The Good Doctor (2017–…): Season 1, Episode 5 - Point Three Percent - full transcript

At St. Bonaventure Hospital, Dr. Shaun Murphy encounters a young patient who looks eerily similar to his deceased brother, Steve. After discovering that the patient's parents have hidden ...

Previously on "The Good Doctor"...

How hard can it be

to just act like a normal human being?!

No!

Stop petting that stupid rabbit!

We're never going home again.

We have each other,
and that's all we need.

My brother went to heaven
in front of my eyes.

Never forget, you're the smart one.

And I'm proud of you, Shaun.

Dad?



Hey!

Yeah, I missed you, too!

Oh, Penny, come.

Stay.

Hey, Dad.

Sorry it's so early. I just landed.

Actually, you're a bit late.

Five weeks.

I know. I know.

I'm sorry.
I-I-It's a long story, okay?

But h-how was it?

It was your mother's funeral.

Dad, I'm...

Okay.



Well, um, you have my cell number.

It only works if you answer it.

Dad?

Dad?!

Hey, hey! Hey... you okay?

You okay? You can't breathe?!

No? No. Okay. I'm gonna call for help.

Yeah, 911? My dad collapsed!

He can't...
he can't breathe, please hurry!

Just hold on, Dad!

Good morning, everyone!

Right on time. What, did you sleep here

or use a teleportation device?

I used a teleportation device.

Nonsensical questions
usually imply sarcasm,

which I've found people
often answer sarcastically.

Good one.

Trauma wants a consult
on a 66-year-old male

who collapsed from severe anaphylaxis,

complicated by respiratory arrest.

His son just got back from Thailand.

Almost immediately,
the father had his allergic reaction.

Patient has a few allergies...

pollen, mold, shellfish...

but no corresponding allergens
were in evidence.

Why are we doing a
surgical consult on an allergy?

Well, we're not. We're doing a consult

on the excruciating
abdominal pain he now has.

As you may have heard.

Mr. Wilks, hi, I'm Dr. Neil Melendez.

Heard you had some abdominal pain.

The guy was in some serious pain...

10 milligrams of morphine worth.

Test results show elevated lipase,

amylase, pancreatic enzymes.

Pancreas is enlarged.

Could be pancreatitis,
maybe alcohol-induced.

The son said he smelled
alcohol on his father

at 6:00 in the morning.

And anaphylaxis has been known
to precipitate

attacks of pancreatitis.

Guess that's it, then.

Meaning you totally disagree.

Not everyone who starts
their day off with a Mimosa

fries their pancreas.

Your eyesight must a
hell of a lot better than mine.

Because I can't see the entire pancreas

due to the overlying bowel gas.

We'll order an abdominal CT
and take a better look.

There you go.

Where the hell is Murphy?

It's a severe fracture,

but I don't think you'll need pins.

Young bones tend to heal very well.

Young Bones? Isn't that a "Star TREK:
Origins" graphic novel?

I'm not sure.

No, that was a joke.

Where are your parents?

They're coming.
They both work in the city,

so it's a long drive for them.

I was on a school field trip,

and I tripped over my own feet.

Of course,
it was right in front of Shelby Lomar.

At least it was pretty gross,

so I got some sympathy points for that.

I would expect this to have been caused

by a more serious accident.

Nope, just a trip.

I do that a lot.

What can I say? I'm clumsy.

Yes. Now follow my finger.

You have some nystagmus...

an involuntary eye movement.

So what's that mean?

When you fell, did you hit your head?

No.

What, you think I have brain damage?

Nystagmus can be a sign
of a neurological issue.

Oh.

Well, that would explain the "C"
I got in social studies.

That was another joke, wasn't it?

Mm.

I'm going to order a head CT for you.

Go for it.

Shaun, are you getting any sleep?

Yes.
Really?

I mean, really getting sleep?

I got here on time.

Well, that's good.

I used a teleportation device.

Radiology form, please.

Shaun, that boy, he looks like...

Steve.

He does.

Is he related?

His name is Evan Gallico,
so I don't think so.

Wow. That is uncanny.

Just coincidental.

He looks exactly like your brother.

No, he doesn't.

His hair is shorter.

It freaks me out.
It doesn't freak you out?

No.

It's okay if it does...
No, he's not Steve. Steve's dead.

"I used a teleportation device"
was a joke.

Yeah, that's... that's good.

So, I couldn't come to Mom's funeral

because I fell in love.

She was another teacher at the school.

A Thai woman.

And she was kind and...

and beautiful and loving...

and very, very sick.

She had a congenital heart defect.

Look, if you don't want to
tell me where you've been

for the last six months, then don't.

It's your business.

But don't insult my intelligence.

Well, I couldn't just leave her.

You couldn't leave her for five minutes

to make a phone call?

This a bad time?

No, come in.

According to the CT,

you have a lesion on your pancreas.

Well,
what do you think this lesion could be?

Not sure.

That's why we need to biopsy it.

It could just be a benign cyst.

Or...?

Or...

it could be cancer, right?

We'll know soon enough.

This won't take long.

I know. I've had two of these.

One more and I get my Scout badge.

That was funny.

Tough to tell without looking at you,

but I'm guessing that was sarcasm.

No. I have autism,

which makes it hard for me
to read social cues.

Jokes are difficult.

I used to know a kid with autism. Peter.

He was kind of weird but super nice.

Used to know?

You don't know him anymore?

He died.

Hit by a car.

You know anyone who died?

My brother.

That sucks.

Why did you have the other CT scans?

My parents have...

uh, what's the word for
fear of getting sick?

Hypochondriasis?

Mm, no, worse than that.

They have... nosophobia.

I love that word.

What do you think of Miss Gannett?

She's nice.

I think she's callipygian.

She's what?

Callipygian?

It means "having shapely buttocks,"
Shaun.

Duh.

You read the dictionary.

What it lacks in plot,
it makes up for in vocab.

So, you married?

Girlfriend?

Boyfriend?

Tropical fish?

I like Lea.

Ooh. And who's Lea?

Lea is a friend.

A friend you date?

A friend with benefits?

I lend her batteries sometimes.

I like where this is going...

So, you know, keep going.

'Cause if you don't, I will.

It's kind of my thing, you know?

Just constant talking...
annoys everyone.

Murphy.
Well, I guess not everyone.

Hey.

My family's pretty used to me now.
I mean...

my friends are very talkative as well,
so...

You're giving
the fractured arm a head CT?

Yes.
Get back to the pancreas.

He's not clumsy.

He has a brain tumor
behind the inner ear.

Forget the pancreas.

Mr. and Mrs. Gallico?

Hi.
Hi.

I'm Dr. Shaun Murphy.

I'm treating your son.

Well, how is he?

We were told it was a bad break,

but it should heal no problem.

I know why Evan tripped.

He had a tumor in the temporal
bone behind his left ear,

which is affecting his balance.

I've arranged for a consult
with Dr. Najid in oncology

and she's going...
No, that won't be necessary.

We...

We already have an oncologist.

Evan's been diagnosed with
stage four osteosarcoma.

He was complaining of a sore shin.

The last thing that we expected
was bone cancer.

The doctors at SFM,

they gave him a year to live.

That was seven months ago.

Osteosarcoma explains
the severity of his fracture...

he will need pins in his arm after all.

Uh, can we see him?

Yes. He's in room 414.

Uh, Dr. Murphy?

He doesn't know about his diagnosis.

We would really like
to keep it that way.

He's the patient.

Doesn't he have the right
to know the truth?

Well, no.

He's also a minor, so, no, he doesn't.

Evan's very intelligent...

he'd be able to handle it.

Well, Shaun,
maybe it's not just about Evan.

Maybe it's about his parents, as well.

Maybe it's just too difficult
for them to tell Evan right now.

I don't know.

Then they're the ones
who shouldn't be told.

Well, let me ask you this, Shaun...

what's so wrong about Evan being allowed

to enjoy as much of
his life as possible?

Evan wants to know the truth.

How do you know that?

If this were Steve,
if this were your brother,

would he want to know the truth?

Is that what this is?

Dad's such a tool.

I found my birthday present...

in their closet,
right where they always hide it.

I was just about to open it

when Dad caught me snooping
and freaked out.

I hate all that phony surprise stuff.

It's an AquaBlast Water Cannon.

I was with Mom when she bought it.

Thank you, Shaun.

Your honesty's refreshing!

Yes, he would want to know the truth.

Well,
there's nothing we can do about it.

It's not your decision... it's theirs.

He's their son.

Claire, I need you.

Sure, what's up?

I need someone to lie for me.

Okay...

I'm flattered?

Hey, doc?

There's something I need to tell my dad.

We haven't moved him.
He's still in room, uh, 326.

Do you have a medical question for me?

Is he dying?

We don't know yet.

The biopsy will tell us more.

Okay.

My dad is a good guy.

We've just never been on the same page,
you know?

My mother was the one
that I could talk to...

same for him.

So, without her,

we're both pretty useless.

Room 326.

Right.

Dr. Murphy called me in
for a second opinion.

Um, you need some pins in your arm.

Why?

What's changed?

Well,
after studying the radiology report,

given how bad the break is,

we just think it would be
a prudent step...

to ensure an efficient and
thorough mending to the break.

Will I be able to play baseball again?

Well, I don't see why not,

once it's completely healed,

after some physiotherapy.

How long before I can pitch?

It's hard to say.

He wanted someone to lie for him.

And he picked you.

Merrill's son asked for personal advice.

And he picked you.

I know, right?

He's lying to his dad about something.

Yeah? What?

I don't know.

You didn't ask?

It didn't seem relevant, medically.

You know it's not that difficult
to be a human being.

Just tell him to "come clean,"

"honesty is the best policy,"

"a lie is a stone in your heart."

Who said the last one?

Me.

I made it up.

Hmm.

And... I got it.

He's anaphylactic.

Would you get me an epi?
I'm coming out.

The throat's constricting.
Pull the tube!

So, what's up with "Dr. Browne"?

She's Lea, isn't she?

Claire is my colleague.

Oh, come on,
I saw the way you were looking at her.

How?

I don't think I look like that.

Okay, so then why'd you
call her in for a "consult"?

Mm...

Okay.

Yes, she's better at talking
to people than I am.

Wow. I counted like 50 tells there.

You really suck at lying.
I know.

Too bad. It's an important social skill.

So how do you know when to lie?

When people need to know things,

they need to know.

If they don't,

lie through your teeth
and feel good about it.

What if they need to know the truth,

but it'll hurt them?

Some can handle it, some can't.

So how do you know
who can and who can't?

You tell the truth.

If they like you after,
then you'll know.

If they don't?

Then it doesn't really matter anyway.

You have cancer.

Yeah, I know.

My parents took me in for a sore leg.

After a whole bunch of tests,

they talked to the doctor,

then came out and told me I was fine.

That's it. Just "fine."

The next day, they bought me a PS4.

So I Googled my symptoms,

and I narrowed it down to osteosarcoma

or growing pains.

Kids don't get gaming systems
for growing pains.

Hey, it's okay.

I'm not afraid to die.

You're not?

Well, I mean, the dying part will suck

if it hurts, but...

I'm not afraid about
the actual death part.

Because you believe
you're going to Heaven?

Because I don't.

If I believe in Heaven,

then I got to believe in God,

then I got to believe God made me sick.

How messed up is that?

It's just easier to think
that it's all random

and when it's over,

it's just...

over.

So what about Lea?

Where'd you guys meet?

In the hallway.

That's a beautiful story.

Yes.

She's my neighbor.

Convenient.

He had another allergic reaction.

The pancreas?
Merrill Wilks, yeah.

And the second attack was even
more severe than the first.

It coincided with biopsying
the pancreatic lesion,

which now appears was a cyst.

Well, now we know he's allergic to
whatever's in that cyst.

We also that the next cyst that pops

will probably kill him.
Well, if there is a next.

Let's run a couple tests,

see if there's any evidence
of parasites.

And MRI his entire body...

if we're lucky,
he only had the two cysts

and he can go home.

Are you looking for loopholes?

Hoping to save Evan?

Everyone makes mistakes.

Which means you should double-check

every file in the hospital.

The oncologist flagged his
neutrophil count of 634 as low.

That is low.

Low normal.

I can still hear
the word "low" in there.

Mm.

He's just a kid.

I know how hard it is
to think of him dying.

He's okay with that.

I find that hard to believe.

We all die...

if we accepted that, we'd be happier.

Maybe. But we're not good
with contentment.

Fighting death is what keeps us alive.

Okay.

We got a hit... Echinococcus.

Echinococcus?

The cysts are filled with tapeworms?

Cysts? There are more?

Three more?
Four more.

You missed the one in his brain.

Dr. Glassman?

Yeah?

You used to be a neurosurgeon, right?

So they say.

Take this, will you?

I need one.

Who would you recommend?

What you got?

Wow, that's cool.

How the hell did I get
tapeworms in my head?

No idea, but you do.

You can pick up the eggs
from coyotes or wolves.

You been hanging around
coyotes or wolves?

I live in the suburbs...

we don't even have a petting zoo.

You might've had these cysts
for quite some time.

When one of them burst,

that's what caused
the first allergic reaction.

Well, why did it burst?

Why did it burst?

Any sudden movements,
twists, turns, squeeze.

A hug?

Could be.

But you weren't there
for the second one.

I punctured the cyst on your pancreas

during the biopsy.

As you've seen,
allergic reactions get worse

each time they happen.

So a third one, that would be bad.

That would be...

That would be very bad.

So we're gonna have to
surgically remove...

all the cysts intact.

Dr. Glassman's
one of the most highly acclaimed

neurosurgeons in the state.

You are very lucky to have him.

And Dr. Kalu is fast becoming
a very accomplished flatterer.

The cranial cyst, that is a big deal.

We're gonna have to take off
the top of your skull.

You'd be digging in to my brain?

Well, yeah, pretty much.

With saline.

We use it to gently displace the cyst,

and then, poof, it magically pops out.

Kind of like delivering a baby.

You know, if childbirth were painless.

And then we move on to the other cysts.

Hey, we're gonna take good care of you.

Evan doesn't have cancer.

Cowards cowering in concrete
showers in Rikers Island

Victims,
we the wolves that's wilding

We often smilin'
at sights of violence

Acting brave and courageous

Ain't advantageous
for health and safety

So when we say "run the jewels"

It might not be cancer!

And that goes for a guy or lady

It might not be cancer!

Look at you on time... two for two.

It might not be cancer.

Fractured arm?
Yes.

You said he'd been diagnosed
with stage four osteosarcoma.

Evan was diagnosed with
the flu eight months ago,

but his symptoms were
actually a better fit

with Epstein-Barr virus,

which is linked to
Langerhans cell histiocytosis,

which causes osteolytic lesions

in the long bones of the upper limbs.

And those lesions could be misdiagnosed

as signs of osteosarcoma.

Yes.
What about his brain tumor?

Langerhans can also manifest
in the skull.

Instead of a death sentence,

he could have something
that could easily

be treated with prednisone?

Next, we need to do a bone-marrow
aspiration to confirm.

I assume you've looked at his file.

For a very long time.

Well, there must've been a biopsy.

What did the pathology report say?

Yes. There were two biopsies.

Both were positive for osteosarcoma.

Murphy...
They could be false positives.

Do you have any idea how unlikely it is

to have two false positives?

0.3%.

Which we can comfortably
round off to "not likely."

It is possible...

Yes, but it means telling
the parents of a dying child

that there's hope,
when really there isn't.

Grab a shower and get ready for rounds.

Wow.

Imaginative and creative.
Yes.

What are the chances you're right?

0.3%.

330 to 1.

333 to 1.

You really think that it's worth

putting Evan's parents through all this?

Of course.

If we did this 333 times,

we'd be giving false hope
to 332 people...

for approximately four hours,

and we'd save one life.

Isn't that worth it?

Anyway, Dr. Melendez won't let me

ask for consent to test.

What if I don't tell them
what I'm doing?

A blatant ethics violation...
that's your solution?

Yes.

How do I do that?

Well, uh,

you do it and then don't tell anyone.

No one. If anyone asks...

your attending noticed
a low RBC count...

and needed to find the cause...

that's it... no biggie.

Hmm.

You know Wilks'
Grocery on Santa Clara 17th?

It's been an institution
for nearly 60 years.

My grandparents started it in 1958,

and my wife and I took it over in '82.

But when my wife got sick

and I started talking to Kevin
about taking it over,

he just... took off.

To him, it was just a place

to sell lettuce and toilet paper.

My father chairs a real-estate
development company in the U.K.

Thought I'd be the perfect person

to set up the U.S. office.

You wanted to be in
the "helping profession," hmm?

I wanted to be in my profession.

It's not about how small
or how big the venture is,

it's about doing something that's yours.

I guess.

When he was little, we were inseparable.

Ah, he used to love to
come to the store to "work."

I even had a little apron
made for him...

had his name on it, too.

Still, you know, kids...

grow up.

I'm just grateful that
he stayed close to his mother.

He could talk to her, tell her anything.

So could I.

And when she went...

I lost them both.

Looks like he's back now.

All I know is he ditched me
when I needed him.

Well, you know,
as a wise person once said,

"holding a grudge is a stone
in your heart."

What's that for?

Local anaesthetic
for a bonemarrow aspiration.

Why do I need a bonemarrow aspiration?

My attending saw a low RBC count

and wants to find the cause...

no biggie.

"No biggie"?

You're lying.

What's going on?

You already told me
I have terminal cancer,

what's worse than that?

You might not.

It might not be osteosarcoma...

might be Langerhans cell histiocytosis,

which is treatable.

Treatable?

As in, I might not die?

That's why I need to aspirate...

to find out for sure.

Do my parents know?

Mm...
I was told not to get their hopes up.

Then let's do it before they get back.

Roll onto your side.

Is there a Scout badge for aspirations?

I think someone just made a joke.

Hello.

What are you doing?
Painkiller.

My arm hurts.

That wouldn't explain

why I'd be injecting your lumbar region.

Okay. Yes, hello.

I think Evan may have been
misdiagnosed with cancer.

I think he has something
that creates bone lesions

that look like osteosarcoma.

It's a small chance, 0.3%, but I...

You... You told Evan that he has cancer?

And now you are telling him... and us...

that he doesn't?

I'm telling you he might not.

That's why I need
to perform this aspiration.

He says whatever I have
might be treatable.

Are you insane?
No. I am not insane.

I thought you'd be happy.

There is a significant link between

Langerhans cell histiocytosis and...

Go! Get out!

Let me get you some water.

Oh, my God!
Hands right here...

All right, buddy. Right here!

Respiratory, stat!

He has a massive embolus,

probably thrown from his fracture.

It's located at the bifurcation

of the pulmonary arteries.

He's close to hemodynamic collapse.

Yeah, no kidding.

I'd like to assist.

Not a chance.

Okay. I'd like to assist.

You're obviously too close to the case.

I think I'm just
the right amount of close.

Murphy, you lied to the parents

just so you could try to
prove your ridiculous theory.

You're too damn close.

Saddle embolism, scrub in.

We have to get rid of
the embolus before he arrests.

His heart is barely pumping blood.

I can feel the pulmonary artery...

I just need to find the obstruction...
there!

I got it.

Knife.
Knife.

EKG is showing right heart strain.

He can't take this much longer.

I know, but if I move any quicker,

I could nick the left main artery
and kill the boy.

The phrase "no biggie" gave me away.

You really got to learn how to lie,
Shaun.

Am I in trouble?

Yes.

Unless you're right.

If I'm wrong, they shouldn't be upset.

They know it's highly unlikely.

False hope, Shaun...

it's just plain cruel.

Hey.

He talk to you?

Did you talk to him?

I don't know what to tell him.

You love your father, don't you?

Yeah, of course.

Right. Well,
he's about to go in for brain surgery.

There's huge risks involved.

Whatever this lie is,

can you live the rest of your life

knowing you kept it from him?

My... My girlfriend wasn't sick.

Okay? She dumped me.

She's married with two kids...

had no intention of leaving them.

I-I was an idiot.

You got your heart broken,
that's the problem here?

No... no, Dad.

The problem is...

I didn't run away to Thailand

because I thought Wilks'
Grocery was beneath me.

I was afraid that I would never be able

to fill your shoes...

And then I proved myself right.

Left pulmonary artery's open.

Ring Forceps.

Ring Forceps.

Come on.

Got it.

EKG is normalizing.

He's okay. Nice job.

All right,
flush the left pulmonary artery

and close him up.
Okay.

Um... Dr. Melendez...

Take a look at this.

Recycling... Shaun, very responsible.

It's a book.

I appreciate that.

Thanks, Shaun.

Hey.

We got the embolism.

He's in recovery and he's doing fine.

But while we were in there,

we did find something else.

Lesions on his ribs.

Irrefutable proof of osteosarcoma.

It's metastasized to his chest cavity.

I'm sorry.

I'm very sorry.

Give that a nice, warm saline bath.

Forceps and Taylor scissors, please.

Forceps and scissors.
Thank you.

Look at that.

That's what built the pyramids,

painted the Mona Lisa,

invented the Internet.

And there is our interloper.

Squeezeball please, Deidre.

Squeezeball?

His name for it, not ours.

The saline gently displaces the cyst

and coaxes it out of
its little hiding place...

Hopefully in one piece
so we don't have to call 911.

Come on, now...

Tray, please.

There we go...

And...

And you got it.

Got it.

He has his father's eyes.

That was incredible.

One down, three to go...

Hey. There he is.

Hi, Sweetie.

What's the matter?

Nothing.

We're just happy you did so great.

You had what's called an embolism.

It clogged an artery in your lungs.

But the good news is they got it.

And you're gonna be just fine.

Still...

too bad about the cancer, huh?

No, no, no, no.

The doctor did not know
what he was talking about...

Dad, I know all about it.

I have for a long time.

Well, I...

I am so sorry.

It's okay.

Because I'm not gonna be alone.

Grandma's gonna be there, too.

Auntie Arlene.

Uncle Jim,
if he figured out how to stop swearing.

I'll get you some water, buddy.

So, I took Penny for a walk...

just around the block.

And I picked her up some of
those rawhide treats,

you know...

the ones that Mom used to
like to give to her.

I miss her, Dad.

Coast is clear?

Yes.

Thank you.

Mm, I was wrong.

You tried.

I was wrong.

Your parents hate me.

I know.

I gave you false hope.
Yeah.

But for a minute there,
it was pretty awesome.

I'm going to ask you for a favor.

Well,
I'm not giving away my Make-A-Wish.

Mm,
would you mind if I read you something?

It's not long.

That I can do.

"Atticus was right.

"One time he said
you never really know a man

"until you stand in his shoes
and walk around in them.

"Just standing
on the Radley porch was enough.

"The streetlights were fuzzy

"from the fine rain that was falling.

"As I made my way home,
I felt very old."

I can't protect you
from the course of life

But you know me
and you know I was born to try

It's just the symptom
of a middle-aged attack

"... while he hadn't done
any of those things,

"Atticus, he was real nice.

"His hands were under my chin,

"pulling up the cover,

"tucking it around me.

"Most people are, Scout,
when you finally see them."

"He turned out the light
and went into Jem's room.

"He would be there all night,

"and he would be there when Jem
waked up in the morning."

Sounds like a good book.

Could've used a spoiler alert, though.

Thank you.

Confusing you,
from what you need

Every hand that you hold

It comes back

That's all.

Every word, every ride

It comes back every time

It comes back every time

Every time