The Good Doctor (2017–…): Season 3, Episode 7 - SFAD - full transcript

Dr. Shaun Murphy's unique ability to relate to a patient isolated by an immune deficiency yields an unexpected result; a 12-year-old patient is about to become blind; tension builds between Dr. Neil Menendez and Dr. Audrey Lim.

Good morning.

That's your third ding.

Good morning. It's Carly.

She has arrived
at her pathology conference.

Hmm.

Hmm.

Shaun, you need to
text her back.

Her text wasn't a question.
It doesn't require a response.

True. But it sucks
to be left hanging.

You didn't like how it felt

when you thought
Carly was ignoring you.



I have received your message.

Sent.

Hmm.

You made me breakfast?

Oh, God, no.
I ordered breakfast.

But I managed to keep it warm.

You don't have to do this.
I'm fine.

Did you get any sleep?

I got enough.

Her death's not your fault.

She knew the risks.

She made a choice
to save her baby.

I bet she'd make
the same choice again,

even knowing how it would end.



Thank you.

Thanks for breakfast.

We do a complete enucleation
of the right eye,

then replace it
with the temporary implant,

and in a few weeks, you'll...

You know why blind people
don't skydive?

It scares
the hell out of the dog.

Let the doctors finish.
Okay, bud?

Yeah, cancer eye out.
Fake eye in.

Just like last time. I got it.

Check it out.

It even moves and everything.

You can't even tell it's fake.

Very cool.
Like a bionic superhero.

Yeah, and my superpower
is tripping over stuff.

What time is the surgery?

3:00.

Which means
I've got six hours left

to blast some aliens.

If anyone utters the word
"Bubble Girl,"

I will transfer
to a different hospital.

When you were his age,

would you have faced
going blind with h-humor,

maturity, and acceptance?

I would have burned things down.

He's dealing with it
in his own way.

We'll check in with him

while you're taking care of
the rest of the paperwork.

Make sure Charlie knows
there's people he can talk to.

Thank you. Thank you.

Dr. Reznick, take
Charlie's blood to the lab.

Dr. Browne, talk to him.

Maybe he'll open up to you.

Heart sounds are normal.
No sign of pericardial effusion.

You are the oldest
SCID-patient I am aware of.

People with your condition
usually die very young.

Yay. I win.

Tara, imaging confirms that you have
infected tissue on your right lung,

that's what's causing
your breathing issues.

And we're gonna remove it with a
procedure called decortication...

And you'll use
the thoracoscopic approach

to decrease risk of infection.

And I'll be in an enclosed
chamber in the O.R. What else?

I assure you, we'll be taking
every precaution to keep you safe.

Dr. Melendez, this building
is a glorified incubator

for every infection
on the planet.

Considering I don't come
with an immune system,

I don't need assurances.

I need you to tell me
how you're gonna not kill me.

We will administer a course

of broad-spectrum antibiotics.

You will be transported to the O.R.
under a respiratory hood.

The room will be equipped
with laminar air flow

and kept at a positive
pressure of 8 Pascals.

Surgical instruments
will be double-sterilized

and all blood products
will be irradiated.

Thank you, Dr. Murphy.

Visitors will also have to go
through a strict decontamination...

There won't be any.

The less time I spend
with people, the better.

Are we done?

How'd your talk with Charlie go?

He wants to be left alone.

No, you want to be left alone.
And yet here we are.

Precocious pre-teen going blind.

Come on, that's Claire catnip.
You have to talk to him.

Did he have any tests scheduled?
No.

No one's seen him, heard him, smelled him.
I'm calling Security.

Hold on. What are you doing?

Where's Charlie?

Did something happen?
Is he okay?

He's in imaging.

We'll have him back very soon.

He ordered a ride
15 minutes ago.

To where? It's close.

We could have him back
before anyone knows he's gone.

Are you insane? You're right.

It's much better
if we go back in there

and freak out two
already-freaked-out parents,

and while you're at it,
explain to Andrews

that you didn't do
what he asked you to do.

Hmm.

Which emoji was it?

Just send it to me.

Oh...

You told me I have to respond.

There is no response to...

Okay, I think Carly's
saying she misses you

and wants to know
that you miss her, too.

You know all of that
from one fake face?

Just text her back
something flirty, casual.

Say something like, "I can't
stop thinking about you."

I have stopped thinking
about her many times today.

Do not text Carly that.

I have to go.

Okay.

This popcorn is terrible.

We have to get you back before
your parents start to worry.

We're gonna be three years,
five months too late.

The game is a blowout.
So, we leave now...

What's her name?

What?

I dunno.

The only words
I've ever said to her are,

"Can I have a slushy?"

I just wanted to see her
one last time.

Go say hi. Are you crazy?

I was asking her that earlier.

Tell her you think she's the most
beautiful girl you've ever laid eyes on,

and with your last
few hours of sight,

you wanted to see her
face one more time.

As lovely as this is...
Don't ruin the moment.

The necrotic debris has completely
encased the visceral pleura.

- Follow me with the camera.
- I don't want to spring a leak.

Tissue's fused her lungs
to her chest wall.

I need the Kaiser Forceps.

Damn it.

Tissue's too thick to fit
through the ports.

We need to do a thoracotomy.

And we can't open her up
in an air-tight chamber.

If we have to cauterize a bleed,

the whole thing could explode.

We have to take our Bubble
Girl out of the bubble.

Lemonade!
Get your ice-cold lemonade!

We've been gone too long.

Calm down. It'll take the kid
15 seconds to chicken out.

Or less.

I'm a wuss.

Most kids wouldn't have gone over at all.
Good for you.

Can I... No.

I'm just... No.

It better be fast. What?

We're giving a sad,
nearly blind kid

a few more minutes in the sun.

We could get an award for this.

Change gloves every 20 minutes.

We need to be fast,
but extremely careful.

Knife.

It's a Northern flying squirrel.

They don't fly so much as glide.

You're lucky it's not infected.

Well, it's
a fascinating species.

They're uncommonly high-strung
for a nocturnal rodent.

Is the squirrel in the bag?

Yes.

Henry comes everywhere...
No, no, no, no, no.

That's okay.
I don't need to see him.

Okay.

Has he bitten you before?

It was my fault. I provoke him.

Henry's a good boy.

It's not your fault.

You can't take him from me.

He's not allowed to hurt you.

Hi. It's 12:47.

Thank you.

You're 17 minutes late
for your 12:30...

Mrs. Pryce and I
need to have a little talk.

It's okay. Henry and I are fine.

Who's Henry?

You hesitated
before cutting her open.

We had to work fast
once I made the incision.

I was running through
the procedure in my head.

There's no shame in needing
to process a tough loss.

You should talk to someone.

I'd prefer to focus
on my current patient

rather than my last one.

Hey. Dr. Browne,
where's my patient?

And before you say, "Imaging,"

I already know that's not true.

He's with me and Morgan.

He just needed to process
a few things. Everything's...

Watch out!

What's going on?

Morgan just missed a turn.
She's a terrible driver.

Uh, no, we're on
our way back now.

Hurry. Okay.

How long was I out in the open?

Thirteen minutes.

We got all of
the infected tissue.

That's annoying.

It was necessary
to save your life.

No, I meant your phone.

Oh. It is.

I bet it's your girlfriend.

How did you know?

Only annoying girlfriends
text that much.

I used to text my
boyfriend all the time.

It annoyed him, too.

I am supposed to flirt with her,

and I don't know how.

Did your boyfriend
break up with you

because you were annoying?

No. He died.

That's the downside
of outliving your prognosis.

You outlive everyone else's too.

That is a downside.

Get out your phone.

Hmm.

I'll tell you what to type.

I'm really good at phone sex.

It's the only kind
of sex I can have.

We haven't had sex.

I'll stick to foreplay.

No, thank you.

Do you text your parents?
Or are they dead too?

My parents are in Denver.

My dad's job
transferred them there.

They always wanted
to live near the snow.

They're outdoorsy,
and I'm, you know, not.

I am not close
to my parents either.

I have autism, and they don't.

I need to listen to your lungs.

I just got really dizzy.

What's going on?

You have an infection.

Temperature is 103.6.
BP is 80/50.

She's showing
early signs of sepsis.

Start her on a course
of IV immunoglobulin therapy,

ADA-enzyme replacement
and GM-CSF.

Okay.

I think we can do more
than treat her infection...

Gene replacement therapy.

We harvest her stem cells
and use a retroviral vector

to transduce her DNA
with the modified ADA gene.

If it works, she's cured.

And if it doesn't work,
she dies.

There's a 50% chance her body
will have an acute toxic reaction.

We're going to treat
the infection.

She'll get another infection.

And another, and another,

and eventually,
one of them will kill her.

You don't know that.
She's already beaten the odds.

By cutting herself off
from the world.

Traditional treatment
is the safer course.

He's blowing off steam.

He's with the doctors.
He's safe.

He's scared and overwhelmed,

and obviously he felt like
he couldn't tell us...

Because you've been keeping
him under lock and key.

I'm protecting him.

We have to stay strong.

I think Charlie
knows you're strong.

And he knows you love him.

But the moment you all
heard the word "cancer,"

everything in
Charlie's life changed.

And I think he needs to know
that, at some point,

it's going to start to feel
like his life again.

My mom and dad used to do
these things called

spontaneous
family adventure days...

SFADs.

They were pretty lame.
But they let me skip school.

Got to go to baseball games,

drive around with blaring music.

I got to eat food that was
inorganic and genetically modified.

Sometimes I even got to
stay up past midnight.

Now we go
to doctor's appointments.

And my mom makes lists.

And cries.

And my dad's... quiet.

Just one more quick stop.

Morgan, Andrews is
expecting us to...

Please, just 20 more minutes.

Fifteen.

Park told me you rejected
his gene therapy idea.

We can't dismiss plausible
treatment options out of fear.

It's not fear.

It's a reasonable
degree of caution.

Since when are you cautious?

The benefit of the cure
may be worth the risk.

Let Park take it to her.

No. It's not worth it.

The cure is riskier
in the short term,

but the long-term upside
is much greater.

We can give you the chance to live a
long, healthy, normal life.

No, you can't.

I've been a freak my whole life.

And curing my disease,
letting me take a breath of fresh air,

it's not gonna make me normal.

Increase the oxygen
to 15 liters.

Start her on the IVIG.

We need to let her rest.

I'm a freak, too.

People have called me that

because I am not neurotypical.

And I used to be alone,

like you.

Sometimes that was easier.

Because it is hard
to be around people

when you're not like them.

But now I have Dr. Glassman,

and a roommate who is a girl,

and a girlfriend who is only
annoying some of the time.

And I think it is better
than being alone.

If you're... cured,

you can be... "outdoorsy"

like your parents.

Or you can stay inside
and have phone sex.

It will be your choice.

The next time you go over
my head will be the last.

Prep her for
the gene replacement.

Nice work, Shaun.

No. No way.

He's going blind.

It's his last chance
to see a naked woman.

You're a woman.

I bet under those clothes,
you're a naked one.

I'm his sister.

I'll slip you 50 bucks.

My budget proposal,
for your approval.

Surgical cases, for your review.

Before the board meeting
tomorrow night.

The pregnant woman...

How's Neil taking it?

Five minutes, please.
I'm with Dr. Lim.

I see there's a new member
on the clinic team.

How's that going?

Well, it's been half-a-day.
We're working out the kinks.

Well, if it's still smooth-sailing
by close of business,

let me know your secret.

I guess that answers
my initial question.

He keeps telling me he's fine.

You're the last person
he'd tell if he weren't.

I'd be the second to last.

I'm almost done.

You're the President.

He has to listen when you talk.
Or, pretend to.

Hey, the four-year-old with the ear
infection has been here half an hour,

his mother just pulled
out fingerpaints.

You need to go.

Debbie, this is Dr. Lim,
Chief of Surgery.

I know. It's very impressive.

Come back if you get
an ear infection.

One more. No.

We're done.

The surgery can't start
without me.

Where are we going next?
Yosemite? The Great Wall?

The top of Everest?
It's never gonna be enough.

Claire, stop.

You can't pack a lifetime of things
you're gonna miss into one day.

Your situation sucks,
and it is unfair.

But you know what, life
sucks, and it's unfair,

and things end
before we're ready.

We are going back. Now.

No.

I'm not gonna have the surgery.

How long before I know

if I've let you talk me
into something really stupid?

You could have an acute
toxic reaction and die

in the next 24 hours.

But we hope to see some positive
sign your body is responding soon.

Okay.

Your transfusion is done.
We'll check on you in a half-hour.

Dr. Murphy.

Would you... Sit with me?

What do you want to know?

Nothing. I...

I just want someone to be here.

In case I croak.

Hmm.

It's probably all your
annoying girlfriend wants, too.

Just to know you're there.

Carly's in good health
and unlikely to die soon.

Some girls have all the luck.

Debbie!

You bellowed?

This thing is broken.

Can you call someone from I.T.
and send them over, please?

Oh, I meant to tell you that
I, um, upgraded our software.

It's gonna be faster,
more efficient.

Not if I don't know
how to use it.

You can't just change my entire
software system without asking me.

I didn't change it.
I upgraded it.

There.

Or kick out my Chief of Surgery.

Or interrupt my appointments.

You'll be here 20 hours a day

if you don't stick
to a schedule.

It's my call.

I'm not here
to slap on Band-Aids

or to write prescriptions.

That woman had serious issues
we needed to discuss.

The one with the rodent
in her purse?

It's a squirrel.
It's a Northern flying squirrel.

You weren't gonna fix
whatever issues she has

with an extra five minutes.

It's my clinic, okay?
I decide how it runs!

Okay.

I thought that you wanted
me to be a part of it.

You know,
to actually help and to...

Make changes, have opinions.

But if that's not what you
want, then I...

I should do what I promised...

I quit.

You're out of sutures.

I'm sorry.

I... I shouldn't
have said any of that.

I lost somebody recently.

And it hurts.

A lot.

And I took it out on you,
and that is unfair.

But if you don't
have this surgery,

you won't ever drink another
slushy at a baseball game.

Or feel the wind in your hair
when you speed down the road.

Or...

Or touch a naked woman.

Now, this sucks.

It really, really sucks.

But it will get less sucky.

And the part that
hurts so much right now

will start to hurt less.

And life goes on,

and you will have
wonderful moments,

and you will have sucky moments.

And it will be your life.

And it'll be a good life,
Charlie.

I suspect it might
even be a great life.

Oh, thank God.

Sorry it took a while.

Car trouble.

Welcome back, Charlie.

You had some good
people very worried.

I'm really sorry.

You guys can ground me forever for
this, but I just...

I just wanted to have
one last day of fun.

We can be fun, too. Again.

I was thinking

it might be time
to reintroduce the SFADs.

Baseball games, concerts,
staying up late.

That sounds pretty lame.

We're running a little late,

and we need to get you prepped.

I'm sorry. I need
some 5-0 nylon sutures.

And apparently we need to talk.

You can report back to the
Chief of Surgery that I'm fine.

You don't have to talk to me.
You don't have to talk to her.

But you need to talk to someone.

I'm not a med student, Aaron.
I've lost patients before.

But you never lost someone
who should have lived.

No one would be fine.
I wouldn't be.

You're not fine.

If for no other reason than
your boss doesn't think so.

And the bigger problem

is your girlfriend
agrees with her.

We'll be right there
as soon as you wake up.

We love you so much.

I love you, too.

We'll take good care of him.

Thank you.

You ready?

Yeah.

I forgot to take his vitals.

I'm sorry.

Go ahead, I'll...
I'll bring him out.

I-I thought
you already took my...

Shut up.

We're bringing the patient down now.
Vitals okay?

Temp might be a little up,
but he's ready now.

I just need you
to count back from 10.

Ten...

Nine...

Eight...

Seven...

Six...

Five...

You were right.

I'm not fine.

It's okay not to be fine.

You can't blame yourself.

I was the one holding the knife.

The blame lies with me.

But the responsibility is ours.

Yours and... mine?

Yes.

You're not objective about me

because of our relationship.

If we weren't together,

I'm not sure you would've agreed
to let me do that surgery.

You honestly believe
I approved a procedure

that I didn't think you could do

because we're sleeping together?

No. You thought I could do it.

That's the problem.

I think your personal feelings

may have led you
to overestimate me.

You came to me.

You sold me the surgery,

told me that
you could pull it off.

And now I'm at fault because
I believed that you...

It's not about fault.

It's about being aware

so that this doesn't
happen again.

It will happen again.

I will make decisions.
You will have bad outcomes.

That doesn't mean
either of us was wrong.

My approval had nothing to
do with our relationship.

We can't know that for sure.

If we weren't dating,
that woman might still be alive.

And we both have
to live with that.

Mom?

Dad?

We're here, honey.

We're right here.

You did so good.

We're so proud of you, buddy.

Charlie.

It's Dr. Reznick.
How are you feeling?

Not awesome.

Are you in any pain?

No.

No, I'm okay.

I'll let you rest.

Wait, Dr. Reznick.

Yes?

Thank you so much.

For everything.

You're welcome.

And Dr. Browne?

Dr. Browne, are you here?

Your T-cell count has increased.

And your fever dropped to 99.3.

Your body's fighting
the infection.

So, what does that mean?
I'm cured?

It's too early
to use that word exactly.

We'll need to keep you
in isolation

for a few more weeks
to make sure

that your immune system
is developing on pace.

And there is still a 5% to 7%
chance of a toxic reaction.

But yes, the cure
appears to be working.

You should tell your
parents the good news.

What are they gonna do?
Feed me juice through a straw?

They could just be here.

I'm fine.

Let us know
if you need anything.

I'll check in on you
in the morning.

Thank you.

For not killing me.

You're welcome.

Oh, there is still
a 5% to 7% chance of a...

Shaun. She knows.

Aaron, you...
You do not owe me a gift.

I owe you an apology.

I was out of line today.
I was pushing way too hard.

It's not a gift.

Oh...

Is it punishment?

Nurses swear by them.

The arch supports are
supposed to be spectacular.

I'm not coming back
to the clinic.

It was a bad idea,
terribly executed.

Two of the smartest
women I know,

my wife and my
new office manager,

think that I need
to make some changes.

You wanted to help,
you wanted to be a part of my life,

I fought it.

I proposed,
and then I freaked out.

Mm-hmm. We got married...

You freaked out again.
Yes, I did.

But for a legitimate reason.

There was a gun in the house,
but that's not the point.

The point is that,
in the midst of all of this...

I took on not one,

but two jobs at the hospital.

Yeah, which you love.

Not more than you.

Mm.

Come back to the clinic.

Do I get to boss you around?

A little.

Let's go upstairs.

Charlie asked for you.

You connected with him.

I said what I had to
to get him into surgery.

Nah.

You were your old self again.

My old self...

Was always there for everyone.

Was giving away pieces
of herself over and over.

Charlie is still blind.

It was a hell of a day.

The blind kid
didn't get me depressed.

You, on the other hand...

Deal with your crap

before this is
who you really become.

Hey, this is Audrey.
You know what to do.