The Good Doctor (2017–…): Season 3, Episode 2 - Debts - full transcript

Previously on The Good Doctor:

- We had the clinic at the hospital.

Come back as president
and we'll reopen it.

We need to go to HR and break up.

I've accepted your explanation
and report.

- Thank you.
- But I don't believe it.

You don't get to lead surgeries
until fourth year. That will be changing.

When the right surgery comes along,
it'll be yours.

I want you to meet our new attending,
Doctor Marcus Andrews.

Pleasure to meet you.

You had a date last night,
didn't you?



It was hard, uncomfortable, unpleasant.

And I have no idea if she was happy.
And I know I wasn't happy!

- I don't like when you do that.
- I know.

But I did it anyway,
because you need to snap out of it.

- The moping, it accomplishes nothing.
- I'm not moping, I'm eating.

Which is the only thing you're doing
outside of your room now.

You didn't even come out to tell me
to turn down the Talking Heads.

- It didn't bother me.
- The walls were shaking.

I'm surprised the cops
didn't show up.

You like Carly. You need to get
back in the saddle,

and luckily, you have
a totally awesome roomie

- who's here to help you.
- I'm not going on any more dates.

Shaun, everyone gets it.

Dating is stressful,
but being alone is worse.



I'm not alone. I have you.
I have Doctor Glassman.

Friends are great,
but everyone needs a special friend.

I don't.

- Shaun, I just...
- I'm not like everyone.

No one is like everyone.
We're all unique.

But we're also the same.

I had rent control.

The only way for them
to jack the rent is to get me out.

So they make up a reason.

Said that I was playing my music
too loud.

And all-night parties,
fighting with neighbors,

wandering around the parking lot
without clothes?

I had a robe on!

And I wasn't wandering,
I was trying to take the trash out,

but they moved the damn bins.

- It was windy.
- Mom,

you are clearly off your
meds and drinking.

Okay. Was.

It was a temporary setback.

Nobody's perfect,
but it is under control now.

People under control don't show up
at 1 a.m. looking for a place to stay.

I will be out of your hair
before you even know. Two weeks.

- Three, tops.
- One!

I don't have time
to babysit a grown woman.

Three weeks until the end of the month.
You owe me that.

No, I don't, actually. One week.

- We need help!
- Male, 30s,

10-centimeter laceration
to his left cheek.

Probable fractured temporal bone,
maxilla, definitely shattered mandible.

What happened?
- Tried to stop a creeper

from groping a woman.

Bashed his skull in
with some skateboard.

Wheels broke off
and the metal axle... did that.

Okay, secure his airway, his mouth
is filling up with blood. Intubation cart.

Through-and-through oral defect

and the mandible is crushed.
We need hemostats.

- The woman?
- She's fine.

Cops arrived, Tased the dude,
took him away.

Everybody's fine except the hero.

We need to intubate through the neck.

Betadine, scalpel, 6-0 tube
to place surgical cric.

Doctor Brigham to 435.

Doctor Brigham to 435.

Could you take this up to Lim's office?
I'm running late.

No problem.

Melendez is waiting.

Sorry, had to help Kellan
with a biology project.

- What's in the box?
- A Ducati throw pillow.

- Think you can bribe Lim with a pillow?
- I'm not bribing her, I'm being nice.

Starting a new
job in a new office.

She'll decide who
gets first lead surgery.

I don't think I can influence
her decision with a gift...

but it never hurts to have
a relationship with your boss.

And it's a damn cool pillow.

Hey.

No signs of any post-op infection.

There's also no sign
your surgery did any good.

Tom!

- How often is he vomiting?
- After every feeding.

Okay. Shh...

This is not the outcome we hoped for,

but a pyloric stenosis
requires a cautious approach.

If we're too aggressive...

It's okay, buddy.
I got you. There we go.

Shh...

- Hold on.
- Our baby is in pain.

He can't eat
and you don't have any clue why.

I would be upset too if I were
in your position, but you're wrong.

We need to conduct tests
to confirm, but I am confident

it's a matter of going back in
and making an adjustment.

Your son's in good hands.

Thank you.

- I'm sorry, I'm...
- A father who loves his son.

You've got nothing to apologize for.

That was impressive.

Get an abdominal ultrasound
to confirm

it's just an incomplete
pyloromyotomy.

You're wasting your ass-kissing.
First surgery isn't his decision.

No, he's just the one sleeping
with the one making that decision.

- Pupils are equal and reactive.
- Do you know where you are?

And do you know
how you ended up here?

Josh, you have multiple fractures
in your cheek and jaw,

and a large piece of your cheek tissue,

skin and underlying muscle was torn off.

You're going to need extensive
reconstructive surgery

to save your jaw function.

You need to read these consent forms,

and if you have any questions,
write them on this pad.

Was the woman on the subway
a friend of yours?

He's a fool.

Trying to prove how macho you are
can get you killed.

Clamp the branch
of the inferior alveolar.

So you would just stand by?
Let a woman get groped?

Apply manual compression,
try and close the fracture gap.

Do you help every homeless addict
you see on the subway?

- I don't.
- And neither does Browne.

Which is why she ought not get
so self-righteous.

Yes.

I help my patients
to the best of my ability

because it's meaningful, and to me,
the downside is purely financial.

For friends, I'll risk more,

but the only people
I'm risking life and limb for

are my family.

Someone gropes my wife on the subway,
they're gonna get whupped.

This isn't gonna work.

The mandibular ramus is too shattered
and I can't get stabilization.

We can't do skin or muscle grafts
if we can't fix skeletal structures.

Alloplastic augmentation
to bridge the gap?

The span is too wide.

We're going to wire him shut.

Wake him up.

He should know he's never gonna talk
or eat solid food again.

Forever.

Do you have questions?

I'm sorry.

The Cantrells want a new surgeon.

What can you tell me
about the first surgery?

Is this an M&M review?

Not yet.

Is it possible, you may have been
a little too aggressive?

- Cut too deeply?
- Are you really asking me that?

I need to know.

Definitely didn't go too deep.

Great. We'll talk to the Cantrells.

Audrey...

is this weird for you?

A little. You?

Trying not to let it be.

Good. Me too.

Hello. I'm here to pick up
artificial dermal regeneration templates.

Let me get it. Hey, Shaun.

I heard what happened to the guy.

It sounds horrible.
Is he gonna be okay?

He won't be able to eat
or speak normally ever again.

- Thank you.
- Shaun.

You seem a bit uncomfortable.

If it has anything to do with our date,
I want you to know, I had a good time...

and hope we can do it again.

I had... a horrible time...

and... don't want to do that ever again.

Extensive swelling.

But within the acceptable range
of post-op edema.

The very top of the range.

I think maybe Melendez
did go too deep,

- injured the pylorus.
- Well?

The swelling is within the acceptable
range for a post-op edema.

Got your muffins. Delicious.

- I'm glad you liked them.
- I did.

Just surprised you thought
I could be bought.

We're not trying to buy you off
with muffins or a pillow.

Someone got me a pillow?

No. I wanted to show
my support for your promotion.

You're all gonna lead surgeries.
Doesn't matter who does anything first.

The only thing that matters
is that you do it right.

So, what was in the box?

Sample marketing pamphlets.
My buddy owns a print shop

and asked me to give Lim samples.

Well played.

But it's all moot anyway,
it doesn't matter who goes first.

Right.

So I'm clear, that "right" was sarcastic?

Right.

Hey.

Since when does the president
need to stock his own shelves?

When it's a free clinic
and want it done right.

Thank you.

Have you ever had sex in the office?

I'm not gonna answer that.
First, it's embarrassing if I say yes.

And it's even more embarrassing
if I say no. I take the fifth.

If we're gonna get
married, I need to know all your naughty...

I brought us lunch.
I know what you each like.

Doctor Melendez
is not just our best surgeon,

he's one of the tops in the country.

With the expertise to know
the best way to avoid

a truly bad outcome in this procedure
is to err on the side of caution.

- We hear all that.
- We do.

And we appreciate you
taking time to explain everything.

But we would just
be more comfortable

having someone else take over.

You do understand.

Of course.

I assume you'd be okay if I performed
Braden's second surgery?

The chief of the department? Uh...

Absolutely. Thank you, doctor.

Of course.

Nobody likes dating.

It's awkward and uncomfortable
and it's expensive.

Ah. That's why you proposed
after two dates, to save money.

I proposed after two dates
because after one,

I realized how much
I loved being around you.

And how much fun
we'd have together.

He's right, Shaun.
Because the fun can be so fun.

That didn't happen to me.

I have to go to surgery.

Shaun, whenever you're ready,
you'll try again.

- What?
- Whenever he's ready?

He's gotta go at his own pace.

- He needs to be pushed.
- I'm not gonna push him.

A man doesn't push another man
into a date.

- He pushed you.
- Shaun doesn't know any better.

If you want him to find love,

he literally needs to be
pushed into it.

Literally?

Shaun's not like other men.

He easily admits he's wrong?

He easily changes course?

If you don't talk to him,
is anything gonna change?

No good deed goes unpunished.

Why does it always work out that way?

It doesn't.
Most good deeds get rewarded.

What do you base that on,
Murphy?

Certainly not the news or the Forbes 500.

- Or the Bible.
- I base it on neuroscience.

Bad outcomes just implant deeper
in our cerebral cortex.

So evolution agrees with me,
our brains encourage us to be selfish.

Yes, which makes it strange
that people keep being unselfish.

You were.

You saved my job,
and now you're an attending

instead of the president.

Screws and wire ligature.

We're not doing this.

We can do better.

There is no other procedure.

We'll invent one.

Truce during surgery.

- Fair. What about procedures?
- Imaging is fair game.

Anything invasive, we go to our corners.
I left my keys.

- Losing my mind. I'll see you tomorrow.
- Night.

What about a muscle graft
from the temporalis?

Well, that wouldn't address
deep mucosa or bone.

Unless we took
an osseocutaneous free flap

from the radial forearm.

We'd need two inches

and could use the natural concavity of...

And lose the use of his hand.

That seems like a reasonable trade-off.

I'm not telling this guy
we can restore his speech,

- and all it'll cost is his hand.
- Because he's a hero?

What he did has nothing to do with it.
It's what we can do that matters.

What we can do is what we were doing.

That's the protocol.

Aren't we risking more damage
leaving him in a bed

while we try to invent
a new treatment?

How about attaching
two free flaps on vessels

on either side of his neck.

Heard from Claire you were having
an all-hands-on-deck sesh.

- Happy to join.
- Good.

- How about Park?
- He left.

Said he had a thing with his son.

I don't have kids,
so extra hours, not a problem.

Have you considered
allograft augmentation or a...

Heard y'all were working late,
so I got coffee.

Any way I can help?

I wanna talk about the Cantrells.

On date night?

Can it wait 10 and a half hours?

- I guess.
- Thank you.

Ever been to The French Laundry?

- No.
- We should do a weekend in Napa.

I know this great B and B
south of Saint Helena...

It's not about the Cantrells,
it's about what you said to them.

Has it been 10 and a half hours already?

I erred on the side of caution?

- Caution is a good thing.
- Err isn't.

- I didn't err. Not at all.
- I was going to bat for you.

You're so afraid of appearing to favor
your boyfriend you're overcompensating.

Given I think you may have erred,
I'd say I was incredibly supportive.

You went against better judgment
to favor your boyfriend.

So I'm too supportive
or not supportive enough?

Should I change the reservation
to two tables for one?

I've had plenty first dates
that were actual disasters.

Took one woman to a Coyotes game,
saw four minutes of it,

spent the night in the ER while she got
17 stitches after being hit by a puck.

Got married eight months later.

Then you divorced her.

It was worth it.

We don't have a choice.

Evolution needs us to propagate, so it...

gives us a shot of happiness
every now and again

to suck us in like idiots.

To keep us in a game that we know
we're gonna lose almost every time,

because the upside's like...

nothing else.

Love.

But if Shaun really
doesn't need to play, then...

good for him.

We've officially turned into
an episode of The Bachelor.

Everyone, go home.

- I'm not tired.
- I am.

No, there are still
a number of possibilities...

Murphy, you are smart
and you're creative,

but there are things...

you can't do.

You can't do miracles,
you can't fix the unfixable.

Hey, baby.

You work way too hard.

Yes, I do.

Let me get you something to eat, I made
some pulled pork and peanut coleslaw.

No, thanks, Mom.
Did you find a place?

I saw one, but it was nasty.

- You must be hungry.
- You saw one

and then you came home and cooked?

Yes. I came home
and cooked dinner for my daughter.

I'm trying, Claire.

Okay? I'm taking my meds,
I'm seeing Doctor Donovan.

I am doing my best.

I've heard that before.

You got six days.

Shaun, you need sleep, your neurons
will be sparkier in the morning.

There are 640 muscles
and 206 bones in the body,

but only 284 and 72 of those
are of sufficient size

for our grafts, but that still leaves
20,448 possible permutations.

It's not unfixable
until I rule out every...

So some anatomy problem
you won't give up on,

but after one date,
you think you've explored

all the possible permutations?

- Stop distracting me.
- I'm distracting you?

By talking about you? About love?

Yes. I... I need to concentrate.

Okay. I'll shut up.

- You're still talking.
- Good night, Shaun.

- You're still...
- We only have 206 bones?

- Still talking.
- Oh.

Yes.

Shaun?

I think we should talk.

So did Lea,
but I have to find a solution

for an oromandibular defect
that doesn't involve titanium plates,

356 of our muscles
or 134 of our bones.

I don't think you never want
to see me again.

I have to find a solution
for an oromandibular...

We have to talk.
You owe me that much.

Why do I owe you that much?

Because I thought we had a nice time.

And I thought you were a nice guy.

An honest guy,
and I still think you are

and I'm confused about how you feel,

and about how I feel about how you feel,
and I just need to talk about it.

So if you have feelings for me at all,
help me understand.

Okay.

My little sister Andie has autism.

We're not all the same.

I know.

I think growing up with Andie
helps me understand you.

But it also makes me wonder
about myself.

Did I date you to prove something?

Did I date you to somehow
make things better for Andie?

I don't think I did, but...

My point is...

I have questions too, Shaun.

Trying to figure out what we want,
and why we want it,

and is it good for us,
are good questions.

And they can't all be
answered over one dinner.

I have to go.

Murphy...

I've... I've got it!

I've got it!

We take a vascularized
free flap and suture it

to the facial artery and vein,
then flip up the pectoralis.

It's a great idea.

We're not doing it.

It's never been tried before.

Risk one, graft failure brings infection

and he loses the other half of his face.
Risk two, sepsis and he dies.

- Three...
- Yeah, yeah, whatever.

We do the standard procedure,
the guy never speaks or eats again.

Doctor Murphy,
could you give us a minute?

Why do you want to do this?

You've been my boss for a few hours

and you're questioning my motivations?

You fell on your sword
for Shaun and your

reward for your heroism was getting fired.

And now you're back here
answerable to me.

I imagine you've been
asking yourself if it was worth it.

Your issues with the procedure are valid,

- but let me put them before the patient.
- He'll say yes.

- I won't sugar-coat the risks.
- He'll say yes anyway.

He wants to believe things will work out.
That's why he's a hero.

Sometimes the hero loses.

Which is why he's gotta learn
when to stand back...

when there's nothing
he can do to help.

Are you gonna order me to stand back?

No.

Hey, Shaun, you got a minute?

Okay.

Debbie wanted me to talk to you.

To tell you... not to give up on love.

Don't give up on love.

Okay, do you want me
to let her know you told me?

Yes, please.

Hey, Shaun?

I know this dating thing can be scary.

You're good at dating?

Well, before Debbie,
the last time I went on a date,

"Wake Me Up Before You Go-Go"
was the big hit.

Because after Maddie and the divorce,

I kind of shut down for a while.

Yeah, and it felt better to be
in a place where I couldn't get hurt.

But then last year, I got my diagnosis,

I thought I was gonna die
and Debbie came into my life

and I said to myself,
I don't want to be safe anymore,

you know? I want... I want to...
I want to feel alive.

And... And if I get hurt, I get hurt.
That's part of the deal.

Morgan says it's biological,
that it doesn't make sense.

- Morgan's right.
- So I'm right?

No. No.

Look, it... it's wonderful,
this love thing.

Why should it make any sense?

When I think about the reasons
I'm in love with Debbie,

okay, she's... She's kind, she's funny,

she's... She's loving,
but that's not it, not really.

Heh. Don't tell her, but there are
other people that are kinder, funnier,

that are more loving than she is,
but she makes me happy.

Just being around her,
makes absolutely no sense...

but I wouldn't trade it for anything.

Okay.

I have an ethical dilemma.

I was going through state regulations
for medical staff, specifically residents,

and their new guidelines
have raised an issue for me.

The state caps residents at 80 hours
a week, but I don't think that's enough.

I work over a hundred
and I don't plan on cutting back,

so I'm wondering how I
should be reporting my hours...

Park offered to co-write a paper with me.

- What a suck-up.
- I said yes.

It's an interesting case,
it should be written up.

- So he's...
- Gonna do a lot of work for nothing.

Except for the good
of the medical community.

I'm gonna tell you what I told him.
You come with one more favor,

one more humblebrag, if I suspect
either of you have lips puckered,

- you're going to the bottom of the list.
- Yes, ma'am.

Doctor Lim...

do you ever think about
what it means, me doing all this?

Means you've underestimated me.

Maybe.

But it also means that I care.

That getting the first surgery
means something to me.

Enough to go out and overspend

on designer desserts
and then spend even more time

trying to make them look homemade.

If I'm putting that much effort
into muffins,

imagine how hard I'll work to make the most
of this opportunity if it's given to me.

With considerable
physio and speech therapy,

this graft would allow you to not only
chew and swallow whole foods,

but it would enable you to talk again.

It's an untested procedure
with not insignificant risks.

If the graft doesn't take,
more skin and bone

could become infected,
possibly necrotic.

- We need to know you understand.
- It's an experimental procedure.

In addition to all
of the usual surgical risks,

there are all of the unknowns.

Bleeding out,
permanent graft loss, stroke...

death.

Good for you, Josh.

Get him prepped.

Okay.

Infuse carbon dioxide.

Grasping duodenum distal of the pylorus.

Huh.

- Look at that.
- That's not good.

Page Doctor Melendez.

An intussusception.

Telescoped bowel
is causing a blockage.

The baby had two unrelated conditions
causing the same symptom.

We only know about the second
condition because of the first surgery.

Treatment protocol's a barium enema,
but not for someone Braden's age.

- An air enema might work.
- Unless the intestine's torn.

Morgan, reposition the scope
to get a better look

at the intestinal wall
around the intussusception site.

Too much swelling and edema
to be sure.

With the risk of infection,
we don't have time to find out.

- You're gonna have to open him up.
- You should.

The Cantrells made their wishes clear.

Well, that's when I made them think
you'd erred. Which you did not.

Not on the side of caution, not at all.

We do the surgery together.

- Who's the lead?
- I think you know.

- Pulling rank?
- Absolutely.

As chief of surgery, I designate you.

It's like a puzzle.
You secure the artery,

then the vessel
just won't quite stretch to the vein.

You could mobilize
the recipient vessel.

Repeat that, Doctor Browne.

Mobilize the recipient vessel
to create more slack.

- You saw Carly again. How was it?
- Inconvenient.

But despite her intrusion,

I was still able to concentrate
on medicine.

It wasn't an intrusion,
that was a date.

It was walking.

Walking with someone you like
who likes you too is a non-date date.

Some of the best dates I've had

did not involve flowers
and restaurant reservations, just

sharing a bag of chips
and sitting on a couch.

Secured. Remove clamps.

Blood flow to and from graft.

Let's move on
to the pectoralis flap.

- Blood pressure's dropping.
- Okay, heart rate is up.

Push IV fluids, give epinephrine

one milligram, then start a drip.

- There's intestinal wall perforation.
- Repairable?

There's too much tissue damage.

- Infection?
- No sign of peritonitis,

but we'll need to remove
this section of bowel.

- He's tachy.
- Hypotensive.

Push vasopressors and antibiotics.

Check an i-STAT hematocrit,
ABG. Give two units PRBCs.

I don't see any major bleeding.

Push more fluids,
start an inotrope.

Check all vessels we worked
on for clots with the doppler.

Okay.

Large clot in the carotid.

Clamps back on,
performing carotid arteriotomy.

Will try to aspirate out the clot.
Standby with heparin.

Carotid clot removed.

EEG looking good.

Resuming pectoralis flap dissection.

Good work, everybody.

Go ahead, say something.

Yeah, you can talk.
Maybe not too much at first,

give the jaw a chance to heal.

Thank you.

On behalf of all of us,
you're very welcome.

The woman who was being accosted
when you intervened is here.

Is she all right?

She's not here as a patient,
she's been waiting to see you.

Okay?

Hello.

Hey.

I am so sorry this happened.

Me too.

You look...

When the swelling goes down,
he'll look a lot better.

It's okay.
My face was never my fortune.

What made you do it?

Why did you step in?

I don't know.

You needed help.

Olivia, by the way.

- Josh.
- We'll let you two get acquainted.

It didn't matter who got
the first lead surgery to me,

but it's recently been brought
to my attention

how much it might mean
to some of you.

Seems I'd forgotten
how important this decision is

when you've been dreaming
about it for years.

You're all excellent candidates,

each deserving
and will all get your turn.

- Starting with Doctor Browne.
- Yes!

Thank you.

- Congratulations.
- Thanks.

- What the hell was that?
- I was happy for a colleague.

You weren't campaigning for you to win,
you were campaigning for me to lose.

Do you dislike me that much?

I just wouldn't want you
supervising me as chief resident.

You'd be a nightmare of a boss.

Shaun...

Doctor Lim thought my motives
for fighting this hard

for this patient were miscalculated.

She was right.

We shouldn't have saved his face?

We have limited resources
and we're even more limited

in our personal capacity
to determine who is deserving,

so we make a choice
to treat everyone the same.

So why did you treat
this patient differently?

Because I was angry.

I made a sacrifice to save you.

I lost my job,
I took a substantial demotion

and I thought I was a fool.
The cost was way too high.

I resented you
and I, kind of, resented the universe.

But today...

you made me proud of my sacrifice.

Thank you.

You're welcome.

Very few things that are worthwhile in life
come without a cost, Shaun.

This is tricky.

I feel like we were just tested
and both of us failed.

But... we'll get better at this.

Hey, honey. I'll make you a plate
and you can take it to your room.

Thanks.

I saw three more apartments today.
One was kind of nice,

but it's not ready
until a week from this Tuesday,

which puts me
over your deadline by three days.

No.

- Three days, come on.
- You can stay here.

For a little while,
until you're a bit better.

But you have to stay on your meds.

Keep away from other drugs and alcohol,
I'm testing your urine every two days.

Don't miss any appointments
with Doctor Donovan.

Can you live with that?

Do you have a couch?

♪ You held the balance of the time ♪

♪ That only blindly I could read you ♪

♪ But I could read you ♪

♪ It's like you told me ♪

♪ Go forward slowly ♪

♪ It's not a race to the end ♪

♪ Well, you look like yourself ♪

♪ Only it ain't on the surface ♪

♪ Well, you talk like yourself ♪

♪ No, I hear someone else, though ♪

♪ Now you're making me nervous ♪♪