The Good Doctor (2017–…): Season 2, Episode 6 - Two-Ply (or Not Two-Ply) - full transcript
Morning, roomie.
Morning, roomie.
I'm going to the market later.
You need more apples?
No, but we need more toilet paper.
No prob.
May I?
No prob.
Angel Fluff Plus, two-ply,
unscented, ultra-wide, extra soft.
Two-ply. No prob.
Y-You have to hang the toilet paper
on the dispenser the correct way.
The paper goes over on the top,
not under hanging against the wall.
Sorry, I forgot you like it like that.
I don't "like it like that."
It's "right" like that.
NBD.
It's no big deal.
I got to run.
Ms. Kohl?
Hi, I'm Dr. Melendez.
Sorry. I have to practice whenever I can.
I practice whenever I can, too.
We heard you hurt your finger.
Can we take a look?
I got a crappy manicure
a couple days ago,
and now my nail looks disgusting.
Paronychia... it's an abscess caused by
a common bacterial infection.
We'll drain it, pack it,
and send you home.
In 72 hours, the pain and
swelling will be much better,
and you'll be back to Paganini.
Apologize already.
- I did nothing wrong.
- So?
You don't want to be iced out
by the future
- Chief of Surgery forever.
Lim could be Chief, too.
Andrews hasn't decided yet.
Hey, Brown, Park. Hustle in.
EMTs are less than a minute out.
Park, make sure Bay 3's good to go.
13-year-old female.
Progressively worsening epistaxis.
Bolus on the bus. BP 86/51.
It won't stop! I can't get it to stop!
I got home, and she was calling 911.
Not your first nosebleed, huh, Dad?
Well, these things usually
go away on their own,
but Riley claims she's been
like this for over an hour.
Ugh! It's not a claim, it's a fact!
Gonna need to get her on
a monitor right away
and apply 4% phenylephrine solution.
Gonna need to cauterize the bleed.
It's not my first nosebleed either.
I have my premiere at Davies
this weekend,
hence the manicure.
Rosin, beeswax... that stuff
is tough to get off.
You play?
I know my way around bow strings.
I dabbled in archery
when I was in high school.
I started when I was 5.
I used to hum melodies doing my homework,
eating dinner, taking out the trash.
I wanted to be a train conductor.
Mm, there's still time.
- Ow.
- She's numbed up.
She shouldn't have
any pain in her finger.
It's not my finger.
It's further up, by my knuckle.
No fever.
Any body aches?
Uh, a little.
Playing violin all day stresses
out my neck and shoulders.
It's likely tendonitis
or mild arthritic pain.
Or it might be flesh-eating bacteria
and we have may have to
cut off your finger.
...Captions by VITAC...
There's the bleeder,
at the posterior rim of
Kiesselbach's plexus.
You called 911?
She did.
How you feeling, baby?
Peachy.
It's a nosebleed. I'm handling it.
She's my kid, too, Bruce.
Bet you couldn't tell they're divorced.
Well, why don't I take Riley's parents
to the waiting room so we can...
Talk about me.
Adiós.
We need to know.
Shaun, what do we need to do
to know for sure?
We need to cut deeper and get a swab.
Fingers have thousands of nerve endings.
Clipping off even the tiniest
portion of Jas' finger
could cause permanent damage
and be career-ending.
But if it is necrotizing fasciitis
and we do nothing, she could die.
That would also end her career.
True.
But the numbers, Shaun, the data.
There's almost no chance
that it's nec fasc.
On the other hand, if we test for it,
we will definitely do damage.
Anything else?
Do you hang your toilet paper
going over or under?
Doesn't matter.
Before the nosebleeds,
it was tummy aches,
insomnia, breathing pain.
Every time, we'd rush her
to the pediatrician,
but they couldn't find anything,
so we stopped taking her.
You think she's faking it?
A therapist said it was
likely her subconscious way
of trying to get her family
back together.
Well, divorce isn't easy for adults.
Why should kids be able
to deal with it any better?
She disengaged,
not just from us,
but her friends, school.
It's been five years.
She should have found
her new normal by now.
Looks like someone's doing better.
Nosebleed stopped,
but Riley's nasal membranes
are pretty thin.
You should be on the lookout
for future bleeds.
Riley, have you been sniffing
or snorting any drugs lately?
What? No way. I wouldn't do that.
There's a lot of stuff
out there that looks harmless,
- but...
- She said no.
Does FLONASE count?
I was coughing.
I had a stuffy nose, itchy throat.
I looked up my symptoms,
because what the hell else
was I supposed to do?
Vasomotor rhinitis fit.
So I went to the drug store,
and I got some FLONASE.
Misuse of steroid sprays
can thin out nasal membranes,
causing terrible nosebleeds.
Quit the FLONASE, you're good to go.
Thank you.
Uh, I need you to take her tonight.
I had to skip a pitch to
an important V.C. to get here.
Sorry, didn't mean to take you away
from anything important.
You're provoking her.
You know she's an anxious kid.
I'm not anxious, I'm sick.
Could you for once have my back?
- What?
- This is your fault.
She's playing us against each other.
What's wrong?
My breathing, I-it hurts.
Just relax, sweetie.
Just stop, both of you.
Vasomotor rhinitis.
That is a pretty unique
diagnosis for an 8th grader.
You'll be numb in a minute.
7th.
And I was wrong.
Doesn't matter.
I get what you're going through.
You were smart, popular.
We don't have anything in common.
I was never popular.
I wore hand-me-downs from Goodwill.
I never knew my dad.
My mom was sick. I couldn't rely on her.
You know, kids at that age
can be total...
Jerks.
Asshats. Turds.
I wouldn't send my worst enemy
back to junior high.
I got so many D's
on my report card last year,
I got held back.
Now everyone treats me like I'm stupid.
It's humiliating.
How'd you deal with it?
I said screw it.
They already think I'm bad.
I mess around in class, leave campus,
do whatever the hell I want.
But you're still angry.
I didn't let my past define me...
and yours doesn't have to define you.
Repeating a grade doesn't make you...
What?
What's wrong?
Nothing.
There doesn't seem to be
any active bleeding.
But I coughed up blood. That was real.
It's possible it's just
post-nasal aspiration...
that the blood you coughed up
was from the initial nosebleed,
and it went down your throat,
into your lungs.
But my chest, it really hurts.
Hey, Shaun. What's up?
You forgot to put your coffee cup
in the dishwasher before you left.
Sorry, I was in a rush.
And remember, rinse it out
before you put it in the dishwasher.
- Noted.
- And on the top rack.
- I got to go.
- Me too.
Morgan doesn't want to know
what's wrong with our patient.
I find that hard to believe.
They talk about bow strings.
I don't know anything about bow strings.
They should be talking about
what's wrong with her.
You can't always know, Shaun.
Sometimes tests aren't worth it.
Sometimes we don't have the right tests.
What are you doing in here?
Lea and I disagree about toilet paper.
And you made a good point
about finding the right test.
Thanks?
I just did a test.
On toilet paper?
Every toilet paper roll in this restroom
has the paper hanging over, not under,
and they were installed by professionals.
Does it matter?
I-D-G-A...
I think it's an acronym
or maybe even an anagram.
I don't think Lea cares about
the toilet paper debate.
It's not a debate. I'm right.
I think you should talk to Lea.
Not text, talk.
Did you talk to Dr. Melendez
after you got in trouble with him?
- No.
- Why not?
Because I did nothing wrong.
Because you were right.
- Yeah.
- So am I.
Make sure all four tips
are touching the ground
before you take a step.
Well, thank you, Iris.
I never would have figured that out.
I'm required to show you how
to use all medical equipment.
Well, I'm not gonna use it.
You want to know why?
- Huh?
- Because I'm not gonna use it.
You remind me of my Grandpa Eddie.
So grumpy, so adorable.
See? Look... no hands.
I'm fine.
Uh, chicken soup...
heard it's good for the soul.
I wasn't expecting you. Thank you.
That's very thoughtful.
It's... Really, it's no big deal.
I signed up to bring you food
at the hospital,
the Meal Train that they set up.
- The Meal Train, yeah.
- Yeah.
How... How are you doing today?
Well, today is actually looking up.
Good.
You want to come in and have some soup?
I have other plans.
Ah, yeah.
But, um...
I'm actually free tomorrow.
Do you like lasagna?
I kind of love lasagna.
Great.
Finally get that second date.
- You know, you don't have to...
- No, Aaron.
I want to.
Well, then, I want to.
Okay. Great.
Then, um...
I will see you, then, tomorrow.
I'll see you tomorrow.
No one dabbles in archery
unless they're at summer camp.
How long did you do it?
Seven days a week for seven years.
Why'd you stop?
It was just time to go to
college, medical school,
be a grown-up.
It was that easy to just quit?
Archery doesn't fill concert
halls or pay the bills.
She has a slight fever,
her rash is spreading, and she has edema.
This is definitely not paronychia.
I know. I've moved on to MRSA.
That's possible,
but you should want proof.
If we do an open, deep-tissue biopsy,
we will know for sure if
you have flesh-eating...
Shaun.
Part of being a good doctor is knowing
when to not scare the crap
out of a patient.
I don't think so.
This is your problem, not hers...
your need to be sure,
your obsession, y...
We need to cut off
a small piece of her finger
so we know if we have
to cut off a larger...
Shaun, you're acting like
you want to amputate her hand.
No. You're acting like you don't
want to amputate her hand.
I don't.
But that's not medically relevant.
Her temperature is 102.
It's gone up two degrees
since we've been arguing.
Okay. We'll test her.
That tissue has begun to die.
Or it's inflammatory infiltration.
Find anything?
W-We're at an impasse.
Look here, at the margin.
Subcutaneous fat and fascial necrosis.
Shaun was right.
Let's go try to save her hand.
She is a young girl with a lot going on.
Well, we agree on that much.
That's why she needs to see a shrink.
Mnh. This...
This feels different.
What, you don't believe in
emotional intelligence?
If I have to choose between
the battery of tests we've done
and your gut, it's an easy choice.
No. You don't relate to her,
and if you don't relate to her,
you can't understand her.
You're probably right.
You think you do relate.
Well, do you have a kid?
My opinion about Riley is medical.
Why haven't you told any of us
you have a kid?
That is a huge chunk of your
life you've been hiding.
I don't feel the need to share everything
about my personal life with
the people I work with.
Oh, that's your passive-aggressive way
of saying I'm an over-sharer?
Yeah.
Your opinion on Riley is clearly skewed
because you're looking at her
through a parental lens.
I've been in her shoes.
I'm better equipped
to evaluate her situation.
You're the poster child of skewed.
You're too emotionally involved
and are overreacting because
you had a crappy mom
who didn't care about you.
And why do I know all that?
Because you're an over-sharer.
The scan's clean.
Is it time to send her home?
Clamp.
Whoa. That is not good.
Muscle's weak. Clamp slid
right through the fascia.
Murphy, pull the skin back.
Smells like rotten eggs.
There's only tissue damage.
If we debride her hand carefully,
we can preserve some mobility
and dexterity.
She's gonna need close
monitoring post-op tonight.
Scissors.
We need to talk.
Can it wait? I'm late for
an all-night coding session.
You hung the toilet paper incorrectly.
Right. Did you flip it?
Great, we're done.
You left the TV remote on the couch.
Shaun, I'm running late.
You have to put it on the tray
on the coffee table.
That is where it belongs.
If it doesn't have a set place,
then it will be in many places
and then it will get lost
and if I can't find it, I can't
watch the Weather Channel...
Okay, enough about the damn remote!
Everything in this place
has to be your way.
We have to make sure to use
two pods in the washing machine,
we have to keep the cups
to the left of the plate,
we have to keep the
air conditioner at exactly 74,
and we have to use one very specific,
very hard-to-find toilet paper.
And I'm trying to be accommodating,
but you are not cutting me any slack.
Oh, God.
Shaun.
Shaun, I am sorry. I'm... Are you okay?
You have a ruptured Achilles.
I'm afraid your weekend warrior
days are over...
Help! Can we get some help here?
Right there.
What happened?
She couldn't sleep, uh,
she spiked a fever.
It's only getting worse.
I can't breathe.
Take a deep breath, in, out.
104.6.
I need IV acetaminophen
and cooling blankets ASAP.
She's tachypneic with an O2 SAT of 87.
Is this... Is this something new or...
Did... I mean, did she
do this to herself?
She has an infection.
I think she's developed pneumonia
due to an underlying condition.
What underlying condition?
I have no idea. Page Park and Lim.
No signs of PE or pneumonia.
CFTR was negative for cystic fibrosis.
I think we may have missed
something on her CT.
There... that slight shadow
on the bronchus.
A slow-growing carcinoid tumor
could cause chronic airway inflammation.
As the tumor grows, symptoms worsen,
leading to airway obstruction
and infection.
Or it's just a shadow,
a slight shadow.
It is pretty subtle.
I would like to do exploratory VATS.
You want to poke holes in her chest
and go rooting around in her lungs?
Riley's body's already compromised.
There are no obvious lesions,
and her symptoms
are more likely indicators
of a simple sinus infection.
The safer, better plan is
to treat with antibiotics.
If she has a progressing tumor,
we can't just send her home
with medication.
Pitch the surgery
to the parents and Riley.
Okay.
Hey, hey, hey!
Don't touch those. Those are vintage.
Well, I'm just scooting your toys over
so it's easier to get to your medication.
Toys. Toys?
These are not toys.
That's Reggie Jackson.
Well, when that timer goes off,
Roger Johnson can give you your medicine.
Reggie Jackson.
Hey, guess what.
Quitting time.
Okay. Have fun.
- Take your pills.
- Yeah.
I think I broke Shaun.
- Hi.
- We got into a big fight, huge,
and I was yelling and he just fell apart.
It was awful.
And he pushes and pushes
and pushes. I pushed back.
Well, Shaun's not easy,
but you knew that.
I knew it was gonna be hard,
but living with him is a lot.
I know.
I mean, there's stuff I've
never even thought about.
And I know he has idiosyncrasies,
but there's a lot of them. I mean, a lot.
I know. Is Shaun okay?
Yes. No. I don't know.
He's at work.
Glassy, you know him,
like really know him.
How do I deal with Shaun?
Well, it's been 12 years,
and I'm still learning.
He just always has to be right.
I mean, do you... do you know
how many calls and texts
and notes he's left me about
how I'm doing stuff wrong?
I have a pretty good idea, yeah.
Yeah, well, it's exhausting.
You know what? We all have quirks.
We can all be a pain in the ass
from time to time.
Okay, admittedly Shaun a little more so.
That is not helpful.
- Sit down.
- What?
- Sit down.
- Why?
Why? Because you're agitated
and you're annoying me
and I can't give you
good advice in that state.
Sit.
Thank you.
Do you like Shaun?
- Of course.
- Why?
He's sweet, kind, honest,
sometimes brutally honest,
there's never an agenda with him.
He's just Shaun.
So?
So I want him to change...
a little.
You moved in expecting him to change?
He doesn't want you to change.
I know that.
And if I made the wrong decision?
Then you move out
and you do it right now.
It'll devastate him,
but the longer you wait,
the more...
...the worse it will be for him.
If Riley has a tumor,
we need to open her up to find
out what we're dealing with.
Why do you think she has a tumor?
It's consistent with her symptoms.
The same symptoms she's been
having for years?
Yes.
The same symptoms we've been
told are psychological,
the same symptoms
a dozen doctors have run
a hundred tests for and found nothing?
There is a shadow on her CT image.
A shadow?
And it's risky surgery?
Opening her up in a weakened
state could be dangerous.
Look, I know Riley frustrates you,
drives you crazy,
but I also know you love her.
You have a chance to show her that.
So you want to do this as a statement?
We want you to believe in your daughter,
because that's what a parent does.
When she was little
and had a bad dream,
she used to come into our room
and snuggle up under your arm,
just like she's doing to me.
You would stroke her face
until she was finally at peace
and fell asleep.
She's in so much pain,
and I don't know how to make it go away.
Riley?
Hey, um...
The doctors,
t-they want to see what's
going on in your lungs.
They think you might have a tumor.
And we want them to operate.
You think I have a real tumor?
It's scary, I know, but...
yes, we do.
Her BP's dropping out... 73/51.
Heart rate is spiking to 137.
- Hang an IV saline bolus.
- I need a 12-lead.
The necrosis has migrated.
She's septic.
There's definite infiltration
to the bone.
We're gonna have to amputate her arm.
Polish the bone to help stump healing.
Rasp.
The margins appear to be clean.
There's still a small chance microbes
may have spread to her organs.
If they did, then her mortality rate
just increased exponentially.
What if we put her in
hyperbaric oxygen therapy now?
Oxygen's toxic to bacteria.
There's a lot of things
that could go wrong in there.
We wouldn't be able to
decompress the chamber in time
to help her.
We wouldn't have to wait to help her
if someone goes in with her.
I'll do it.
Okay. Get the chamber ready.
Lung tissue looks normal.
And there are healthy-appearing bronchi.
Nothing...
yet.
Damn it. Tore a lobar artery.
BP is 81/49, oxygen SATS 93,
heart rate is going up. She is tanking.
Park, I need more suction.
I can't see a thing in here.
We need to do an open thoracotomy now.
- Browne, crack her chest.
- 10 blade and a rib spreader.
There are only
7.18 cubic meters in there.
How does it feel?
It's fine.
I thought it might feel claustrophobic
for someone neurotypical.
It is.
Got it.
It's still bleeding.
Stroke volume just bottomed out.
Rapid infuse 4 liters of whole blood.
Get ready to start cardiac massage.
Wait. I think I have an anchor
in the arterial wall.
Stroke volume is rising,
BP increasing, 90/60.
Pulse is 90 and regular.
She's stable for now.
This was a mistake.
We need to close her up
as soon as possible.
It doesn't make any sense.
Her arterial wall
shouldn't be this fragile.
Something else has caused it to thin out.
What else is going on in here?
Browne, I need more light.
Yeah. See that?
A localized granuloma
on the right lower lobe.
You think it's cancer?
Not sure but something's in there.
Park, retract the lung.
It's a LEGO.
Riley must've inhaled it years ago.
It settled in your lung
and became encased
in inflammatory tissue.
Your body's immune response attacked it,
making you progressively
more sick over the years.
It's small, thin, and made of plastic.
There was no way of seeing it
on any of the imaging.
Ugh. This is so gross.
I'm gonna make it into a necklace.
Good luck. Excuse me.
We're sorry that we didn't
believe in you.
We're sorry that we put
you through all this.
We're sorry that we got divorced.
Whoa.
You guys are way better off apart.
W-We always thought you were
upset because we split up.
I was upset because
you fought all the time.
You still do.
It freaked me out.
So I'd hide in my princess tent,
bite my nails, gnaw on crayons...
...chew on LEGOs.
We screwed up,
and we promise we can do better.
I am not saying that "Ordinary People"
is not a good movie. I'm...
It's a good... It's a great movie.
It's a great movie.
Okay, but I'm saying
is that "Raging Bull"
is a superior cinematic experience.
It is raw. It's, like, romantic.
- It's romantic?
- Yeah!
It pummels you from start to finish.
Exactly. Exactly.
It's like adrenaline is
pulsing through your veins.
It leaves me breathless
every time I watch it.
Oh!
Do you... Do you want to,
like, go for a walk?
Well, it's a little cold outside.
- I'm gonna kiss you.
- You are?
- Uh-huh.
- Okay.
Mm.
- Maybe we'll walk upstairs?
- Okay.
- Yeah?
- Yeah.
- This way?
- Yeah.
Yeah.
Whoa.
- C-Can... Can I help?
- No. Thank you.
I'll get there. I'm okay, I'm okay.
I'm okay. Ow.
Is my hand okay?
Your biopsy was positive
for necrotizing fasciitis.
We had to do multiple surgeries
to remove the infected muscle and bone.
Bone?
I'm so sorry, Jas.
We had to amputate your arm.
No.
No, my... my arm still hurts.
I can... I can feel it. It's still there.
What you're experiencing
is "phantom pain."
Your arm is gone.
H-He told you.
My arm.
My arm is gone.
It's gone and...
and it's... it's your fault.
Get out.
Get the hell out.
I can't.
Neither of us can.
You called it.
Well done.
Thanks for your help.
Finally a believer in the power
of emotional intelligence?
Oh, it did get her parents on board,
even if it's only for a little while.
They believe their kid,
and they're working on
their family relationships.
It's pretty big steps.
It was a nice moment.
But if you think you changed
them, that they'll be
different people tomorrow
than they were yesterday,
then you're kidding yourself.
Right now, my emotional
intelligence is telling me
even you don't believe that.
Kitchen's clean,
leftovers are in the fridge.
How you doing?
Fine.
I just got a little lightheaded.
Balance isn't quite back to normal.
Well, now that you're
feeling a little better,
you want to watch "Raging Bull"?
No.
Okay. Another time.
No.
I can't do this.
We can take it slow.
I'm... I'm happy to just
be here with you, like this.
No. I can't... I can't be here like this.
I-I-I don't want you to f...
I just... I don't want to...
I'm sorry. I just...
I need you to go, please.
Jas practiced violin
every day since she was 5.
She put all her faith in me
to do the right thing, and...
I thought I did. I...
Shaun didn't care. He...
He didn't see her dreams.
He just saw her symptoms.
Sometimes that'll be the wrong choice.
My second year in the program,
there was this resident.
She was kind of weird.
She wore comic book T-shirts,
always ate the exact same lunch.
But she was smart.
She would get surgeries and
knock 'em out of the park
over and over again.
Couldn't stand her.
And one day I realized
I was competing against her,
but she wasn't competing against me.
She spent her time observing,
asking questions,
preparing herself to be a great surgeon.
Is she?
Dr. Lim is one of the best
trauma surgeons in the country.
- Dr. Melendez.
- Dr. Browne.
Dr. Lim.
Nice save today.
I heard. Yes, good work, Dr. Browne.
Thank you.
Good night.
You know she showed bad judgment.
You got something to say, just say it.
Want to grab a beer?
Yes.
Hey.
Are you okay?
Yes.
I'm so sorry for my outburst yesterday.
I'm fine now.
I'm not, Shaun.
Coming back to California
and starting a new job
and moving in with you...
it's been so stressful,
harder than I anticipated.
You're moving out.
No, I'm not moving out.
We are still figuring out
each other's quirks.
Oh, yes.
You're very difficult to live with.
I know I forget stuff a lot,
and sometimes I snap and yell.
I promise to work on that.
And I don't need you to change,
but I do need to know that you know
you're annoying as hell.
I need to know that you'll
try to compromise.
I don't think I can use
one-ply toilet paper.
Oh, no, you were so right about two-ply.
Totally worth the extra $1.50.
But maybe the cups can go
to the right of the plates.
Sometimes.
Well, everything's unpacked.
We're officially moved in together.
I'm gonna take these down
to the recycling.
And I know I probably didn't put
everything in the right place,
but maybe we can rearrange it together.
I like that idea very much.
♪ All I am is all I need
I like that idea very much.
Morning, roomie.
I'm going to the market later.
You need more apples?
No, but we need more toilet paper.
No prob.
May I?
No prob.
Angel Fluff Plus, two-ply,
unscented, ultra-wide, extra soft.
Two-ply. No prob.
Y-You have to hang the toilet paper
on the dispenser the correct way.
The paper goes over on the top,
not under hanging against the wall.
Sorry, I forgot you like it like that.
I don't "like it like that."
It's "right" like that.
NBD.
It's no big deal.
I got to run.
Ms. Kohl?
Hi, I'm Dr. Melendez.
Sorry. I have to practice whenever I can.
I practice whenever I can, too.
We heard you hurt your finger.
Can we take a look?
I got a crappy manicure
a couple days ago,
and now my nail looks disgusting.
Paronychia... it's an abscess caused by
a common bacterial infection.
We'll drain it, pack it,
and send you home.
In 72 hours, the pain and
swelling will be much better,
and you'll be back to Paganini.
Apologize already.
- I did nothing wrong.
- So?
You don't want to be iced out
by the future
- Chief of Surgery forever.
Lim could be Chief, too.
Andrews hasn't decided yet.
Hey, Brown, Park. Hustle in.
EMTs are less than a minute out.
Park, make sure Bay 3's good to go.
13-year-old female.
Progressively worsening epistaxis.
Bolus on the bus. BP 86/51.
It won't stop! I can't get it to stop!
I got home, and she was calling 911.
Not your first nosebleed, huh, Dad?
Well, these things usually
go away on their own,
but Riley claims she's been
like this for over an hour.
Ugh! It's not a claim, it's a fact!
Gonna need to get her on
a monitor right away
and apply 4% phenylephrine solution.
Gonna need to cauterize the bleed.
It's not my first nosebleed either.
I have my premiere at Davies
this weekend,
hence the manicure.
Rosin, beeswax... that stuff
is tough to get off.
You play?
I know my way around bow strings.
I dabbled in archery
when I was in high school.
I started when I was 5.
I used to hum melodies doing my homework,
eating dinner, taking out the trash.
I wanted to be a train conductor.
Mm, there's still time.
- Ow.
- She's numbed up.
She shouldn't have
any pain in her finger.
It's not my finger.
It's further up, by my knuckle.
No fever.
Any body aches?
Uh, a little.
Playing violin all day stresses
out my neck and shoulders.
It's likely tendonitis
or mild arthritic pain.
Or it might be flesh-eating bacteria
and we have may have to
cut off your finger.
...Captions by VITAC...
There's the bleeder,
at the posterior rim of
Kiesselbach's plexus.
You called 911?
She did.
How you feeling, baby?
Peachy.
It's a nosebleed. I'm handling it.
She's my kid, too, Bruce.
Bet you couldn't tell they're divorced.
Well, why don't I take Riley's parents
to the waiting room so we can...
Talk about me.
Adiós.
We need to know.
Shaun, what do we need to do
to know for sure?
We need to cut deeper and get a swab.
Fingers have thousands of nerve endings.
Clipping off even the tiniest
portion of Jas' finger
could cause permanent damage
and be career-ending.
But if it is necrotizing fasciitis
and we do nothing, she could die.
That would also end her career.
True.
But the numbers, Shaun, the data.
There's almost no chance
that it's nec fasc.
On the other hand, if we test for it,
we will definitely do damage.
Anything else?
Do you hang your toilet paper
going over or under?
Doesn't matter.
Before the nosebleeds,
it was tummy aches,
insomnia, breathing pain.
Every time, we'd rush her
to the pediatrician,
but they couldn't find anything,
so we stopped taking her.
You think she's faking it?
A therapist said it was
likely her subconscious way
of trying to get her family
back together.
Well, divorce isn't easy for adults.
Why should kids be able
to deal with it any better?
She disengaged,
not just from us,
but her friends, school.
It's been five years.
She should have found
her new normal by now.
Looks like someone's doing better.
Nosebleed stopped,
but Riley's nasal membranes
are pretty thin.
You should be on the lookout
for future bleeds.
Riley, have you been sniffing
or snorting any drugs lately?
What? No way. I wouldn't do that.
There's a lot of stuff
out there that looks harmless,
- but...
- She said no.
Does FLONASE count?
I was coughing.
I had a stuffy nose, itchy throat.
I looked up my symptoms,
because what the hell else
was I supposed to do?
Vasomotor rhinitis fit.
So I went to the drug store,
and I got some FLONASE.
Misuse of steroid sprays
can thin out nasal membranes,
causing terrible nosebleeds.
Quit the FLONASE, you're good to go.
Thank you.
Uh, I need you to take her tonight.
I had to skip a pitch to
an important V.C. to get here.
Sorry, didn't mean to take you away
from anything important.
You're provoking her.
You know she's an anxious kid.
I'm not anxious, I'm sick.
Could you for once have my back?
- What?
- This is your fault.
She's playing us against each other.
What's wrong?
My breathing, I-it hurts.
Just relax, sweetie.
Just stop, both of you.
Vasomotor rhinitis.
That is a pretty unique
diagnosis for an 8th grader.
You'll be numb in a minute.
7th.
And I was wrong.
Doesn't matter.
I get what you're going through.
You were smart, popular.
We don't have anything in common.
I was never popular.
I wore hand-me-downs from Goodwill.
I never knew my dad.
My mom was sick. I couldn't rely on her.
You know, kids at that age
can be total...
Jerks.
Asshats. Turds.
I wouldn't send my worst enemy
back to junior high.
I got so many D's
on my report card last year,
I got held back.
Now everyone treats me like I'm stupid.
It's humiliating.
How'd you deal with it?
I said screw it.
They already think I'm bad.
I mess around in class, leave campus,
do whatever the hell I want.
But you're still angry.
I didn't let my past define me...
and yours doesn't have to define you.
Repeating a grade doesn't make you...
What?
What's wrong?
Nothing.
There doesn't seem to be
any active bleeding.
But I coughed up blood. That was real.
It's possible it's just
post-nasal aspiration...
that the blood you coughed up
was from the initial nosebleed,
and it went down your throat,
into your lungs.
But my chest, it really hurts.
Hey, Shaun. What's up?
You forgot to put your coffee cup
in the dishwasher before you left.
Sorry, I was in a rush.
And remember, rinse it out
before you put it in the dishwasher.
- Noted.
- And on the top rack.
- I got to go.
- Me too.
Morgan doesn't want to know
what's wrong with our patient.
I find that hard to believe.
They talk about bow strings.
I don't know anything about bow strings.
They should be talking about
what's wrong with her.
You can't always know, Shaun.
Sometimes tests aren't worth it.
Sometimes we don't have the right tests.
What are you doing in here?
Lea and I disagree about toilet paper.
And you made a good point
about finding the right test.
Thanks?
I just did a test.
On toilet paper?
Every toilet paper roll in this restroom
has the paper hanging over, not under,
and they were installed by professionals.
Does it matter?
I-D-G-A...
I think it's an acronym
or maybe even an anagram.
I don't think Lea cares about
the toilet paper debate.
It's not a debate. I'm right.
I think you should talk to Lea.
Not text, talk.
Did you talk to Dr. Melendez
after you got in trouble with him?
- No.
- Why not?
Because I did nothing wrong.
Because you were right.
- Yeah.
- So am I.
Make sure all four tips
are touching the ground
before you take a step.
Well, thank you, Iris.
I never would have figured that out.
I'm required to show you how
to use all medical equipment.
Well, I'm not gonna use it.
You want to know why?
- Huh?
- Because I'm not gonna use it.
You remind me of my Grandpa Eddie.
So grumpy, so adorable.
See? Look... no hands.
I'm fine.
Uh, chicken soup...
heard it's good for the soul.
I wasn't expecting you. Thank you.
That's very thoughtful.
It's... Really, it's no big deal.
I signed up to bring you food
at the hospital,
the Meal Train that they set up.
- The Meal Train, yeah.
- Yeah.
How... How are you doing today?
Well, today is actually looking up.
Good.
You want to come in and have some soup?
I have other plans.
Ah, yeah.
But, um...
I'm actually free tomorrow.
Do you like lasagna?
I kind of love lasagna.
Great.
Finally get that second date.
- You know, you don't have to...
- No, Aaron.
I want to.
Well, then, I want to.
Okay. Great.
Then, um...
I will see you, then, tomorrow.
I'll see you tomorrow.
No one dabbles in archery
unless they're at summer camp.
How long did you do it?
Seven days a week for seven years.
Why'd you stop?
It was just time to go to
college, medical school,
be a grown-up.
It was that easy to just quit?
Archery doesn't fill concert
halls or pay the bills.
She has a slight fever,
her rash is spreading, and she has edema.
This is definitely not paronychia.
I know. I've moved on to MRSA.
That's possible,
but you should want proof.
If we do an open, deep-tissue biopsy,
we will know for sure if
you have flesh-eating...
Shaun.
Part of being a good doctor is knowing
when to not scare the crap
out of a patient.
I don't think so.
This is your problem, not hers...
your need to be sure,
your obsession, y...
We need to cut off
a small piece of her finger
so we know if we have
to cut off a larger...
Shaun, you're acting like
you want to amputate her hand.
No. You're acting like you don't
want to amputate her hand.
I don't.
But that's not medically relevant.
Her temperature is 102.
It's gone up two degrees
since we've been arguing.
Okay. We'll test her.
That tissue has begun to die.
Or it's inflammatory infiltration.
Find anything?
W-We're at an impasse.
Look here, at the margin.
Subcutaneous fat and fascial necrosis.
Shaun was right.
Let's go try to save her hand.
She is a young girl with a lot going on.
Well, we agree on that much.
That's why she needs to see a shrink.
Mnh. This...
This feels different.
What, you don't believe in
emotional intelligence?
If I have to choose between
the battery of tests we've done
and your gut, it's an easy choice.
No. You don't relate to her,
and if you don't relate to her,
you can't understand her.
You're probably right.
You think you do relate.
Well, do you have a kid?
My opinion about Riley is medical.
Why haven't you told any of us
you have a kid?
That is a huge chunk of your
life you've been hiding.
I don't feel the need to share everything
about my personal life with
the people I work with.
Oh, that's your passive-aggressive way
of saying I'm an over-sharer?
Yeah.
Your opinion on Riley is clearly skewed
because you're looking at her
through a parental lens.
I've been in her shoes.
I'm better equipped
to evaluate her situation.
You're the poster child of skewed.
You're too emotionally involved
and are overreacting because
you had a crappy mom
who didn't care about you.
And why do I know all that?
Because you're an over-sharer.
The scan's clean.
Is it time to send her home?
Clamp.
Whoa. That is not good.
Muscle's weak. Clamp slid
right through the fascia.
Murphy, pull the skin back.
Smells like rotten eggs.
There's only tissue damage.
If we debride her hand carefully,
we can preserve some mobility
and dexterity.
She's gonna need close
monitoring post-op tonight.
Scissors.
We need to talk.
Can it wait? I'm late for
an all-night coding session.
You hung the toilet paper incorrectly.
Right. Did you flip it?
Great, we're done.
You left the TV remote on the couch.
Shaun, I'm running late.
You have to put it on the tray
on the coffee table.
That is where it belongs.
If it doesn't have a set place,
then it will be in many places
and then it will get lost
and if I can't find it, I can't
watch the Weather Channel...
Okay, enough about the damn remote!
Everything in this place
has to be your way.
We have to make sure to use
two pods in the washing machine,
we have to keep the cups
to the left of the plate,
we have to keep the
air conditioner at exactly 74,
and we have to use one very specific,
very hard-to-find toilet paper.
And I'm trying to be accommodating,
but you are not cutting me any slack.
Oh, God.
Shaun.
Shaun, I am sorry. I'm... Are you okay?
You have a ruptured Achilles.
I'm afraid your weekend warrior
days are over...
Help! Can we get some help here?
Right there.
What happened?
She couldn't sleep, uh,
she spiked a fever.
It's only getting worse.
I can't breathe.
Take a deep breath, in, out.
104.6.
I need IV acetaminophen
and cooling blankets ASAP.
She's tachypneic with an O2 SAT of 87.
Is this... Is this something new or...
Did... I mean, did she
do this to herself?
She has an infection.
I think she's developed pneumonia
due to an underlying condition.
What underlying condition?
I have no idea. Page Park and Lim.
No signs of PE or pneumonia.
CFTR was negative for cystic fibrosis.
I think we may have missed
something on her CT.
There... that slight shadow
on the bronchus.
A slow-growing carcinoid tumor
could cause chronic airway inflammation.
As the tumor grows, symptoms worsen,
leading to airway obstruction
and infection.
Or it's just a shadow,
a slight shadow.
It is pretty subtle.
I would like to do exploratory VATS.
You want to poke holes in her chest
and go rooting around in her lungs?
Riley's body's already compromised.
There are no obvious lesions,
and her symptoms
are more likely indicators
of a simple sinus infection.
The safer, better plan is
to treat with antibiotics.
If she has a progressing tumor,
we can't just send her home
with medication.
Pitch the surgery
to the parents and Riley.
Okay.
Hey, hey, hey!
Don't touch those. Those are vintage.
Well, I'm just scooting your toys over
so it's easier to get to your medication.
Toys. Toys?
These are not toys.
That's Reggie Jackson.
Well, when that timer goes off,
Roger Johnson can give you your medicine.
Reggie Jackson.
Hey, guess what.
Quitting time.
Okay. Have fun.
- Take your pills.
- Yeah.
I think I broke Shaun.
- Hi.
- We got into a big fight, huge,
and I was yelling and he just fell apart.
It was awful.
And he pushes and pushes
and pushes. I pushed back.
Well, Shaun's not easy,
but you knew that.
I knew it was gonna be hard,
but living with him is a lot.
I know.
I mean, there's stuff I've
never even thought about.
And I know he has idiosyncrasies,
but there's a lot of them. I mean, a lot.
I know. Is Shaun okay?
Yes. No. I don't know.
He's at work.
Glassy, you know him,
like really know him.
How do I deal with Shaun?
Well, it's been 12 years,
and I'm still learning.
He just always has to be right.
I mean, do you... do you know
how many calls and texts
and notes he's left me about
how I'm doing stuff wrong?
I have a pretty good idea, yeah.
Yeah, well, it's exhausting.
You know what? We all have quirks.
We can all be a pain in the ass
from time to time.
Okay, admittedly Shaun a little more so.
That is not helpful.
- Sit down.
- What?
- Sit down.
- Why?
Why? Because you're agitated
and you're annoying me
and I can't give you
good advice in that state.
Sit.
Thank you.
Do you like Shaun?
- Of course.
- Why?
He's sweet, kind, honest,
sometimes brutally honest,
there's never an agenda with him.
He's just Shaun.
So?
So I want him to change...
a little.
You moved in expecting him to change?
He doesn't want you to change.
I know that.
And if I made the wrong decision?
Then you move out
and you do it right now.
It'll devastate him,
but the longer you wait,
the more...
...the worse it will be for him.
If Riley has a tumor,
we need to open her up to find
out what we're dealing with.
Why do you think she has a tumor?
It's consistent with her symptoms.
The same symptoms she's been
having for years?
Yes.
The same symptoms we've been
told are psychological,
the same symptoms
a dozen doctors have run
a hundred tests for and found nothing?
There is a shadow on her CT image.
A shadow?
And it's risky surgery?
Opening her up in a weakened
state could be dangerous.
Look, I know Riley frustrates you,
drives you crazy,
but I also know you love her.
You have a chance to show her that.
So you want to do this as a statement?
We want you to believe in your daughter,
because that's what a parent does.
When she was little
and had a bad dream,
she used to come into our room
and snuggle up under your arm,
just like she's doing to me.
You would stroke her face
until she was finally at peace
and fell asleep.
She's in so much pain,
and I don't know how to make it go away.
Riley?
Hey, um...
The doctors,
t-they want to see what's
going on in your lungs.
They think you might have a tumor.
And we want them to operate.
You think I have a real tumor?
It's scary, I know, but...
yes, we do.
Her BP's dropping out... 73/51.
Heart rate is spiking to 137.
- Hang an IV saline bolus.
- I need a 12-lead.
The necrosis has migrated.
She's septic.
There's definite infiltration
to the bone.
We're gonna have to amputate her arm.
Polish the bone to help stump healing.
Rasp.
The margins appear to be clean.
There's still a small chance microbes
may have spread to her organs.
If they did, then her mortality rate
just increased exponentially.
What if we put her in
hyperbaric oxygen therapy now?
Oxygen's toxic to bacteria.
There's a lot of things
that could go wrong in there.
We wouldn't be able to
decompress the chamber in time
to help her.
We wouldn't have to wait to help her
if someone goes in with her.
I'll do it.
Okay. Get the chamber ready.
Lung tissue looks normal.
And there are healthy-appearing bronchi.
Nothing...
yet.
Damn it. Tore a lobar artery.
BP is 81/49, oxygen SATS 93,
heart rate is going up. She is tanking.
Park, I need more suction.
I can't see a thing in here.
We need to do an open thoracotomy now.
- Browne, crack her chest.
- 10 blade and a rib spreader.
There are only
7.18 cubic meters in there.
How does it feel?
It's fine.
I thought it might feel claustrophobic
for someone neurotypical.
It is.
Got it.
It's still bleeding.
Stroke volume just bottomed out.
Rapid infuse 4 liters of whole blood.
Get ready to start cardiac massage.
Wait. I think I have an anchor
in the arterial wall.
Stroke volume is rising,
BP increasing, 90/60.
Pulse is 90 and regular.
She's stable for now.
This was a mistake.
We need to close her up
as soon as possible.
It doesn't make any sense.
Her arterial wall
shouldn't be this fragile.
Something else has caused it to thin out.
What else is going on in here?
Browne, I need more light.
Yeah. See that?
A localized granuloma
on the right lower lobe.
You think it's cancer?
Not sure but something's in there.
Park, retract the lung.
It's a LEGO.
Riley must've inhaled it years ago.
It settled in your lung
and became encased
in inflammatory tissue.
Your body's immune response attacked it,
making you progressively
more sick over the years.
It's small, thin, and made of plastic.
There was no way of seeing it
on any of the imaging.
Ugh. This is so gross.
I'm gonna make it into a necklace.
Good luck. Excuse me.
We're sorry that we didn't
believe in you.
We're sorry that we put
you through all this.
We're sorry that we got divorced.
Whoa.
You guys are way better off apart.
W-We always thought you were
upset because we split up.
I was upset because
you fought all the time.
You still do.
It freaked me out.
So I'd hide in my princess tent,
bite my nails, gnaw on crayons...
...chew on LEGOs.
We screwed up,
and we promise we can do better.
I am not saying that "Ordinary People"
is not a good movie. I'm...
It's a good... It's a great movie.
It's a great movie.
Okay, but I'm saying
is that "Raging Bull"
is a superior cinematic experience.
It is raw. It's, like, romantic.
- It's romantic?
- Yeah!
It pummels you from start to finish.
Exactly. Exactly.
It's like adrenaline is
pulsing through your veins.
It leaves me breathless
every time I watch it.
Oh!
Do you... Do you want to,
like, go for a walk?
Well, it's a little cold outside.
- I'm gonna kiss you.
- You are?
- Uh-huh.
- Okay.
Mm.
- Maybe we'll walk upstairs?
- Okay.
- Yeah?
- Yeah.
- This way?
- Yeah.
Yeah.
Whoa.
- C-Can... Can I help?
- No. Thank you.
I'll get there. I'm okay, I'm okay.
I'm okay. Ow.
Is my hand okay?
Your biopsy was positive
for necrotizing fasciitis.
We had to do multiple surgeries
to remove the infected muscle and bone.
Bone?
I'm so sorry, Jas.
We had to amputate your arm.
No.
No, my... my arm still hurts.
I can... I can feel it. It's still there.
What you're experiencing
is "phantom pain."
Your arm is gone.
H-He told you.
My arm.
My arm is gone.
It's gone and...
and it's... it's your fault.
Get out.
Get the hell out.
I can't.
Neither of us can.
You called it.
Well done.
Thanks for your help.
Finally a believer in the power
of emotional intelligence?
Oh, it did get her parents on board,
even if it's only for a little while.
They believe their kid,
and they're working on
their family relationships.
It's pretty big steps.
It was a nice moment.
But if you think you changed
them, that they'll be
different people tomorrow
than they were yesterday,
then you're kidding yourself.
Right now, my emotional
intelligence is telling me
even you don't believe that.
Kitchen's clean,
leftovers are in the fridge.
How you doing?
Fine.
I just got a little lightheaded.
Balance isn't quite back to normal.
Well, now that you're
feeling a little better,
you want to watch "Raging Bull"?
No.
Okay. Another time.
No.
I can't do this.
We can take it slow.
I'm... I'm happy to just
be here with you, like this.
No. I can't... I can't be here like this.
I-I-I don't want you to f...
I just... I don't want to...
I'm sorry. I just...
I need you to go, please.
Jas practiced violin
every day since she was 5.
She put all her faith in me
to do the right thing, and...
I thought I did. I...
Shaun didn't care. He...
He didn't see her dreams.
He just saw her symptoms.
Sometimes that'll be the wrong choice.
My second year in the program,
there was this resident.
She was kind of weird.
She wore comic book T-shirts,
always ate the exact same lunch.
But she was smart.
She would get surgeries and
knock 'em out of the park
over and over again.
Couldn't stand her.
And one day I realized
I was competing against her,
but she wasn't competing against me.
She spent her time observing,
asking questions,
preparing herself to be a great surgeon.
Is she?
Dr. Lim is one of the best
trauma surgeons in the country.
- Dr. Melendez.
- Dr. Browne.
Dr. Lim.
Nice save today.
I heard. Yes, good work, Dr. Browne.
Thank you.
Good night.
You know she showed bad judgment.
You got something to say, just say it.
Want to grab a beer?
Yes.
Hey.
Are you okay?
Yes.
I'm so sorry for my outburst yesterday.
I'm fine now.
I'm not, Shaun.
Coming back to California
and starting a new job
and moving in with you...
it's been so stressful,
harder than I anticipated.
You're moving out.
No, I'm not moving out.
We are still figuring out
each other's quirks.
Oh, yes.
You're very difficult to live with.
I know I forget stuff a lot,
and sometimes I snap and yell.
I promise to work on that.
And I don't need you to change,
but I do need to know that you know
you're annoying as hell.
I need to know that you'll
try to compromise.
I don't think I can use
one-ply toilet paper.
Oh, no, you were so right about two-ply.
Totally worth the extra $1.50.
But maybe the cups can go
to the right of the plates.
Sometimes.
Well, everything's unpacked.
We're officially moved in together.
I'm gonna take these down
to the recycling.
And I know I probably didn't put
everything in the right place,
but maybe we can rearrange it together.
I like that idea very much.
♪ All I am is all I need
I like that idea very much.