks like a good stopping point.

Dr. Kalu...step in.

Something wrong?
No, it looks good.

I just want to give Dr. Kalu
an opportunity

to show us what he can do.

As long as that's okay with you.

Sure.

Thank you, Dr. Andrews.
Mm-hmm.

All right, looking good.

Let's move to the lateral side.

So, what are we doing tonight, ladies?

How about we go to Viva's?

Sounds good.

Bovie.

You're awfully quiet over there,
Dr. Browne.

I'm just focused.

I know you're used
to operating with Melendez,

but we have fun here.

I feel like when it's less tense,

people make fewer mistakes.

Okay.

You wanna take the other leg?

Really? Yeah,
best way to learn is by doing it, right?

Definitely.

So go for it.

Well, it's another warm day

In the city of cold hearts

They all just play the part
of who they are

And I'm here on my own

I'd rather be alone

Than try to be someone that I'm not

And you seem like someone
who could appreciate the fact

That I'm no ordinary man

Shaun, good morning.

Good morning, Dr. Glassman.

How'd it go with Melissa?

She was...

very helpful.

You're wearing the same clothes
as yesterday, Shaun.

After you.

Apparently we are at an impasse.

I feel strongly that Melissa
can be very helpful to you.

You feel so strongly that she can't

that you're willing to sacrifice

a good night's sleep and hygiene.

Shaun, you smell.

I will shower in the doctor's lounge.

Well, great. That solves one problem.

You stayed here all night
just to avoid a confrontation.

Just say "no," Shaun.

You know? Just say "no."

No!

No.

Great. That's just great.

I don't have to see Melissa?

No, you don't have to see Melissa.

You're a grown man.
You can make your own decisions.

I just happen to feel that she
could be of great help to you.

That

I'll tell you what.

You see Melissa three times

and I will buy you
the surround-sound system

you want for your television.

Are you bribing me?

I suppose I am.

If you don't like her, she'll leave.

And I promise I will never say
another word about it.

That's a pretty good deal.

Okay.

I will meet with her tonight.

That's good, Shaun.

Saline?
I've never seen it done quite like that.

Yeah, I had a professor from Portugal.

Apparently it's how they do it
over there.

It's supposed to lessen the pain.

Well, the good news is
your tissue is nice and pink,

which means it's healthy.

Unfortunately, the swelling is not

coming down like we'd hoped.

Does this mean you're going
to have to amputate?

No, no. Sometimes it just takes time.

We'll take care of you.

Very nice work, Dr. Browne.

Hey.

Can you do me a solid
and trade patients?

No, not a chance.
Andrews let me take lead.

Coyle let me take lead, too.

So what is the problem?

He's a little too friendly.

He patted my back in a weird way.

I don't know. It was It was awkward.

I'm sure he's just trying
to establish a rapport.

Maybe?

I don't...

Shaun? Switch?

No.

I like Bobby.

He has very good advice.

So, who did what?

Well, I did, uh, most of the surgery

along with Dr. Andrews

and Dr. Kalu aided in replacing
one of your torn ligaments.

You should be back in competition
shape in a few weeks time.

Word.

What about you? What'd you do?

I helped to clean the grafted tendons.

Ah. That's it.

Yes.

Come on. You didn't get up in there?

Y-Your muscle weakness

along with the high body temperature

could be an early indicator
of multiple sclerosis.

We should order an MRI.

We have talked about this
countless times.

Yes. We should order an MRI.

We are not ordering an MRI.

You don't respect me.

Not right now, I don't.

Dr. Andrews, Dr. Melendez.

Given the fact we're dealing
with a pro athlete,

even the slightest hiccup
could be problematic.

I think Bobby would be impressed
by our being extra attentive.

Kalu is right he is a pro athlete

in his prime earning years.

We should make sure we leave him 100%.

Do the MRI.

Nice score. You got 'em to listen.

Do the MRI.

No, Jared did.

How did he get there when you couldn't?

He asked nicely.

Okay, you asked nicely.

Yes. Yes, I did.

You gotta be fierce
if you want the glory, bro.

Oh, no.

I do not want the glory, bro.

I just want to be a good surgeon.

Everyone wants glory.

It It's how you get what you want.

And everybody's got wants.

I want a surround-sound speaker system.

To get it, I have to see a therapist.

I don't want to have to see a therapist.

Okay, yeah,
that's that's how I got my first PS2.

Yeah,
my parents bribed me to go to therapy

after they split up.

What was therapy like?

Pretty basic, bro.

She'd tell me what to do,

how to deal with my parents.

Was it helpful?

I don't know.

I never did anything she told me to do.

Is that an option?

Doing whatever the hell
you feel like doing

is alway an option.

Just a gentle reminder...

dinner with my dad tonight at 8:00.

It is on my calendar.

So was the Gypsy Kings concert,

and I I seem to remember...

Fair enough.

How is the VIP case?

Shaun seems off about something.

Did you talk to him?

Yes. Because talking
to Shaun solves problems.

And Andrews is...

He's a pain in your ass.

No. He's actually too friendly.

Jared kisses his ass
and suddenly he's cutting.

Well, ass kissing
is a useful skill for a surgeon.

That's a very beautiful blouse.

Do I still have
to go to dinner?

Yes. It'll be nice.

You'll have some nice wine
and my dad will pay.

He'll push us to set a wedding date.

April 25th.

Did you book something?

No.

But my dad doesn't need to know that.

What do you got?

Looks like the surgically
repaired elbow is fine.

As I suspected.

But Murphy noticed something
in the periphery,

a little higher up,
just above the bicep.

It was my idea.

Yes, I just said that.

So, we took an image from
higher up and noticed this.

It's encasing the entirety
of his brachial plexus.

This thing is massive.

Biopsy indicated
it's definitely a schwannoma.

And it's definitely malignant.

It's in a tricky spot,
but you might be able to remove it.

Follow it up with a combo
of radiotherapy and chemo

to finish it o...

What? What's the problem?

Robert Ato. Bobby Ato.
Pro-gamer Bobby Ato?

You a fan?

I met three years ago.

Oncology consult for SF Muni.

He had cancer three years ago?

Why the hell wouldn't you tell us
that you had already had cancer?

It was in my lower leg three years ago.

How's that gonna change
how you fix my elbow?

It would have a huge effect
on how I viewed the symptoms

that Dr. Murphy noticed.

You didn't listen
to Dr. Murphy

because you don't respect him.

'Cause Dr. Murphy is different.

I respect him.

He has good ideas, and he has bad ideas.

Turns out this was a good one.
That you shot down.

Why did you hide the truth?

A previous cancer diagnosis
isn't shameful.

After the first diagnosis,

all I was thinking was,
"Will it come back?

How bad will it be?"

I was distracted, man.

I couldn't focus, and I hit a slump...

Wait, you were worried that cancer

was messing with your gaming?

Yeah, man!

It cost me a championship.

I decided to block it out
along with all the thoughts

of negativity and physical weakness,

and like that,
I became the best in the world.

We need to do a full-body scan

to make sure the cancer
has not already metastasized.

What he said.

What I said.

This looks great.

The swelling is starting to reduce.

We can start tightening the sutures.

Finally some good news.

You look like you're doing better,
too...

now your boss is gone.

Dr. Coyle? He's fine.

You don't have to toe
the party line with me.

Trust me. I get it.

I almost rode myself to death
in a spin class

because I overheard
a couple of investors say

that they "liked the concept just fine,"

but that my cankles
were "too distracting."

What? Your idea is brilliant.

And you're beautiful.
Screw those jackasses.

Grace, you don't get it.

You got the face,
perfect little hip-to-waist ratio,

and most VC firms
are run by a bunch of bros,

so there is an inverse relationship

between the size of my ass
and how much money I can raise.

Then you should do something else

where you don't have to deal with bros.

Like what, become a nun?

Sorry.
You agree with her?

She nearly worked herself to death

trying to please some pigs with money?

She shouldn't have to.

Great. Let me know when you find utopia.

But until then, I love what I do.

So I got to play the game
'cause if I call them out,

I just get labeled a "bitch,"
or even worse.

Your heart rate's going up.

Hazel?

She's barely moving any air.

Hazel, can you hear me?

Code blue! I need to intubate her.

Give me a laryngoscope and an ET tube.

Let's get her on 100% oxygen.
Code blue. 4 North, room 407.

Code blue. 4 North, room 407.

Talk to me.

Her lungs...

I think it's a reperfusion injury.

There's no room in here.

Mallampati 3, maybe 4.
You should take over.

You're doing fine. Here, use the bougie.

You feel the epiglottis?
I think so.

Okay, go a bit further,
you should feel it stop.

If it keeps going,
you're in the esophagus.

It stopped, got it. ET tube?

It's gonna be okay.

Strong work, Doctor.

Best in the world or not,
this guy's insane.

Hiding from a diagnosis?

Doesn't work it'll find you.

Bobby wanted to be the best.
He is the best.

I don't think he was
trying to be the best.

I think he was just scared.

What's that? Next to the brain stem.

Oh, another schwannoma.

So much for the power
of positive thinking.

He's a strange kid. He had cancer.

Stopped going to follow-ups
because he started losing.

What's so strange?

Sounds like a classic case of denial.

I was thinking we could try
something new.

Maybe gamma knife?

I don't think so.
Wrong type of tumor for that.

What if I told you every few months

that you had a real possibility
you were gonna die?

I'd be scared. And I'd listen.

Maybe you would, maybe you wouldn't.

Personally, I think he's right...

shut down those voices of doom,

spend your days living instead of dying.

But he may also be crazy.

Short of making him a vegetable,

I don't know if there's anything
we can do.

Is Is Shaun okay?

Is his work okay?

Yes, I just, um...

Then he's fine.

Damn.

Horse walks into a bar.

Bartender says...

We found another mass.

That's not how it goes, but cool.

Let's knock it out, too.

The mass is located on your brain stem.

Which controls
your autonomic nervous system...

your heart, respiration.

Its positioning makes it inoperable.

I...had a good run.

Wish it was longer, but...

I'm gonna go out on top.

If you went out today,

could you say the same thing?

She's lucky you were there.

Me? You're the one who saved her.

With your help. A lot of it.

So, thank you.

Hey, look, you wanna,
you wanna get a drink?

Maybe take the edge off?

No. But thank you, though.

Are you sure? I promise you'll have fun.

I give great massages.

And I'll make a killer omelet
in the morning.

That's really inappropriate.

I said no.

I'm sorry.
W-WWhere's this coming from?

You were...
You were clearly giving me signals.

No, the only "signal" I gave you

was that I wasn't interested
in the slightest.

Okay, see,
I just I heard about you and Kalu

banging in the call room,
so I figured...

This conversation is over.
You're an ass.

I'm pretty easygoing,

but you're approaching insubordination.

You're gonna report me?

I'm not gonna report anybody.

But maybe next time, try not to have

such a stick up your ass
about being asked out.

Oh, come on.

I always thought Bunny
was the cutest nickname.

Of course you did,
but you could've stopped calling me that

when I was 12 or or 20.

Rough day?

Yeah. Yeah, it was something.

Well,
this should make you a little happier.

I have decided to take care
of your entire wedding.

We don't need it.

You're welcome.

We're not 21.

We're more than capable
of paying for our own wedding.

We make good money.

But you won't once you start
having kids, Bunny.

What are you doing in here?

I'm hiding from my therapist.

I am not going to get
a surround-sound speaker system.

But I am doing whatever
the hell I feel like doing.

Mm-hmm.

Can you hand me that mop?

Hmm, okay.

Are you satisfied with what
you've done with your life?

Would you be happy if you died tomorrow?

Uh, satisfied?

Happy?

I mean,
I clean up a building, uh...

But I I married the love of my life.

Uh, we raised three beautiful kids.

One of them had some troubles,
but she's doing great now.

The other two are doing
all right for themselves.

And I was good to people.

At least I think I was.

That's a very good answer.

I got pictures of the girls
if you want see...

No.

So, why do I need to quit my job
to have a family?

Agreed.

She can be a great lawyer
and a great mom.

Yes, she can, but why?

W-Why waste your time working?

You should be enjoying life, like me.

There's plenty in the family trust.

Dad, my work is important.
I'm helping people...

Bunny... you're pushing papers.

How...
How is that really helping anyone?

And maybe I'm old-fashioned,
but I don't get it.

I-I thought you were smarter than that.

You'd prefer her to be a lazy parasite

living off a trust fund

as opposed to actually
contributing to society?

Parasite?

My father made a lot of money.

I'm not going to apologize for that.

He made sure his children
and his grandchildren

could enjoy their lives.

I'm not hurting anyone.

In fact,
I go out of my way to help people.

So I'm sorry if that doesn't qualify me

as a worthwhile person in your book.

I'll get the check on my way out.

Dad, you don't have to...

What am I doing wrong, Shaun?

I don't know.

I tried...

encouraging,
I've tried being supportive,

I've tried bribing you.

I don't need a therapist. No.

Look around you.
What You're sleeping...

What is this, a broom closet?

Look at the sacrifices
you're willing to make

just to avoid...

We're gonna pick this up later.

You have to file a complaint with HR.

I do that and I get labeled
"hostile" and "difficult,"

neither of which work
with my complexion or gender.

All the more reason to take a stand.

Claire, this situation
is exactly what HR is for.

I didn't say it was easy.

Yeah, you did.

Look, it's scary and it takes courage,

but it's the right thing to do.
It's a pointless thing to do.

They'll listen to you.
They will shift the blame onto me.

Like you did.

Whoa, what? How did I...

I came to you,
you accused me of exaggerating

to get back onto the case.

No, no, no, that's not what I meant.
I had no idea...

I said he was too friendly.

You said he was "trying
to establish a rapport."

I'm sleeping with you, Jared,

and you thought I was overreacting.

How do you think three strangers
will see things?

Claire, I'm sorry. I am so sorry.

Don't worry about it.
It's just the way it is.

I've got a patient to round on.

Dr. Melendez and I had a talk

and we believe we can excise the tumor

if you're willing to make a sacrifice.

Sacrifice?

That sounds better than death.

My thinking as well.

We believe we can remove the mass,

but we'll also have to take
a piece out of your brain stem.

A chunk of the red nucleus,

which helps control
the left side of your body.

You'll be paralyzed on that side.

It could also result in difficulty

eating and swallowing.

Speech difficulties.

Let's do it.

Good for you.

Hold on. Hold on.

Bobby, this is very risky surgery.

You could die on the table,
and even if all goes well,

you will be severely disabled.

Yeah, I I was listening, and I'm in.

Guys, hey, I get it.

If I'm dead, I'm I'm dead.

But if not PT,
relearning stuff, whatever.

It's not gonna stop me from competing.

Not ever.

Bobby, your career is over.

We need you to understand that.

Yeah?

Once a gamer, always a gamer, huh?

You got my respect.

What the hell is your problem?

If you ever threaten Claire,

take a disrespectful tone,

or so much as look at her
cross-eyed again,

I'm gonna do a hell of a lot more

than put you up against a wall.

We clear?

Your lungs are looking a lot better.

Overall, you're in pretty good shape.

Thank you.

You're welcome.

All part of the service.

And good for you.

I wasn't sleeping.

I heard the way
you handled that other doctor.

You heard that? All of it?

I wish I had done that.

You were brave.

No, no.

If I was brave, I...

Rick Allen.

Who? One-armed drummer for Def Leppard.

Come on, man.

And there is the tumor capsule.

Richie Parker. Anyone?

Isn't he a NASCAR guy?
An engineer, right?

Born without arms?

And Nurse Ocampo gets the door prize.

And now we will take just a little piece

of our friend here...
a nice sample to test.

Thank you, Doctor.

And now the rest.

He may not be able to tie his own shoes,

but I wouldn't bet against him
ever competing again.

Aut libertatem aut mortem mihi da.

Shaun, do you know that means?

No. It's not relevant to this surgery.

Oh, it's relevant. Look it up.

No, it's not.

Heart rate and ETCO2 are rising.

Slight change in body temperature.

His heart rate's 108.

Check tube placement and suction him.

If he takes a turn,
we might have to abort.

I don't think so. I'm too far in.

Keep him stable.

He's tachy. Heart rate's climbing.

115, 117, 120, and rising.

He is going into v-tach.

Robert Ato is dying.

I'm gonna pull out of the pons slowly.
Well, hold on.

You pull out now, you might
damage the cerebellar peduncle.

If I don't get out now,
I'll kill him if he starts seizing.

Something's not right. Tachycardia?

Bradycardia would make more sense.

Ideas.
Anyone?

Tell me what you see.

Tachycardia,
rising body temperature again,

muscle rigidity, CO2 is rising.

Muscle rigidity? Which side?

It's all over.

Then it's not the brain stem.

We'd only have muscle rigidity
on one side.

Think. Tachycardia, rising temp, CO2...

CO2...

It's the anesthesia.

Malignant hyperthermia. Get the MH cart.

140 dantrolene, STAT.

Kalu, Murphy,
get as many cooling blankets as you can.

We need to get this temperature down.

Coming out.
Now!

Hyperventilate at 100% O2,

10 liters per minute.

Flush out the old anesthetic,
lower the ETCO2.

I want vecuronium on deck.
We got to keep him under.

Let's move!

And we're on.

Uh, temp's not coming down.

Wait.

CO2 is coming down.

Heart rate is coming down, too.

Temperature is 101.

Okay. Nice work, everyone.

Thank you very much.

Terry Fox.

Or my personal favorite Jim Abbott.

Come in.

Hi.

I need to talk to you about Dr. Coyle.

Dr. Browne.

I wanted to talk to you
about the same thing.

Please.

The surgery was a success.

And the outcome
might be better than expected.

There will still be significant
neurological dysfunction

on your left side,
but not as much as we'd anticipated.

Sick!

Thank you.

You did good, my friend.

You have to be patient.

Nah.

Is patience a bad thing?

Acceptance is a bad thing.

When I was a kid,
I I wasn't good at jack.

But I never quit.

I...

found my thing.

Don't ever let anyone tell you

what you can and can't...

do.

I'm sorry. For last night.

It was a rough day. I was tired.

Probably had a few too...

Your relationship with
your father is your business...

Neil, you don't have to.

I'll call your dad, and...

I don't want to have kids.

Shaun, I'm gonna drive you home.

You're gonna see Melissa.

If you don't like her, she'll leave.

But there's no more running away.

Why do you think I'm doing this?

Because you are stubborn.

Ok-Okay, yeah, okay, sure. I'm stubborn.

But I'm doing this for you, okay?

So that you can have a better life,

so that you can have a happier life.

What if it doesn't make me happy?

What if it only makes you happy?

You think You think
I'm doing this to make me happy?

I'm not happy, Shaun.

I'm not close to being happy,
and you know what?

I am done explaining,

I am done bribing,
and I am done talking.

Now let's go. No. N-No.

No! Let's go! No!

No.

No,
I... I want to make my own decisions.

I... Shaun, can you keep your
voice down, please? Please?

You You cannot keep
ordering me around, okay?

You're not my father!

I know that.

Shaun, I don't understand...

Okay...why this is so upsetting.

You don't let anyone I don't get it.

anyone ever tell you what you can and can't
do. Shaun, let's just calm down now, please.

Hey, hey, hey, hey, hey.

Okay, don't let anyone ever tell you
what you can and can't do!

Hey, just calm Shaun. Hey, hey,
Shaun. I want to make my own decisions.

Okay, okay, okay.
I want to make my own decisions!

I'm just trying to help.
I want make my own...

Shaun! I don't want help!

I...

What were you thinking?!

I do not need you to fight my battles,

and I certainly never asked you to.

And if you really respected me,

you would not treat me like some damsel

who needed protection, okay?

You would treat me with the respect

that you would automatically
give to a man.

You'd treat me like a person

capable of handling her own life!

And maybe...
maybe it's too much to ask of you.

Apparently Andrews agrees with you.

I've just been fired

for physically assaulting an employee.

Shaun? Shaun!

Where would he go?

Is there a place he likes to hang out,

a place where he feels comfortable?

No, I don't know.

I mean, he's not at the hospital.

And there used to be
a picture here of Shaun...

and his brother, Steve.

What do you think that means?

It means he's not coming back.