The Good Doctor (2017–…): Season 5, Episode 2 - Piece of Cake - full transcript

Ethicure. Devoted
to an improved, accessible,

for-profit, state-of-the-art
healthcare experience.

An experience we curate

via our Three Pillars
of the Ethicure mission.

Pillar one, our hospital.

A new color palette
designed to create
a sense of well-being.

Cutting edge technologies.

Faster testing
and imaging results.

And countless new
surgical innovations.

Pillar two, our doctors.

We want you healthy and happy,



so if you look
under the table,
you will find,

custom fitness trackers,

Ethicure scrubs,

along with
a few other goodies.

We'll also be introducing
new well-being incentives

and protocols designed
to encourage teamwork

and mutual respect.

Bosses have first names, too.

Which leads us
to pillar three.

At Ethicure,
we do not treat patients.

We serve clients.

So we will be seeking
their feedback

at every stage
of the Ethicure experience,

because a happy client
is a referring client.



My name is Salen.

Welcome to
the Ethicure family.

I really want to break this.

Our jobs no longer depend
on saving lives,

but how many smiley faces
get punched.

It's cute.
Thank you!

She's just
incentivizing niceness.

You of all people
do not want to be rated
by how nice you are.

I can't fake saving lives,
but being nice?

Way easier to game.

It counts your steps,
your pulse ox,

monitors when you sleep,
warns you
when you're stressed,

and stores
a thousand playlists.

If it vibrated,
I'd marry it.
Jordan.

Ethicure knows
where we are,
what we're listening to,

how we're sleeping,
maybe even
who we're sleeping with.

It also tracks paranoia.

You're fine
with all of this?

I mean,
it's great if you are,

but change is sometimes
tricky for you.

I was concerned,

but Ethicure's changes
seem reasonable
and data-driven.

I think we should start
by picking a cake.

You prioritized the cake,

over the date,
the venue,
the caterer...

I like cake.

I've compiled a list
of the most popular ones.

What is
your favorite cake?

Whatever you think
our guests will like.

There is no such thing
as bad cake.

Whew.
Take a good look.

You won't be
seeing much of me
for a while.

I'll be very busy turning
a good program into a bad one.

Yeah.

Shaun.

Shaun.

Oh.

Love you.

She's hemorrhaging.

Ultrasound to
assess etiology.

Hanging blood and fluids,
starting pressers.

The baby's placenta
is covering the cervix.

The baby's brachycardic.
Mom needs C-section, STAT.

You'll need to stay here.

Can't let her
out of my sight, Doctor.

She's doing life
for murdering her first baby.

I'm up there
for two gallbladders.

Do you know
I completed my residency?

Blame SurgiMatch.

I mean, I wouldn't have
put you on the schedule at all

until you at least knew
where the bathrooms were.

Oh, come on, guapa,
look at all this stuff.

I'm a kid in a candy store
and I'm starving to death.

Please don't call me guapa
at work.

Yes, Audrey.

Bosses have
first names, too.

What do you think of her?
I'm not a fan

of an algorithm
telling me what to do.

This thing
did a great job

filling up my dance card
for the next week.

She knows what I like.

Good to have you on board.
Glad to be here.

Not all of our dance cards
are full.

Mind if I tag along
on your morning rounds,

maybe show me
where the bathrooms are?

Sure.

Let's cha-cha.

I looked up her case.

Abby Clemmis was charged

with poisoning her baby
with antifreeze.

She pleaded not guilty
and got pregnant again
before the trial.

But when
she was convicted,

her boyfriend,
like everybody else,
stopped believing her.

Oh, boo-hoo.

Stay focused.
You're now being timed.

All part of the
productivity metric.

Forget the timer.
It takes as long as it takes.

I like knowing
how long it takes.

It was probably
postpartum depression.

Doesn't make the baby
any less dead.

But we might have
a little sympathy.

Because women are helpless
victims of our hormones?

Like people who should be
treated rather than punished.

What's your favorite cake?

Lea and I need to pick a cake
for our wedding.

Angel food cake.

Packing peanuts
have more flavor.

Anything with
cream cheese frosting.

I'd eat dog poop
with that on it.

Oh, please, uh, don't let me
distract you.

So, Salen,
it's great to see you again.

I loved how
you kicked the tires
on this place.

Nice due diligence.

What a beautiful sound.

Discharge them.

Uh, we have a 48-hour
post-op monitoring policy.

And now we have
a new policy.

As soon as they're stable,
you'll discharge them,

to make way
for other clients in need.

This is Madeline, came in
experiencing dizziness

and severe nausea
after running
in a college track meet.

And winning the 100 meter.

Urine analysis
and abdominal X-ray
were normal.

I could try a G.I. cocktail
to rule out gastritis.

Sit back here.

Any pain here?

I just set a state record.

It's heat exhaustion
and dehydration.

You sprint in full face?

I doubt my makeup could run
faster than I do.

I ran track in college.

Mmm?
I found the makeup

really helped.

You feel well enough
to step up on the scanner?

Yeah.

Inset your hand here.

Scanning.

It even knows
what you had for breakfast.

Perfusion's good,

pulses are strong.

Not surprisingly, you're in
top physical condition.

I told you, it's just...

She's hypoxic!

We need to suction
and protect her airway.

Meggie, my baby...

She's fine.

Seven pounds, three ounces,

and, uh, the lungs
of an opera singer.

Can I see her?

Just a peek through a window,
anything...

That's not possible.

We're gonna start
processing your discharge.

After we run a few more tests,
just to be safe.

I know you're feeling
overwhelmed right now,

and I'm sure you'll be
experiencing anxiety, sadness.

If you do suffer
from postpartum depression,

you'll need to get help.

I sure didn't have that
with Troy.

Those were the most wonderful
days of my life.

So, that means I'm either
a victim or a monster.

Pick a side.

We stopped the bleeding,
but your CT confirmed

a lesion in your lung.

Which may be benign,
but we have to do a biopsy
to know for sure.

If I had a lesion
in my lung,

wouldn't that
be slowing me down?

The rest of your lung
is healthy
and compensating very well.

Any history of lung disease
in your family?

I don't know.
A medical history can help

dictate diagnostic
and treatment options.

Can we contact
your family?

No, um...
my parents are...

They're...
Your mother's here.

Are you okay, Madeline?

That's not my mother.

My parents died
two years ago.

I was a toddler when she
gave me up for adoption,

and then went back
to Cameroon...

I didn't give you up.
I was deported.

I let you stay in America
so you could
have a better life.

Welcome back. I worked
in Cameroon for a while.

Is it okay if Esther gives us
some medical history?

Does anyone in your family
have high blood pressure?

I do.
Is that the problem?

I told her
she had to watch
what she eats.

She won't listen to me.

And why should I?

I barely know you.

Showing up
at my track meets

doesn't make you
a mother, Esther.

What about high cholesterol?
No.

In Cameroon,
you don't call elders

by their first name.
Okay.

And you don't show everyone
all your goodies.

Your "parents"
didn't teach you respect.

Abby needs
"a few more tests"?

You just don't want
to send her back to prison.

If she'd been getting
decent healthcare,

they would've caught
the placenta previa long ago.

So if I can delay
sending Abby back there,
I will.

We're discharging her
as soon as possible.

Look at this.

Hypotonia?

She's taking
very little nutrition.

Maybe ultrasound her
for a G.I. tract obstruction?

We could change the formula.
She might just be
a picky eater.

Good point.
I'll try that.

Right after the ultrasound.

Aaron.

Ooh, fishing flies.

Please don't touch.

It's harder
than brain surgery.

Ow!

Your absence
at the presentation
this morning

could be interpreted
as a lack of support.

You think?

When we first met,
you were a fake patient,

and now you're
a hostile corporate raider.

This hostile
corporate raider

saved your hospital
from being turned into condos.

I resign.

And I hate
your new logo.

You've got
a very loyal following,

many of whom will be very
opposed to this takeover.

You leaving could have
a snowball effect.

My board of directors...
and I

think it's important
for you to stay on.

So you can
draw on my expertise?

Or because
you want a puppet?

Either way,
you've got decent leverage.

Normally, I'd be offering
stock options,

salary incentives,
definitely a larger office,

but I suspect
none of those will work.

So maybe, despite it
being a money hole,

I'll just keep
your clinic open.

How's that?

Think about it.

Your baby's not
getting enough nutrition.

Her ultrasound was clear.

I think Meggie needs
her mother's milk.

Hey.

Hey, sweetie.

The biopsy confirmed

the mass in your lung
is malignant melanoma,

stage four.

Your PET scan shows
it's also in the lymph nodes

of your neck, abdomen,
and pelvis.

We'll remove what we can

and follow up with molecular
and immunotherapies,

but...

The prognosis isn't good.

Even with all
targeted treatments,

you're unlikely to live
more than 12 months.

No.

I'm healthy.
I'm strong.

I'm so sorry.

Pray, Madeline.
We have to pray.

God will work through
these doctors.

No!

I can't be dying.

I'm going to nationals.

This can't be right.
It's a mistake.

Stop praying!

Stop pretending like
you care about me.
You left me.

I do care.
I love you...

No! My real mother
loved me and accepted me.

I am your mother,
and right now, you need...

No, I don't need
anything from you.

You're nothing.

Please go away.

She's vomiting. Cyanotic
and O2 stats are plummeting.

She's tachycardic.

Intubate.

CBC, BMP,
stool sample, and echo.

And a tox screen
for the mother.

What's with the tox screen?
The mother's fine.

I didn't change
the baby's formula.

I let Abby
breastfeed her.

I'm wondering if there's
something in that breast milk

that made the baby sick.

More likely
it was antifreeze.

Right. She smuggled antifreeze
into the hospital,

from prison,
under armed guard?

It'd be insane.

Like people
who poison their babies.

We'll be using
a basic Ranked-Choice Vote.

It's not as nuanced
as the Kemeny-Young Method,

which minimizes the sum

of the Kendall Tau distances
to the voters' lists,

but I decided that would be
too confusing for you.

Intralesional injection?

Madeline's melanoma
is too widespread.

Only used for
locoregional disease.

This carrot cake is amazing.
Mmm.

How about
peptide vaccine?

Very high risk for immune
attacks against normal tissue.

Ugh. Does anybody really like
red velvet cake?

It reminds me
of a dumb model,

it's delicious-looking
but not worth the calories.

Mmm.

Complete lymph node
dissection.

The lymphedema
would be intolerable.

People die here, too,
you know?

It's my first day.
I haven't learned that yet.

Wait, there's no way
this thing knows
I'm eating dessert, right?

I have been
thinking about cake
all day.

Oh, don't let me
interrupt you.

You already have.

And since you won't be invited
to my wedding,

you don't get a vote.
Or cake.

You have
an interesting affect.

Are you on
the autism spectrum?

Please fill out
your ballot.

I'm neuroatypical myself.

ADHD.
Mmm.

Okay.

You should look at
Engineered T Cell therapy.

They're all good.
That's very unhelpful.

I've polled 12 people.

The cakes that got
the most "loves"

also got the most "hates,"
and the only cake
that no one hated

is one
that no one loved.

Why aren't you working?

'Cause I'm tasting cake.

Shaun, I...

I have to tell you,
I'm...

I'm thinking
of taking a break,

of moving on.

On to fishing?

Maybe. Maybe not.

Uh, probably not.
I don't really like fishing.

I have no idea
what I'm gonna do.

Are you sad about Debbie?

Yeah.

Yeah, I am.
But you know what?

She wasn't happy,
so it's probably for the best,

and right now, I just
think I want to take
some time for myself.

You want to be alone?

I like people.

I just think
I need to be around
different people.

Different from me?
No. No.

I just think I need
a big change, you know?

Well, there are
plenty of changes here.

Yeah, none that I like,

except maybe
the iced coffee,

surprisingly good
for a cafeteria.

How are you coping?

I need you to help me
pick the right cake.

Shaun,
it's your wedding.

Be selfish.
Pick the cake
that you like.

I've got no wife.
I've got no kid.

I'm soon to have no job.

And I could get
really depressed,

but I'm not gonna do that.

I'm gonna embrace it.
I'm gonna embrace freedom.

And for once in my life,
I'm not gonna care
about anything else.

I'm glad you have
such a positive outlook.

You didn't help
with the cake.

We've scheduled your surgery,
after which, we'll start you

on an aggressive course
of molecular
and immunotherapy.

So you'll make me
sicker first,
and then I'll die.

This could offer you several
more months of healthy l...

Engineered T Cell therapy.

It's an experimental
treatment

that teaches
your immune system
to fight the cancer.

Your body could cure itself.

You're off my case.

The technology's here.

The trial is available.
Why not use it?

You were there
to observe and learn,
not diagnose and treat.

You're not her doctor.

She doesn't have
specific mutations

for most molecular
therapies to work...

He offered her a treatment

that wasn't approved
by me, you, or the FDA.

That's a violation
of protocol,
not to mention, it...

The Wi-Fi's good
in here, right?

Just need to answer
some e-mails.

Oh, please,
continue your discussion.

Sorry for
the overstep, Marcus,

but I do feel T Cell therapy
is a more effective option.

Well, Mateo, the trials
were isolated,

small sample,
and not very encouraging.

Infection could kill her
way before the cancer would.

And what about the patient?
What does she want?

It was presented to her
as a somewhat
magical solution.

Sh...
I like magic.

Did you want to weigh in?

Oh, no.
I'm... I'm not a doctor.

I do have two
doctorates, though,

neurotech and data science.

Not helpful. Right.

Give the client
what she wants.

This is my case.

It doesn't have to be.

Abby's tox screen
is clean.

Whatever the baby got, she
didn't get it from the mother.

At least not
accidentally.

Sometimes, telling the guilty
from the innocent

is harder than you think.

It just got easier.

There are traces of antifreeze
in the baby's blood.

Doctor.

How's Madeline?

The Chief of Surgery
took over her case.

She's in
the very best of hands.

Can I see her?

I don't think she's ready.

I made a huge sacrifice
when I left her in America.

I never thought
she'd be so ungrateful.

Those people turned her
against her culture,

against me.

But that's my fault.

I let her go.

You gave Madeline up
out of love.

Don't let regret
blind you from
seeing how wonderful she is.

And as for the people
who made her that way?

Be grateful for all
the sacrifices they made.

I used to be
a lot like you.

If I was like you,

Esther would love it.

Don't let
the white coat fool you.

I have some ink, too.

I just keep it covered
at work.

My mother doesn't
like it, either.

My mom was
a total hippie.

She didn't care
if I painted my face blue.

She just wanted me
to be happy...

no matter what else
was going on.

Do you think she'd want you
to go through this alone?

I'm here
for another look.

You came home
after I went to bed
and left before I woke up.

It's this re-programming.

It's so frustrating,
I may start punching things.

Make a list.

Of every single step that is
required to complete your task

and then cross off each...

Shaun, this isn't about
a heavy workload.

It's about doing something
that I know
is a waste of time.

But you still need
to do it,

and this will
solve your issue.

I don't want a solution.

I don't need a solution.
I just want to vent.

Okay.

It is very difficult

to find a cake
that everyone likes.

Oh, I get it.

N-No.
I don't want to vent.

I just want a solution.

I wish I had one for you,
Shaun, but I don't.

Fresh out of solutions.
The solution well is dry.

Y-You always tell me
to use my words

and explain how I'm feeling,
but I did that,

and I think it
only made you
more upset.

You're right.
I'm sorry.

And...you have just solved
my problem, so thank you.

Your baby's still
in critical condition,

but we're now treating her
for ethylene glycol poisoning.

We found antifreeze
in her blood.

We're forwarding
this information
to the authorities.

You can't let this happen.

Not again.

Don't let Meggie die,
please.

BP's dropping,
heart rate's crashing.

Crash cart!

That's an Ethicure smile.

She might have had
a uterine tear

in the wake
of her C-section.

We'd see it
on the ultrasound.

Ah.

Ah. Badges are gonna have
bigger photos,

so we need bigger smiles.

Coag profile and CBC
rule out D.I.C.

Bowel perforation?

Park's exposure was...

You can do
better than that.
Just...

Sunshine!

Next.

Park's exposure was perfect,
as were my sutures.

No perforations.

Now, just imagine

you live somewhere
perpetually warm and sunny.

Wait, you do.

Work with what you got.

Overdistended uterus
and atony?

Consistent with time of onset,
clinical history,

and the fact
that we can't stop
the bleeding.

Yeah, she needs
a hysterectomy.

So she never gets pregnant
again? Win-win.

Win.

She's guilty, Park.
And I'm gonna prove it.

How?
I'm gonna ask her.

Salen.
Hi. Uh, I'm Lea.

We met in the server room
a few days ago.

You were pretending
to be a patient,

which I feel was dishonest
and manipulative

You don't like me.
Duly noted.

No, no,
I just think it's important

for people to explain
how they're feeling.

I did judge you, but I have
noticed positive things,

like more efficient
sharing of external EHRs

and a streamlined system to
fast-track hospital transfers.

So perhaps I was being too
harsh... Are we going in a...

Just moved up
to grudging respect.

And I hope this isn't headed
for fawning admiration.

No. The programming
I'm working on
is complicated, redundant,

and, quite frankly,
pointless.

I can design something
much better.

How long have you been
programming?

Four years. Ish.

You went to U Pitt,
got your degree
in three years,

designed and built
cars, desktops,

and entire coding systems
from the ground up.

And the ransomware attempt
that you thwarted

saved this place
a fortune.

And I love that you don't
come from I.T. theory.

You obviously don't come
from sales, either,

because you really don't know
how to pitch yourself.
Yeah.

But I'd love to hear about
this better program.

You wanna grab
a kombucha?

Yeah.

I-I would love that.

This anesthetic cocktail
of Versed and Pentothal

makes people
tell the truth.

Abby? I have
a few questions for you.

Not talking to you,
you stone-hearted bitch.

It's working.

Abby, do you know
what happened
to your babies?

Do you know
why they got sick?

'Cause I'm a bad mother?

Because you gave them
antifreeze.

Because I couldn't
protect them.

Abby,

did you kill
your first baby?

I could never
hurt my babies.

I'm their mommy.

These scrubs have
very rough seams.

Do you think Audrey would have
made a different decision

if I hadn't been in the room
last night?

Do you?

I know she has a personal
interest in Mateo's success,

because
he's her boyfriend.

And I think
how he appears to me

is important
to that success, no?

Audrey is a highly principled
professional and a great boss.

I like you.

You re-ran
all the baby's tests?

Using gas chromatography
analysis.

In case
we missed something.

Good call.

The baby's still
in critical condition.

If it is antifreeze,
why isn't she getting better?

I have no idea.

Same, same, same.

I've solved it.

We will stack
all five varieties

and serve
a quadruple-tiered cake.

Yes, four. Not five.

Five flavors, four tiers,
because Devil's food

and red velvet
are actually both chocolate.

The only difference is
one uses natural cocoa

and the other uses
Dutch-process cocoa,

which is alkalized
with potassium carbonate.

A very minor
molecular difference.

They're not the same.

A very minor
molecular difference.

It's not antifreeze.

It's propionic acid,

which appears
identical to antifreeze

on all tests
except gas chromatography.

Propionic acid
is made by the body,

if that body
happens to be afflicted

with
methylmalonic acidemia,

which is
a genetic condition.

Her first baby
probably had it, too.

It was Abby's
breast milk,

not because it contained
a toxin,

but because
it contained proteins

that triggered
production of the acid.

She is innocent.

They said
I might find you in here.

Something about
the big doughnut
I find very calming.

You're here
to accept my offer.

I used to be
a pretty decent poker player.

You developed a tell.

How much am I increasing
the clinic budget?

Double.

If that's what it costs
to keep you engaged.

Oh, no. No. You don't have
enough money for that.

The clinic can run
perfectly fine without me.

So can everything else
in this place.

I plan on taking my role
as puppet very seriously.

So what do I get
for my money?

Exactly what you asked for...
my support.

I plan on smiling and nodding
through this transition,

and nary a negative word
will cross my lips.

That's a much more passive
interpretation of "support"

than I had in mind.

Mmm. I'm not the only one
with a tell.

Welcome to
the Ethicure family.

We got all of the tumor.

And based on
the T Cell response
to your tumor cells,

we're very optimistic.

The day I gave you away,

I put you
in the prettiest
pink dress

and tied bows
in your hair.

I stared at you,

trying to memorize
every curve
of your little face.

I started to cry,
but you,

you, my strong
petite fille,

wiped the tears
from my face.

"Don't cry, Maman.

"Don't cry."

I gave my heart away
that day,

and over time,
I grew to hate
the people who took it,

who took you.

But without their love
and their sacrifice,

you wouldn't be
the amazing girl
that you are,

and I love them
for that.

Maybe where I come from

has a little bit to do
with how great I am.

Maybe we can be friends.

Work our way up to...
Famille.

I would like that
very much.

Tell me about
your maman.

It wasn't antifreeze
making your baby sick.

She has
a metabolic disorder,

which we're
treating her for now.

Meggie's gonna be
just fine.

We think
Troy had the same thing.

You were a victim.

We've let the authorities
know that, too.

I'm sorry, Abby.

Congratulations.

I hear the results of your
procedure were very promising.

You two
make quite a team.

Thanks.

Do you have an office?

Maybe.

I remember my assistant
saying something about that.

Uh, do you know
what happened

with Bernice Fisher
and Derrick Bell?

Your surgeries
from yesterday.

I rescheduled them when
I took over Madeline's case.

Did you schedule Derrick
at San Jose General?

Because that's
where he's being treated now.

And what about, uh,
Stanley Ferlin,

Kelly Jarnigan,
and Thelma Sewell?

Those are my consults, and
I'm seeing them all tomorrow.

Wonderful.
Except Kelly was awaiting
cancer biopsy results.

Twenty-four hours
is a lifetime
to put that off.

So you're comparing
scheduling issues

to saving
a young woman's life?

All of our clients'
experiences matter, Mateo.

I understand
your license is provisional.

Who you writing
the article with?

I mean, T Cell therapy
on melanoma,

it's kind of a big deal.

But, you know, I got to assist
on two appies, a chole,

and a hip replacement,
so...there.

Not a lot of steps.

I just hit 11,000.

Mmm.
That's impressive.

Mmm-hmm.

'Course it's no 22,378.

It doesn't measure steps.

It measures how many times
you move your wrist

in rhythmic motion.

So you log a quarter-mile
anytime you have
some "me time"?

I haven't had any time
for that, either.

Mmm.

I just strapped it
to a dialysis pump.

That's clever.
Mmm.

It's also cheating.

It's only cheating
if the rules have merit.

Vive la revolution.

Regrets are for when
you make a mistake,

not for when you do
the right thing.

I can handle Dr. Andrews.

After we took his case,
made him look bad?

Andrews is gonna "supervise"
the hell out of you.

I'm not worried.

You know why?

Because, guapa,

I get to see you
every day,

and that makes
everything wonderful.

I solved
our cake problem.

We serve them all?

Kinda brilliant, Shaunie.

I am
quite proud of myself.

I solved my problem, too.

I pitched my program idea
to Salen, and she loved it.

Mmm...

This soap is different.

And I'm proud of you, too.

You've done an amazing job
with all these new changes,

especially those scrubs,
which you look super cute in.

What? No.
They're itchy.

We'll wash them,

try some unscented
fabric softener.

Okay, this soap
won't come off.

Okay, no rush.

Paper towels?

Oh. I think
they got rid of them
for sanitary reasons.

No! No.

No.

No. S-Stop it.
No. Okay.

Okay, Sha... Oh.
No.

Stop it.

I-I can't, Shaun. Breathe.
Stop it. No, please stop it.

It'll be okay. If you just
step away from it...

No. Please. S-Stop it!
Yeah. It's okay.

Shaun?
Stop it! Stop it!

Stop it! Stop it! Stop it!
You're gonna be okay.
Shaun.