The Good Doctor (2017–…): Season 3, Episode 19 - Hurt - full transcript

Previously on The Good Doctor:

Ready to tell me what's on your mind?

I think I'm in love with my boss.

I have rheumatoid arthritis.

I wanted you to know and no one else.

I've been thinking
about synovectomy surgery.

It'll resolve the pain temporarily,
then what?

It'll give me at least 10 years.

Then you're gonna be bone on bone.
What's your plan then?

I understand you're leaving surgery.
That's tough, but it's the right call.

No, I don't think it is.



I'm doing the surgery.

You don't tell me anything
about your life.

- Because you don't wanna know.
- That's not true.

You don't wanna feel guilty
about being a thousand miles away.

You just wanna know that I'm okay.

I love you, Lea.
I want to be your boyfriend.

I'm a challenge for anyone.

I just know
it would be too hard for you.

You have to give me a chance.

- You need to let me try...
- No.

- I will fix it.
- You're autistic. You can't fix that.

You acted like you cared about me,
but you don't even respect me.

You're going to end up alone
and you deserve it!

Because you're a superficial,
selfish and prejudiced person!



Uh, two lychee Kölsch, please.

- Lea? Hey.
- Hey.

I saw the invite at the clinic

and I assumed you wouldn't be here.

Here with a friend?

It's been a rough couple of weeks.

Hey. They're here.

- The guys who made this all possible.
- I don't know about all that.

Yeah, well, you try opening a brewery
or fundraising when you're dead.

Oh, honey, you remember Dr. Melendez
and Dr. Glassman.

- This is my wife, Noreen.
- Aaron, hi.

- This is Lea.
- Your flavor profiles are epic.

- How about a tour?
- Uh, yes.

Okay, great. Come on.

- Marta.
- Carl.

She is in host mode.
We could be here forever.

I'll show you around.

The hops in the Kölsch,
is that the Citra?

In combination with the Noble German.

Lady knows her stuff.

Do you feel that?

It's an earthquake.

Get out of there!

Lea!

- Hello.
- Thank God.

- Are you okay?
- I'm fine, I think.

- The ceiling caved in.
- Were you hit? Are you bleeding?

Not as far as I can tell.

Just some bruises.

The brewing tanks fell over.
One went right through the floor.

And Glassman? Wasn't he with you?

I was, yeah.

Your shoulder, it's dislocated.

Yeah.

I'm okay. Noreen?

We're okay here.

I'm about to assemble a HURT team.
Any idea how many wounded?

No. Let me check.

Come on.

Lea.

Get here as fast as you can.

The hospital is on mass casualty
incident protocol.

Cancel all elective surgeries,

transfer noncritical patients
to urgent or chronic care facilities,

no family members or visitors
are allowed in the ER.

Gonna need all the space we've got.

Use the waiting room
for patient overflow.

Our HURT Team, which I'll be running,

has been assigned
to the Bold Statement Brewery,

- which collapsed during a charity event.
- Melendez and Glassman went to that.

I spoke with Melendez. They're both fine.

That's two out of approximately 100.

Park, Shaun, Claire, with me.
Get the equipment packed up.

I wanna be on the road
in three minutes.

Cover Surgery.
I'll get another attending on the ER.

I'll do both.
I used to run the whole hospital.

It's just a cut. You'll be fine.

I need to focus
on medical emergencies.

Cuts and scrapes do not qualify.

My colleague and I will be com...

- Lea?
- Door to the brew hall is totally blocked.

- Dr. Melendez.
- Noreen.

Marta!

- What hurts?
- My back.

I'm going to need a towel and tape.

Glassman and I
need every first aid kit you've got.

Go.

Hold still. You're going to be okay.

I'm going to stabilize that leg, sir.

Hold on a second.

Sir, please put the light
on your leg.

- What was that?
- Hold still.

What if there's an aftershock?
The whole place could come down.

Just hold still, please, sir.
Just hold still!

Just please sit down.

Hey, you guys.

Head across the street.
You'll be okay there.

Maybe about 40 people inside
in need of treatment

or some kind of onsite evaluation.
Where do you need me?

- The hospital. We're short on surgeons.
- Okay. Shaun...

Lea was here.

- Where is she now?
- I don't know.

She was inside
when the tanks fell down.

But first responders
are gonna find her. Shaun?

Jack's in place. Let's lift it.

- All right, she's clear.
- Melendez?

Fifty-year-old woman,

medical history includes spinal tumor
resection, C1 through 3 fusion,

complaining of severe back pain.

Where were you hit?
Are you dizzy? In pain?

I'm fine. A beam fell,
hit me on my side, knocked me down.

Let me see.

I'm fine.

Let me see.

I'll lay off working my obliques
at the gym for a bit.

Ow.

- How much did that hurt?
- No more than it should.

You're gonna need a full evaluation.

I'll go with Marta back to the hospital,
get checked out.

Where was Lea?

In the brew hall,
but it's completely blocked in.

Glassman and I already tried it.

The danger of spinal fracture.

Let's get a real cervical collar
on her and get her onto the board.

Stop.

Don't touch her.

You winced when they touched
your neck. Did your right hand hurt?

Yeah, like it was on fire.

It's not just a fracture.

Something is pressing
on her spinal cord.

The move to the board
could shift the object,

leading to permanent paralysis.

I need to find Lea.

Get the battery-powered X-ray.

Lucky there weren't more books
on that shelf.

Bay one, 500 milligrams
IV acetaminophen

and page Calderon in Pedes.

Reznick, no, you had surgery
on your hands 48 hours ago.

I don't need them to triage.

We need a surgeon.
Construction worker.

Through and through impalement,
point of entry is his pelvis.

BP 111 over 84. Pulse 107 BPM.

- Pupils?
- Ignore her.

- Normal and reactive.
- Right now, she's a patient, not a doctor.

- Motor exam? All right, thanks.
- Normal.

I'm concerned about the iliac artery.
Check his femoral pulse.

- I was planning to.
- Unh!

Okay, okay, okay.
Right leg is strong.

Left is thready.

Ultrasound his leg to confirm.
His abdomen too.

Look for additional damaged vessels.

Then take him to OR 2 and page Cohen.

There could be a lot of vascular injuries.
Do his surgery, while I help with triage.

Dr. Reznick, I don't need
or want your help.

You have a habit
of withholding key details

from your attendings as it benefits you.

Go to bed.

Lea? Lea, can you hear me?

Help.

Shaun, we need you on triage.
Let the professionals...

- Shh. Okay.
- Help me. Under here.

Someone is down there.

Someone's down there,
but it's not Lea.

- We need Fire and Rescue over here!
- Coming down.

Shaun.

It's right up
against the spinal canal.

The C2 screws we used to fuse
the vertebrae once the tumor was out.

That doctor was right?
I could end up paralyzed?

I'm afraid so.

So, what are we gonna do about that?

We could remove the screw here.

No. You can't operate on my wife's spine
in the middle of this.

It would have its risks,

significantly more than most surgeries.
But Dr. Browne's right.

If we don't remove the screw here,

it's likely you'll be paralyzed
from the neck down.

Take it out.

Lea!

Lea!

Are you there?

- Can you hear me? Lea!
- Please help!

Lea, it's me. Lea, it's Shaun.

Lea...

- Shaun, help.
- Okay.

Hey! This area needs to be stabilized
before any medical personnel...

Lea!

I think I'm stuck.

Okay.

Lea, I'm coming.

Okay.

I am not afraid.

I am not afraid.

I am not afraid.

Of course you are.

You know why?

Because this is stupid scary.

Dispatch rerouted us to Good Sam
for some reason.

I put us on diversion. Too many patients,
too few surgeons.

Now you got two more patients and one
more surgeon. Which procedure?

Pelvic fracture can wait. Bay seven.
I'm overseeing the ER.

Someone has to.
Doesn't have to be you.

Morgan texted me,
she's offered to help.

Hands free.

- I'll handle the ER, you two go cut.
- Who's going to treat patients? Siri?

The nurses. I'll tell them what to do
and then oversee every move.

Running this place isn't a job
for a third year,

even on days without an earthquake.

Well, we've had an earthquake,
there are no options.

Morgan, you be careful
with those hands.

- You could screw them up for good.
- Understood.

Petringa! OR 3.

What were you doing
in a brewery anyway?

I was just sitting at the bar,
having a beer.

- Now I'm trapped under it.
- You're not 21.

I'd show you my ID, but my pockets
are kind of underground right now.

We should let your parents know.

I'm fine. It doesn't even hurt.

You should have someone here.
Mom, Dad...

My mom's dead.

My dad's on a plane.

Do you know the flight number?
We can get word to him.

If my son was in your situation,
I'd want to be there,

no matter what else was going on,
or how he got there.

My dad already thinks I'm a screwup.

And this doesn't exactly
disprove that.

Just get this off me.

Call me a bitch.

Call me a bitch.

We're going to clear this ER
and get the hospital off trauma diversion.

With a patient in every bed
and a doctor with zero hands?

Actually, I've got eight.

You guys are going to do exactly
what I tell you.

I ask you to probe two inches to the left,
I don't mean 1.5 inches or 1.7.

I have you debride a wound,
that's three Betadyne swabs, not two.

I don't care what shortcuts
you've picked up.

I will not say "please,"
it is a wasted word.

I will not say "thank you,"
I will be moving on.

I will be a bitch,
so may as well call me one now.

Bitch.

- You're a bitch.
- Bitch.

As a feminist, I'm not...

- Say it.
- Bitch.

Nice. Let's get to work.

You should be up there
doing your job. Not down here.

- Lea needs me.
- No, she doesn't.

You think rescuing her will make her
fall in love with you. It won't.

You're being...

- You always said I could do...
- Because I believed in you.

Right now, I don't.

She doesn't love you. She told you.

She thinks you're limited.

You are.

You're not her hero.

Please help.

We need a central line,
endotracheal tube,

bag mask, portable oxygen,
anesthesia...

We've got midazolam.

That combined with the morphine drip
should work.

Noreen?

Don't do this surgery, please.

I can't lose her. Not this soon.

When Marta was with her husband,
she was miserable, she didn't know...

We're not the ones to persuade.

Sorry.

I will push your wheelchair,
I'll wipe your mouth, whatever you need...

and be glad for every minute of it.
Because...

you will still be alive...

and we'll still be on our adventure.

Five years...

that's... it's just not enough.

- So greedy.
- Marta, please.

Thank you for being willing
to take care of me again.

Five years isn't enough.

However long I have with you
will never be enough.

I only found you
once I stopped listening to my fear.

Fear of hurting my husband...

being thrown out of the Church,
of dying alone.

Pushing all that aside
made room for you,

and you are my life.

Dr. Melendez saved me once.

He's gonna do it again.

Be brave with me.

Okay.

You found me.

Hmm.

I'm Dr. Shaun Murphy.
I'm here to help you.

What's your name?

Vera.

- Where does it hurt, Vera?
- Everywhere.

But mostly the shoulder...

Take a deep breath, please.

Your lungs are fine.

- Can you feel your hands?
- Yeah.

That means you have no nerve damage.

It missed your vital organs.

I can remove it
without risking permanent injury.

That's good news.

This is bad.

When I cut, brace this.

Her neck cannot move at all.

Making initial midline incision
to posterior neck.

It'll take time
before we can move that bar.

Fine. We need to get a sense of the kid's
injuries before you do anything.

I need to get under
there and take a look.

Follow me.

Asthma and dust inhalation.
Bad combination.

Take deep breaths.

Higher. Higher.

Where her lungs are.

- You're the one who can hear them.
- There.

Deeper.

Trying. Just... can't.

That's probably because your lungs
are hyperinflated.

Start nebulizer, albuterol and oxygen
at eight liters per minute.

Why are you using plaster of Paris?

Told me cast her arm, you didn't tell me...

To use fiberglass, which takes half
the time and is twice as effective?

I wasn't aware I had
to instruct you on common sense.

Bitch.

Can I speak to Dr. Lim, please?

Shaun, where are you?

I found a woman with shoulder
and leg impalements.

I'm going to extract the shoulder,

but freeing the leg could sever
the posterior tibial artery.

- That sounds bad.
- You would die.

- What's the leg impaled on?
- Mm. It appears to be steel rebar.

We'll send down a firefighter.

Once they've sawed through the rebar,
they'll transport her up.

Keep this channel open
so I can hear you.

- Have they found Lea?
- No, they're still searching.

Okay.

Aaron, can you head back to the ER
when you finish?

Not unless you can take

the transected aorta
being prepped in OR 3.

I've got a myocardial contusion
and tamponade in 2.

Ceiling fan fell on this guy's chest.

I'll see you on the other side.

Yeah.

- We've got a bleed.
- Clamp.

The hardware tore a muscular branch
of her right vertebral artery.

I can't find the bleed without suction.

I see it.

Vitals are stable,
but she's lost too much blood.

We can't keep cutting
until we give her a transfusion.

Check all local hospitals
and blood banks.

See who can get us O-negative, stat.

There might be another way
to transfuse her.

So I'm 16, in my dad's car,
a dime bag in my pocket,

- and a cop approaching...
- Did you get arrested?

Hey, let me tell the story.
It's got a beginning, middle and end.

- I want the end.
- Better with the middle.

We roll down the window, and the cop
is hit with a cloud of smoke.

She makes us get out,

pats us down,
searches the whole car...

I'll be right back.

Wait, come on!
Don't leave me hanging.

- Come on.
- She didn't find anything.

Our bodies can do amazing things.
Even hide dime bags.

Holy crap, dude.
Wait, did you still smoke it?

- I'll be right back.
- Oh, man, you did. Ew.

How bad is it?

His spine's been severed.

He's lost a lot of blood,

no femoral pulses,
his legs are ice cold.

The bar's basically cross-clamping
his abdominal aorta.

He's gonna bleed out
when we lift the bar.

No, there's gotta be something
we can do.

We can get his dad here
before it's too late.

Inject five CCs bupivacaine,
wait 20 minutes, then pull it out.

You here for me to discharge
our asthmatic?

No. She's gotten worse.

And she's complaining
about back pain.

She fell during the earthquake.
Symptom explained.

Sutures need to be closer.

Add budesonide to her nebulizer.
That should help her breathing.

I think she might be pregnant.

Shortness of breath plus back pain

could be UTI,
kidney stones, or pregnancy.

Urine dip ruled out UTI
and kidney stones.

Her symptoms have nothing to do
with the earthquake?

It's possible.

How can you be both slow and sloppy?

This is my first time doing sutures.

Finish up so I can discharge him.

Stop with the zebra hunting.
Put her on budesonide and clear the bed.

I asked you to be my hands,
not my brain.

Dr. Reznick, I'm over the bitch plan.
After three years of it.

- We're in crisis.
- That you're using to rehabilitate

your reputation with Andrews,
which is fine.

But stop biting the hands
that are your hands.

What are you doing?

Sterilizing the instrument.

Do you know someone with cancer?

Uh...

I'm curious why you were
at a fundraiser for cancer research.

I was there for a man...

one without cancer
or any interest in being with me.

My ex-boyfriend is on the board
of the charity.

Why did you want
to see your ex-boyfriend?

I guess...

I hoped he'd realize he was still in love
with me and beg me to take him back.

- Clever, huh?
- I understand.

I still want Lea to be my girlfriend.

But she doesn't feel the same way?

- I have autism.
- Oh, Shaun, that shouldn't...

Why didn't you warn me?

Studies have shown that anticipation
only heightens pain.

I used small talk to distract you.

Where did you two meet?

Church.

Not a member anymore.

Hey.

Place that in the surgical cavity.

- You made a cell saver out of a...
- Beer engine.

I ran alcohol through it
to sterilize it.

Attach this to an IV.

We're going to pump her own blood
back into her.

We've got somebody down here.

Can you hear us? We're coming.

- Lea. Are you okay?
- I think so.

Hey, how long before you guys
can get this thing off?

We're working on it.

You said your dad thinks
you're a screwup.

Has he actually said that?

No.

The reason I told you that story is...

everyone does dumb stuff
when they're a teenager.

I bet your dad doesn't judge you
nearly as harshly as you think.

My dad doesn't know me,
and neither do you.

Can you stay with him?

That's incredible.

Thank you.

Spend enough time around Dr. Browne,
you get used to incredible.

Okay. Thank you.

There'll be a cruiser waiting to pick
Casey's dad up when he lands.

What if we compress Casey's aorta
against his spine,

create a higher cross-clamp?

You didn't tell him yet, did you?

No.

We could buy time to repair his aorta
after we lift the bar.

- Casey is about Kellan's age...
- This has nothing to do with Kellan.

Yes, it's a 1 percent chance
of success if we do this,

against a 100 percent chance
of death if we don't.

Okay. Prep him.

When will we know
she's going to be okay?

When she wakes up.

Still a risk of infection.
Let's get her stabilized and out of here.

I'm administering the budesonide
and checking to see if she's pregnant.

- I told her I'm on the pill.
- Ever miss a day?

Look at that, an unoccupied uterus.

Prep for discharge.

Can you give me something
for my back pain?

It's bruised from when you fell
in the earthquake.

- Take some Tylenol.
- It's been bad all week.

Muscle relaxers usually help.

Check her tubes.

You're pregnant.

The fetus is developing
inside your fallopian tube.

It's an ectopic pregnancy,
it's not viable.

That's a relief.

But if your fallopian tube ruptures,

it can cause a serious,
possibly fatal bleed.

We'll get you into surgery
soon as possible

to make sure that doesn't happen.

It's gonna be fine.

If we get out of this alive,
let's promise to move on.

You can do better than Lea.

Not that I have any business
suggesting that.

I might die because I'm still hung up
on Paul.

No, I don't want to move on.

If she doesn't feel like...

I always knew
I could be a good doctor.

But until I met Lea,
I never knew I could drive a car.

Or enjoy music.

Or sing karaoke.

Or take tequila shots.

Or fall in love.

I don't want to stop being
the person I am with her.

Lea makes me...

more.

But I don't make her more.

If I did...

then Lea would want
to be my girlfriend.

She's tachycardic and hypotensive.

Abdomen?

- Rigid.
- Her fallopian tube ruptured.

Any chance he can wait an hour?

Rapidly expanding
subdermal hematoma.

It still doesn't hurt. Can't this wait?

- We need to fix something right away.
- Okay.

Whatever you gotta do.

Hey, um, about my dad...

The minute he lands, we'll get him here.

Thank you.

Okay.

She needs a surgeon, stat.

I'm a surgeon.

Harmonic scalpel, DeBakey forceps,

two yankhauer suctions
and vasopressin.

Marta.

Can you squeeze Noreen's hand?

Let's get you to the hospital.

You two, free beer for life.

Aftershock.

We need to immobilize your leg.
Cover your head.

Right, get her out of here.

That was a big one.

Oh. Are you okay?

Yeah.

- Just a little... A little motion...
- Oh!

I need oxygen here now!

You okay?

- What about our patient?
- Vitals stable.

Shaun? You okay down there?

I am okay.

Except for the water.

Please hurry.

Please hurry!