The Good Doctor (2017–…): Season 1, Episode 14 - She - full transcript

Dr. Shaun Murphy is surprised to learn that his young cancer patient identifies as a girl while being biologically male. Shaun must quickly learn to understand his patient, her medical ...

[ Knocking on door ]

♪♪

[ Knocking continues ]

Kenny: Morning, doc!

Good morning, Kenny.

♪♪

Hey, hey, hey.

♪♪

Brosef, your cable's out.

I don't have cable.

I have a digital antenna.



Why?

Digital antennae

receive superior picture
and sound quality,

and the channels are free.

Yeah, but you get, like,
10 channels that way.

I only watch three.

You mind if I run a line
to your tube?

Cable guy can't fit me in
till next week.

Mm.

Come on, 10 channels
are better than none.

Yes, they are.

All right.

Gracias, amigo.

No hay Nada Que agradecer.



What?

♪♪

Melendez:
Dr. Reznick was orphaned

once Dr. Coyle
was transferred,

so she'll be joining our team.

Hi. I'm Claire.

Nice to meet you.

Are you the autistic one?

No.

That's me.

Dr. Shaun Murphy.

Hi.

We've got two
pretty straightforward cases,

nice level playing field
for an eager group.

Not interested.

Competition can foster teamwork,

which can lead to
a greater understanding

and appreciation

of residents' strengths
and weaknesses

and improve patient care.

You're playing the same game
Glassman had us do

when we were interns.

Not interested.

Winning team gets first dibs

on assisting
on all surgeries next week.

- In.
- In.

Out.

Mm.

♪♪

I pick the boy genius.

♪♪

That's you.

♪♪

♪♪

Dr. Browne.

♪♪

Kalu.

Melendez: Dr. Reznick.

Thank you.
I'm looking forward to it.

Thank you.

♪♪

Same stakes as last time?

Absolutely.

♪♪

Lim: Hi, Quinn.

We hear you've had
some stomach pain.

Do you mind if we take a look?

It doesn't hurt that bad.

Poor thing says
everything is okay,

but when Quinnie didn't
want to go swimming today,

I knew that something
must be wrong.

We'll be as gentle with her
as possible.

[ Groans ]

Quinn's parents are out of town,

so I'm... I flew in to babysit.

Mm-hmm.

[ Inhales sharply ]

Okay.

Let's see.

♪♪

That's a...
Penis.

She's not a girl.

He's a boy.

...Captions by VITAC...

♪♪

It's just a phase.

Quinn: Stop saying that.

I'm not a boy.
I'm a girl.

You're transgender?
Yes.

Shaun: No.

Quinn has XY chromosomes
like Jared and me,

not XX like you.

Science says he's male.

No, Quinn has gender dysphoria.

Her assigned gender is not
the one she identifies with.

She's mismatched,
Dr. Murphy.

But biologically...

Quinn:
Other than biologically,

how do you know
you're supposed to be a boy?

Your question
doesn't make sense.

I'm not supposed to be anything.

I am a boy.

Biologically, that's it.

♪♪

[ Inhales sharply ]

Okay, deep tenderness
at McBurney's point.

Could be acute appendicitis.

Murphy, get imaging to confirm.

Mm.

♪♪

[ Breathing deeply ]

Mr. Shaw,
your chart says

that you passed out in class.

What do you teach?
History.

I got a little dizzy
because I skipped breakfast.

I-It's nothing.

The school insisted on
calling an ambulance.

Taken any medications
in the last few months?

Uh, I took some Vicodin

after I threw out my back
six weeks ago,

and then I had a stomach flu,

so I took Ofloxacin.

But the flu part
didn't totally go away,

so I took Azithromycin
and Prednisone

because my glands were swollen.

But I still had a sore throat,
so I took some Cipro.

What doctor prescribed you
all that?

Uh, they were leftovers

I had in my medicine cabinet.

Uh...
All right,
lay back for me.

[ Groans ]

Look, I'm a single dad
with twins

who bring home
every disgusting germ

they touch at preschool.

I can't afford to miss work.

[ Groans ]

You've got a fever

and you've gone through two IVs

which tells me that
you're severely dehydrated.

You can't stand me
touching your stomach

without wincing in pain.

Dr. Reznick, let's get
Mr. Shaw here an ultrasound.

♪♪

We've been trying
for while.
Five months.

I realize my prime egg days
were two decades ago,

but I've been vigilant.

Ovulation kits,
LH and FSH testing,

basal body temp.

I've checked my estradiol
and AMH levels.

The old-fashioned way
wasn't working.

Okay, well, there are a lot of
possibilities to consider.

Many benign,
many easily corrected.

So I will take some samples
from you both,

run some tests,
we go from there.

There's a clock.

We need to know
if we start with IUI or IVF...

Both of you...
You need to stop worrying.

Isabel, you are not
the first 40-something woman

to come here
and ask these questions.

Myself included.

You came to me
because you trust me, yes?

Right.

So let me do what I do,

and you two focus on each other.

♪♪

Hey.

We're a team, babe.

In this together, all right?

Okay.

♪♪

♪♪

I'm afraid, Howard,

your appendix
has already ruptured.

Book an OR stat
and page Melendez.

Wait.

I need to figure out

who's gonna
take care of my kids,

call the school so they can
get subs for my classes.

Mr. Shaw, if we don't
get you into surgery now,

your infection could spread
and you could become septic.

Dr. Browne will make all
the necessary phone calls

while I prep you for surgery.

Isn't that so,
Dr. Browne?

You're in good hands,
Mr. Shaw.

We've got you covered.

Let's go.

♪♪

Shaun: Hello.

Do you wear dresses?

Murphy, don't.

Quinn is a boy
who thinks he's a girl.

I want to know
why he thinks that.

Sometimes I wear dresses,
but sometimes I wear leggings.

Do you like the colour pink?

[ Chuckles ]

I'm more of a purple girl.

Do you play with dolls?
Since I was 5,

but I'm super into mermaids.

Do you take dance...

Murphy, 20 questions are up.

I only asked four.

Do you wear perfume?
It doesn't matter.

The CT's ready.
Let's go.

Do you always
paint your nails?
Let's go.

♪♪

Melendez:
Perforated appendix is out.

Lavage or no lavage.

Dr. Browne.

Lavage before closing the wound

decreases residual
fluid accumulation

and minimizes
residual contamination.
Morgan: Claire's right.

Although, a recent study

documented a higher abscess rate

when irrigation was used
for perforated appendicitis.

Well, someone
did their homework.

I'm partial to AMSURG
since they published me.

As a medical student?

It was about the cost
and stabilization of disease

in patients undergoing
transcatheter

and surgical
aortic valve replacement.

Are you thinking of specializing
in cardio-thoracic?

A girl can dream.

Staple up and close up.

It's, uh...

it's good to have you on board,
Morgan.

It's great to have
another female surgeon.

Oh, uh, I'm sorry,

you and I are not
gonna be friends,

hanging out, having sleepovers,

braiding each other's hair.

That's not exactly
where I was going with it.

When residency's over,

the hospital's likely
only keeping two of us.

Shaun is Glassman's pet project,
so he's in.

Jared is persona non grata,
so he's out.

Which means every time you win,
I lose.

And vice versa.

♪♪

Thanks for the heads up.

♪♪

[ CT machine whirs ]

Do you think he's complicated
or confused?

[ Sighs ]

Dude, you've got to quit
calling her a "he."

We're never going
to win this competition

with you disrespecting
our patient.

Don't they have transgender
people in Wyoming?
Okay.

Transgender patient care

was not part of my
medical school curriculum.

Was it part of yours?

No.

[ Monitor beeps ]

Quinn doesn't have appendicitis.

He has testicular cancer.

[ Sighs ]

She.

We found a mass
on Quinn's left testicle.

She has cancer, but...

Am I gonna die?
Lim: No, no.

Prognosis is very good.

We've caught it
before it spread,

and we'll do surgery on the mass
to remove it.

The CT also showed
he has osteopenia.

[ Sighs ]

Murphy,
stop with the "he."

[ Cellphone ringing ]

Um, Quinnie, it's your mom.

I... I have to...

Of course.

Osteopenia.

That's low bone density,
right?
Jared: Yeah.

How'd you know that?

Do you know how I got cancer?

There are several
possible causes, but I...

Microlithiasis, mumps,
hypospadias...
Murphy.

Intraepithelial
germ cell neoplasia,

inguinal hernia, HIV...

Murphy. Enough.

Your parents
are on their way here.

Um, they just told me...

Quinn, are you
on puberty blockers?

That's the likely cause
of the osteopenia.

Are you taking leuprorelin
or histrelin?

I've been leuprorelin
for nine months.

Why didn't you say
anything earlier?

Because my parents didn't
want my grandma to know.

♪♪

Looks like he has an abscess.

You have an infection.

We'll drain it,
put you on antibiotics.

It's nothing to worry about.

It just means
you might be in the hospital

a couple of extra nights.

I... I can't spend

a couple of extra nights.

I need to get out of here.

Are you worried about your kids?

Well, they're with my sister,
they're safe,

but they've never spent
a night without me

since they were born.

Well, then consider
this a blessing.

A free vacation from your kids.

They're my life.

♪♪

My wife died of ovarian cancer
last year.

♪♪

I...

I hate hospitals.

I'm so sorry.

Why don't I find a laptop

so you can Skype with them?

And I'll rustle up a couple
of toy bears from Peds

for you to take home.

Thank you.

♪♪

Lim:
I want to reassure you

that the puberty blockers

are in no way responsible
for causing cancer.

Shaun: The leuprorelin
did cause your osteopenia.

Does this mean I have to stop
taking puberty blockers?

Yes.

Jared: We'll get you
on dietary supplements

to help regain
your bone strength,

but the puberty blockers
are hurting you.

You'll be fine without them.

Fine?

I... I don't want
an Adam's apple

or a deep voice
or hair all over my body.

You can't reverse that, can you?

No, I'm afraid not.

♪♪

Girls have body hair, too.

[ Sighs ]

♪♪

Toy bears, Skype with kids...

you've got game.

[ Scoffs ] "Game"?

I believe the name
for what I did

is "basic human decency."

Everyone has an agenda.

Sometimes it's conscious,
sometimes it's not,

but it's always there.

And you've got this whole

"queen of kindness" thing
down pat.

Awfully cynical
for someone so young.

Mm, not cynical.

Just the reality
of how the world works.

[ Alarm blaring ]

It's Howard.

[ Monitor beeping rapidly ]

Nurse Dhanoa:
He spiked a fever, temp's 105.

BP's tanking, 80 over 40.

He's soiled his sheets.
Morgan: Site's clean.

Infection should be
clearing by now.

What's going on?
I don't know.

Page Melendez.

Give me 500 milligrams
acetaminophen,

2 grams of meropenem
IV infusion empirically.

Run a chem panel, CBC,
and get cultures ASAP.

Hang in there, Howard.

We're gonna figure this out.

♪♪

Any word on Quinn Darby's labs?

Big backup today.
Nothing much I can do.

Text you when they're ready.

Yeah.

Morgan: Hey, Gus.

I saw raspberry
and rose petal doughnuts

in the cafeteria today.

Got you the last one.

You remembered.

Thank you.

Howard Shaw's labs.

I put a rush on them
for you.
You're the best.

♪♪

Why did you give Gus a doughnut?

I was being nice.

I needed my patient's labs
expedited.

Gus likes doughnuts.
It's called bribery.

I call it
"basic human decency."

See you later.

Howard has a superbug.

A C. Diff infection?

It's resistant
to all medication.

[ Sighs ]

Lim: Quinn's pre-op labs
are normal,

so we can do the surgery
first thing in the morning.

The procedure is called

a radical inguinal orchiectomy.

It's radical in that

the entire cancerous testicle
is removed.

All functionality
will remain the same.

Quinn should be able
to resume her normal activities

in one or two weeks.

See?
Baby, that's good news.

Quinn: No, not really.

Without the puberty blockers,

I'll be the freak in ballet
with a moustache.

Aren't there any other options?

I wish there were...

If we do
a bilateral orchiectomy,

Quinn will have

the testosterone level
of a girl.

We are not removing
both testicles.

You want to castrate
my grandson?

No.
No.

[ Sighs ]

I'm so sorry
for Dr. Murphy's outburst.

I'm gonna have
gender confirmation surgery

when I'm 18 anyway.

Why not just do it now.

♪♪

Quinn is a child

who still plays dress-up
and make-believe.

He may want to have children
of his own some day.

Ew.

♪♪

We'll give you some privacy.

Denise: Thank you.

♪♪

I will not allow you...

It's not up to you.

You are making me
doubt the wisdom of
drafting you, Murphy.

If you go around
saying inflammatory
things to people,

it will only upset them.

How will I know if I said
something inflammatory

until I say it?

Test it on Kalu first.

Which you can do

while the two of you prep
an SDA for this case.

An SDA?

A Shared Decision Aid

is a paper presenting
the pros and cons

of making a difficult...
I know what it is,
Murphy.

But why am I being punished?

It's not a punishment,
it's necessary.

It'll help Quinn's family

understand all the options
available to them

for her care.

Understood?

Understood.

♪♪

The stool culture
and sensitivity test

indicate that you're resistant

to every antibiotic.

Which only happens
when you've been exposed

to every antibiotic.

I... I did this to myself?

But I've used
those medications before

without a problem.

Why did this happen now?

You weren't
under a doctor's care,

so you were likely
taking the wrong medication

for the wrong symptoms.

But you can fix this, right?

We're gonna have
to perform a colostomy

where we attach
an ostomy pouching system

to your abdomen

to collect waste from your body.

For how long?

Well, with the level of damage

we're seeing
throughout the colon,

indefinitely.

♪♪

I'm so sorry, Howard.

♪♪

I don't understand

why you'd suggest
the bilateral orchiectomy

when you don't even
believe Quinn's a girl.

I was answering
Dr. Lim's question.

She said there were
no other options,

but I found one.

And now we're here.

Yes.

You're actually enjoying
this SCUT work, aren't you?

Yes.
We are being helpful.

We're not doing this
to be helpful, Murphy.

We're doing this because
you pissed off Lim,

and I'm collateral damage.

We're still being helpful.

Doesn't matter.

Doesn't matter,
competition's over.

Is it?

We're in here
and not with the patient.

No face time
plus you calling her a "he"

equals crappy survey scores.

[ Chuckling ]
It's okay. It's a game.

It's not important.
It is to me.

I'm a pariah.

These scores are part of
our resident evaluation.

Our jobs depend on them.

Mine does, at least.

♪♪

Then we should do
this SCUT work very well.

♪♪

[ Door closes ]

Finola called.

She found an irregularity
with one of the tests

but wants to re-run it
to be sure.

Okay, so we wait
until she re-runs it.

Marcus, we're both doctors.

The results aren't gonna change.

I waited too long.

It's all my fault.

This is the part where you say,

"No, babe, it isn't."

You had goals, other priorities.

You said you supported
my career choices,

just like I supported yours.

I do support you.
Always.

And I am so proud of you.

But it came at a cost

that we both knew was possible.

We should have started
trying sooner.
When?

When you were 3,000 miles away
teaching at Dartmouth?

Or, what, when you were
chasing down head of surgery?

We would have
figured it out.
"Figuring it out"

would have meant
me and a nanny
raising a baby.

I didn't want that.

I tried to bring it up
four years ago,

but you wanted to get
your practice up and running.

A baby didn't fit
in that picture, either.

It is not the same.

How many pregnant women
get hired for anything?

Or when they find
out a woman's got
a child at home,

suddenly it's all

"Who's gonna
take care of the baby?"

No one asks men that question.

Yeah, well,
none of it matters now.

Right?
Because it's probably too late.

And I knew it.

I knew this was gonna happen.

You've been stewing over this.

Resenting me.
For how long?

I don't resent you, Is.

But, you know,
if you want me to sit here

and tell you
that it's not your fault,

I... I can't do that, I'm sorry.

♪♪

[ All speaking Spanish on TV ]

[ Sliding door opens ]

Hey. You like?

That door was locked.

Oh, I know.

The cable guy
had a cancellation,

so he hooked me up,
got us a two-for-one.

Little thanks for being
so chill earlier.

Gracias, amigo.

[ Indistinct conversations
on TV ]

So, what kind of doctor are you?

I'm a surgeon.

A surgeon?

Your stuff doesn't say surgeon,
does it?

It's like, uh,
Selena and Justin.

It doesn't really go together.

Furniture's from, like,
a dozen different places.

14.

14.

The people in Casper
knew I didn't have any money,

so they gave me things
to make a home.

The bookshelf is from Jennifer,

the town librarian.

My table and chairs
are from Mr. Grady's diner.

The lamp is from Sheryl

who teaches Sunday school
at Highland Church.

Dr. Glassman,
he got me my bed.

Well, you don't have to tell me
the whole list, but...

Okay. Yes.

Everything I have works.

There is no need to change it.

Respect.

[ Muffled screaming on TV ]

[ Woman speaking Spanish ]

[ Speaking Spanish ]

Hi.

I'm Dr. Glassman.
Hi.

I'm the president
of the hospital.

Is everything okay?

Sit down.

There has been no change
in Quinn's condition.

However, her grandmother

has made a claim of child abuse

against you and your husband.

She's claiming that

putting Quinn
on puberty blockers...

and these are her words,

"making her think
that being trans is okay"...

is a form of emotional
and physical abuse.

♪♪

Now, just to be clear,

we don't believe
any of these allegations

have any merit whatsoever.

I know my mom, okay?

She's not gonna drop this.

She'll go to court.

Could she get custody?

Well, she could try,
but, uh, Dr. Lim would testify.

They could put her
in a foster home.
Hey.

Ty, she won't make it.

If we let Quinn do the surgery
she wants now,

it'll all be over.

There will be no reason
for Ruth to fight us.

♪♪

[ Sniffles ]

Do what Quinn wants.

Do the bilateral surgery.

♪♪

Finola:
There is an issue.

Your tests confirmed

abnormalities
in the semen parameters.

I beg your pardon?

The semen analysis.

It showed that you have

a low sperm count
and low motility.

It's my fault?

No.

We... we do not speak
in terms of fault.

[ Exhales sharply ]

15% of all couples
struggle with infertility,

and of those, 50% have
a male factor component.

It's not great news,
but it's not a dead end.

So what's the next step?

I'm gonna refer you
to Dr. Arjun Dhillon.

He's an excellent urologist,

and he'll give Marcus
a... a full physical,

do some blood work,
and an ultrasound.

That can't be right.

Marcus.
It can't be right.

Marcus. We got this.

Okay?

We're gonna get
through this together.

♪♪

Hey. Hey!

Why didn't you tell me
Howard's labs came back?

I should have been there

when you broke
the bad news to him.

So Melendez could see
your touching bedside manner.

It doesn't matter anyway.

Oh, it doesn't?
How the hell not?

The poor guy's getting
a colostomy.

There's no way we're winning
this competition.

You really have no sympathy

for what Howard's going through?

It's a major bummer, no doubt.

But we don't have time
to get emotionally invested

in every patient that we treat.

Our job is to go in,
do the surgery,

and get out.

Afterwards... his poop,
someone else's poop...

it's not our problem.

Hey, well, wait.

What if we could get Howard

a fecal microbiota transplant?

FMT for a surgical case?

Theoretically, we transfer
healthy feces to him,

it restores good flora
to the body,

kills off the CDI,

and he avoids surgery
all together.

We could actually
win this thing.

[ Sighs ]

I'm gonna pull all the research

before pitching it to Melendez.

♪♪

Glassman:
So, this meeting is called

a Challenging Patient
Consultation Process.

The name sucks,

but there are things about it
I do like.

All you got to do
is talk and listen

and try to understand
each other.

What's to understand?

Ruth accused us
of being child abusers.

Denise:
And what's to discuss?

We are Quinn's parents.

We get to make
her medical decisions.

What if Quinnie's
better off as a boy?

You have no idea
what Quinn has been through.

Every kid
goes through rough patches.

Every kid is confused.

Quinn has always told us
exactly who she was,

ever since she was 3.

So you let Quinn
play with dolls.

Big deal.

You don't make
life-altering decisions

because a child
wants to be a princess.

We used to let Quinn
do whatever she wanted at home.

But when she went out in public,

we made her present as a boy.

It felt false to her.

She hated it.

She hated herself.

She became reclusive, depressed.

And then a year ago,
Quinn tried to kill herself.

♪♪

Sorry I'm late.

♪♪

♪♪

Howard might not need
the colostomy

if we give him
a fecal microbiota transplant.

Hasn't the FDA gone
back and forth on that?

We could be introducing
new bacteria into his system

that could kill him.

The likelihood of that is low.

But not zero.

But if we do the colostomy,

we may not really
be helping him.

15% to 30% of patients

get recurrent CDI
after the initial bout.

That's a good point.

I believe 65% of that time,

recurrent CDI becomes chronic,

which can lead to repeated
hospitalizations and death.

♪♪

Are my numbers right, Claire?

Yes.

But recent studies

show better than
a 95% success rate with FMTs.

Howard is a good candidate.

We should try it

before he develops
a toxic megacolon.

Don't we owe it to him,
to his twins,

to at least try
an experimental treatment

before doing an invasive surgery

which will alter his life
forever?

You're right.

Prep him for the procedure.

I appreciate
your passionate advocacy

for your patient.

Good work, both of you.

Oh, now you're a team player.

When it benefits me, yes.

Speaking of which,

while you were
doing your research,

I found Howard a match
at the stool bank.

Sample arrives
in a couple of hours.

Great.

I let them know you'd be
the designated doctor

to handle the medical
chain of custody

when the sample arrives.

So...?

So you're the only person
who can handle the sample.

You'll have to dilute it,
blend it, strain it

all on your own.

To safeguard against
cross-contamination, of course.

Of course.

♪♪

Your temperature and BP
are normal.

Quinn: Normal.

Whatever that means.

Typical. Usual.

Expected.

Yeah, I don't feel like
any of those things.

What does it feel like
to be a girl?

Are you angry?

Was that
an inflammatory question?

I'd rather people ask questions

instead of pointing and staring.

When I used to look like a boy,

I felt... different.

The kids at school
didn't understand me,

so they picked on me.

I spent a lot of time alone.

♪♪

When my parents let me be me,

I felt...

like I didn't
have to pretend anymore.

I felt free,

like when you're in a pool

and you just let go and float.

♪♪

I'm not a very good swimmer.

[ Chuckles ]

♪♪

I don't know what it feels like

to be anyone but me.

♪♪

Me, too.

♪♪

Is the bilateral more risky

than the unilateral surgery?

The big issue with the bilateral

is Quinn will never be able
to have biological children.

If Quinn's parents think
that Quinn's mature enough

and strong enough
in her beliefs,

then they should do it now.

It's an elective surgery
on a child.

There is no medical necessity.

Except with
a previous suicide attempt,

she's still at risk.

Her situation is different now.

She's socially transitioned
and living as a girl.

But there just
isn't enough good data

on trans kids
and their outcomes.

On the other hand,
there's very good reason

to preserve future fertility.

Glassman:
Dr. Lim and Dr. Andrews

are both
very excellent surgeons,

and they very clearly have

some passionate points of view,

but their views are their own.

You all need to decide
what's best for Quinn.

Whatever we decide,

Quinn is still gonna be a girl.

I don't know if I'll ever
be able to accept that.

I know that makes me
sound horrible.

I know what it's like
to not put your family first,

and it cost me.

It cost me a great deal.

And if I had to do it
all over again,

I'd ask myself...

is it really worth
sacrificing a life

with someone I love

over an idea that may never be?

♪♪

Why don't we give them the room?

♪♪

[ Monitor beeping rapidly ]
Hey. I got the page.
What's going on.

She started screaming in pain
and vomiting.

Temp's 104.

Shaun:
Increased groin pain

could be attributed
to epididymitis,

kidney stones,
inguinal hernia...

The extra weight of the tumour

could be causing the testicle
to twist on itself.

There'd be no blood flow.

♪♪

Quinn: [ Retches ]

She has a testicular torsion.

She needs surgery now.

♪♪

Excuse me.
Have you made a decision?

Not yet.
I mean, there's a lot to...

We need one now.

Quinn has testicular torsion.

The spermatic cord is twisted

and cutting off blood supply.

We need to operate.

♪♪

If you want Quinn
to live the way she wants,

don't limit her future now.

You heard her when my mom said

she might want kids some day.

She can't even
fathom the thought

because she's just a child.

♪♪

Just do what's
medically necessary.

[ Sighs ]

[ Monitor beeping ]

Andrews:
Doesn't appear to be any
palpable lymphadenopathy.

It's likely a stromal tumour,

but get that to pathology
right away.
Yes, sir.

[ Monitor beeping rapidly ]

Quinn has tachycardia
and Hypotension.

I'm not seeing any bleeding.

EKG's normal.
It's not coronary.

CO2 and O2 are normal,
so it's not a P.E.

It must be a reaction
to the anesthesia.

I'm already pushing fluids
and vasoconstrictors.

♪♪

Six syringes in,
and no sign of leakage.

Okay, we're wrapped up here.

Let's get Howard into recovery.

Well done.
Thanks.

I was thinking of
writing up the procedure,

possibly submit it
for publication.

I'd be happy to assist,

seeing as I've done it before.

Thanks, but I think I can...

I read your paper in AMSURG,
Dr. Reznick.

You continue to impress.

Coming from you,

I take that
as a huge compliment.

When you get a chance,
Dr. Browne,

you should read it.

Will do.

♪♪

J.L.:
I've given vasopressors

and reduced her meds
as much as I can.

She's losing volume somewhere.

It was dry when we ligated
the spermatic cord.

I'm still not seeing the bleed.

Shaun:
Could be vagal stimulation
from the severed nerve.

But she's not responding to epi.

Sepsis?
It's too early
for an infection.

Her MAP is 20.
She's barely profusing.

♪♪

Okay, excuse me, guys.

You're breaking scrub.
I'm so sorry.

Grey-Turner sign.

Could be a retroperitoneal
hemorrhage.

♪♪

♪♪

Jared could be right.

It is possible that
there's internal bleeding.

The testicular artery

can retract up into the pelvis.

It's rare, but it can happen.

Rare is an understatement.
Dr. Andrews?

I don't think we have
any other choice.

We need to do an ex-lap.
10 blade.

♪♪

Murphy, retract.

Internal bleeding.

Jared was right.

Nice call, Dr. Kalu.

Thank you, sir.

Kalu, suction.

We need a clear view
of the field.

♪♪

Fever's down, and the flora
in your system

seems to be returning to normal.

We expect
a full recovery.
Thank you.

For everything.

Do you know
when I can have visitors?

I thought you might
ask that question.

There are a couple
of eager preschoolers

who'd like to say hi.

Oh.

- Daddy!
- Keira!

Sammy! Oh!

Oh, I think you guys have grown!

[ Chuckles ]
Hey.

Hey, these are the doctors
that saved Daddy.

Dr. Reznick
and this is, uh...

Uh, I'm sorry,
I forgot your name.

Dr. Browne.

Thank you.
Thank you.

You're welcome.

[ Chuckles ]

Blah!

[ Laughter ]

Okay.

Morgan: Who's this guy?

- Bear Bear.
- Bear Bear?

Did you do it?

Did you remove both?

No.

Just the cancerous one.

What? Why not?

That's on me.

I couldn't, in good conscience,
remove a healthy organ.

Quinnie.

This was our decision.

No! You said
you were on my side!

Hey, we are. Always.

We haven't had
enough time to talk,

not with each other,
with your therapist,

with your doctors.

So I'm gonna turn into a boy.

Well, not right away.

Your endocrinologist
will talk to you

about the right timeline

for starting
feminizing hormones.

[ Sighs ]

You know...

the thought of having
your own kids someday

is a big decision,

but you never know
what you will or will not want

once you get older.

Cis people
are always so worked up

about having bio kids.

If I really want a kid that bad,

I can just adopt.

You know,
I'll be back when I'm 18

for my gender confirmation
surgery.

And when you do,
I'll be here to help you.

♪♪

Patient satisfaction
survey scores are in,

and it was very close.

Not really.
She's being kind.

Congratulations go
to Dr. Reznick and Dr. Browne.

Yes.
Thank you.

Congratulations.

Thank you, Shaun.

Claire and I make a nice team.

You should be psyched.

Yeah. I should be.

To the victor belong the spoils.

Pay up.

Oh, humility was never
your strong suit.

Thank you, Mortimer.
Mm.

Don't spend it all in one place.

Spend it?

I'm gonna frame it.

♪♪

What made you think of
a retroperitoneal hemorrhage?

Homework.

You were right.

Prepping for an SDA
was important.

We make a good team.

Quinn doesn't like pink.

Oh.

Uh, I think she will like these.

I hope so.

She's more of a purple girl.

♪♪

Did you read Morgan's
AMSURG article yet?

[ Scoffs ]

It is on the top
of my to-do list.

I didn't tell you to read it
to rub it in.

♪♪

I told you to read
it so you knew what
you'd be up against.

You think I need to be
more cutthroat?

No.

That's Morgan's M.O.
You're different.

You're smart, you're special.

Rise up, play the game
on your own terms.

Don't wait for it.

♪ A year from now
we'll all be gone ♪

♪ All our friends
will move away ♪

♪♪

♪ And they're goin'
to better places ♪

♪ But our friends
will be gone away ♪

♪ Nothin' is
as it has been ♪

I heard you saved Quinn's life.

Jared and I did.

I like her.

"Her."

♪ And I guess
it's just as well ♪

So you get
that she is a "she."

I have lots of questions.

Yeah, well, questions are good.

Leads to awareness
and understanding.

And, who knows,
maybe even acceptance.

Being a kid is tough enough,

But being a trans kid?
Oh, man, that's...

that's off the chart.

♪♪

I can't imagine how it must feel

to be so different
on the outside

than you are on the inside.

♪ Oh, oh, oh

♪ Oh, oh

Hey, Shaun.

I can give you a lift.

We could grab a bite.

♪ Oh

You said you can't be my friend.

So, no, thank you.

♪ Been talking 'bout

Okay.

♪ The way things change

♪♪

♪ If you don't know what
to make of this ♪

Hey, amigo.
What's up?

♪ Then we will not relate
I need your help.

[ Scoffs ]

♪ Rivers and roads

♪ Rivers and roads

♪ Rivers till I reach you

♪ Rivers and roads

♪ Oh, rivers and roads

♪ Oh, rivers till I reach you

♪♪

♪ Rivers and roads

♪ Rivers and roads

♪ Rivers till I reach you

♪ Rivers and roads

♪ Rivers and roads

♪ Rivers till I reach you

You're not gonna do
any laps or nothing?

No.

♪♪

Then what are you doing?

Understanding.

♪♪

♪ Oh
♪ Rivers and roads

♪ Rivers and roads

♪ Rivers till I reach you

♪♪

♪♪

♪♪

♪♪

.srt Extracted, Synced and Corrected
by Dan4Jem, AD.II.MMXVIII