The Good Doctor (2017–…): Season 6, Episode 3 - A Big Sign - full transcript
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I love...
our married people plates
so much. Don't you?
They have a pleasant heft
and no rough surfaces.
No. Hmm.
You finished?
We should have a dinner party.
We have six smooth, beautiful
married people plates.
We can invite Frank and Morgan.
That sounds not fun and like we
might have fewer plates by the end.
What about Jordan and Asher?
That could be fun.
But if we invite Asher and
not Jerome, is that offensive?
Okay, best idea yet,
skip the dinner party, skip the
awkwardness, see our friends at work.
I'll be ready in a minute.
It will be closer
to four minutes, possibly five.
Both are acceptable.
-== [ www.OpenSubtitles.org ] ==-
I need
the M&M report on my surgery.
And by your surgery, you mean?
The one Shaun performed on me.
The committee found no evidence
that Shaun did anything wrong.
Inconclusive.
They decided the evidence
was inconclusive.
I would like to do
my own review.
Do you really think
you can be impartial,
or will you just be searching
for a reason to punish Shaun?
I don't know why I would,
unless something in the report
suggests Dr. Murphy made a mistake.
I'll email you the file.
How are you?
I'm fine.
Mm. So brave,
pretending not to be hurt
after your crush shot you down!
I asked Perez to drinks
to be nice
because I was mean
to him all day.
- I do not have a crush.
- Yeah, whatever.
Sorry. Forgot these.
That was extraordinary.
I feel nothing.
Help me!
Cady Stinson, 24, history of
bipolar and depressive disorder.
Came in with cuts, abrasions,
and likely right distal radial fracture.
She jumped out of our car
while it was moving.
They're kidnapping me!
Have five milligrams
of haloperidol ready, in case.
Cady, you're safe.
I'm Dr. Park.
I'm here to help. I need to
examine your wrist, okay?
We were on our way
to an inpatient psych facility.
She's so worked up
because she doesn't want to go.
She hasn't even recognized us
in at least two months.
No, no, no. Don't talk to them!
- They're liars!
- Cady, Cady, Cady, please hold still.
You... You can't trust them.
Please, please, Dr. Park.
- No! No! Get that away from me!
- Cady, Cady, Cady.
- Careful with the arm.
- No! No, no!
Don't touch me! Don't touch me!
- Aah!
- Aah! Aah!
Radial artery's lacerated.
We need to get her to an OR.
This is Dr. Shaun Murphy,
one of our surgical attendings.
This is Julianne.
She fractured her ankle
falling off a curb.
The tibiotalar joint
may be an issue.
I got dizzy from hypoglycemia.
Must've mistimed my insulin.
No idea how that happened.
Is it time to check
my blood sugar?
No, not yet.
Oh, that is a very shiny
wedding ring.
How long has it been,
Dr. Murphy?
Lea and I have been married
for three months
and seven days and 13 hours.
Wet cement year. Oh.
I wish I met more
of my clients at that stage.
I'm a marital therapist.
And best-selling author,
host of one of my
favorite podcasts,
and probably the reason
why Jay-Z
and Beyonce are still together.
Full plantar and dorsiflexion
range of motion.
The first year of marriage
is crucial
for cultivating good patterns
and weeding out bad ones
before they can harden
into habits
that will define
your entire relationship.
What habits define
your marriage?
I'm afraid all our habits
are in the past.
My husband died recently.
I'm so sorry for your loss.
How long has he been gone?
A little over five months.
Is it time to check
my blood sugar?
You asked her
about a minute ago.
- It was longer than that.
- No, it wasn't.
And I know, from your podcast,
your husband died
several years ago.
You need surgery on your ankle,
but we should MRI your brain.
We've repaired the laceration
to her radial artery,
but there's still
a decision to be made
on treating her wrist fracture.
There's a choice between
external or internal fixation.
The external fix at or involves
attaching a metal frame
to her forearm and hand.
It requires a longer stay
and frequent adjustments
for eight to twelve weeks.
Internal gets Cady
out of the hospital sooner,
but has a high risk
of complications,
like nerve damage or infection.
Uh, I don't like the sound
of those complications.
The treatment center will only
hold her spot for a week.
What happens if they can't
handle those adjustments?
I can reach out to them.
I-I-I'm not certain
about sending Cady
away for treatment
at this point.
She nearly killed herself
rather than go to that place.
She's a danger to
herself. She's a danger to others.
She needs more help
than we can give her.
We'll leave you two
alone to talk.
As Cady's mother,
it's my decision.
Moira!
I love Cady like a daughter.
But if she comes home...
I'm not sure I can.
Please do the external fix at or.
Thank you, doctors.
I gave Lim a copy
of the M&M report today.
She was very insistent.
She come see you?
Not yet.
- Uh, I'll clear out.
- Please stay.
I am interested
in your opinion, as well.
Must be a real doozy of a case
if you called all of us,
the chief included.
I am treating
a 51-year-old woman
with a fractured ankle
and a distorted sense of time.
It is too soon to tell
if it is a doozy.
Now, we can begin.
Please describe all of the
bad habits that developed
during the first year of your
respective failed marriages.
Or good habits, if you had any.
So, we're all here because...
As an attending,
I no longer have time to talk
to you all individually,
so, I called a meeting
of the divorced.
Dr. Glassman, you have
the most failed marriages.
Park's split-up was much
more recent. You go first.
Well, that was a break-up,
not a divorce.
You and Dr. Reznick
seemed pretty serious.
Um, don't get involved
with a pathologically ambitious
narcissist and, uh...
be as emotionally open
as possible,
which you're already great at.
And that goes for everything.
Nothing is too small to discuss.
Except for the infinite number
of differences of opinion.
And how do you know
which ones don't matter?
Dr. Murphy, if you have
concerns about your marriage,
talk to your wife.
Meeting adjourned.
Julianne's brain MRI.
Check out the parietal lobe.
Dr. Andrews!
You have a grade 2
oligodendroglioma
centered in your parietal lobe.
It's disturbing
your precuneus region.
May I?
Looked at a lot of brains during
my doctoral psych program.
It's close to the motor
and primary sensory cortex.
We will need to map out
the critical structures
of your brain
to determine
a surgical approach.
There are risks,
but if we can get all of it,
the prognosis is excellent.
Or we could
try to shrink the tumor
with chemo and radiation,
but there's an increased chance
the tumor will progress
to a grade 4 glioma.
I want the surgery.
My life's work has been
to help people find
what my husband and I had.
I'm not done yet.
That is... very good to hear.
This transcranial
magnetic stimulation
will pinpoint the pathways
of your motor cortex
and help us resect
your brain tumor.
And this is my wife, Lea.
- Hey.
- Lea, met Julianne.
She is a marriage therapist
and told me to be careful
of the habits we set.
Great to meet you,
but under the circumstances...
Chatting with you two
is much better
than contemplating those
circumstances.
Stay.
I made a list of small habits
that could become
larger problems.
"Snoring, minor tardiness."
- Is that supposed to happen?
- Yes.
A disconcerting tolerance
for dust.
- These are all my habits.
- Yes.
Do I have habits
you would like me to change?
At this point,
you better just say it, hmm?
The dishes.
You take them
out of the dishwasher
and rerinse them
after I've already done it.
Because you are doing it wrong.
Try to hold still.
We just need to make sure that your
wound's clean for surgery tomorrow.
My head hurts.
I-I need to sit up.
Hey.
Please, just let me see my mom.
She wouldn't like
what you're doing to me.
We're all trying
to help you feel better.
You hungry?
Paul went to get you some food.
I want to go home.
Okay, wound looks good.
Now, let's pack it with gauze.
We can give her something
to try to help her relax.
No. No more poison.
She doesn't need to be
drugged. She's uncomfortable.
Please, just let her out.
I can't. I'm sorry.
On all three fundamentals,
water temperature, choice of
equipment, and application of force,
your technique is lacking.
Shaun, we have a dishwasher.
This is just
a preliminary rinse.
Shaun, um, instead
of offering a critique,
try stating a positive need.
You know, something like, "I wish
the situation was more like this..."
I wish the situation
was more like
Lea knew how to wash the dishes.
We're done with the mapping.
Lea, do you enjoy
doing the dishes?
Does anyone?
I do.
Then forget finding
common ground on this, huh?
Divide and conquer.
He went three for four, two doubles,
three RBIs, and struck out the side!
Well, wait until he's 16
and can throw a curve.
Oh, I-I think I can
get back from here.
Oh, please.
I'm enjoying the company.
Ohh!
You're so sweet.
- I feel nothing. Leave me alone.
- Fine.
What have you two been
fighting about?
- Everything.
- Just little stuff.
Yeah, because you're so crabby.
Because you're so distracted.
It's always like this
when I'm on night shifts.
Why do you think night shifts
are a problem?
We have less time together
to hang out and...
Sex! There's no sex.
Because he's too tired
when he gets home.
Hmm.
Why do you have to wait
until he gets home?
Five more on this side,
then switch.
I'm going to get a heat pad.
You wanted to do
a hemihepatectomy,
but Shaun changed
your surgical plan.
Is that right?
Would you like me to put my
hand on a Bible, counselor?
I thought removing a lobe
was the safest choice.
After I left, the parameters
changed. Shaun adjusted.
A resident overruled
your judgment,
without bothering
to consult you,
and you were fine with that?
That resident was days away
from becoming an attending,
and he did exactly
what you trained him to do:
He made a tough decision,
a hard call,
with limited data.
Would you have made that call?
When I got back,
I evaluated the progress,
and I decided
that it was safe to continue.
It was safe?
Or you had no choice?
Clearly, you read the report.
You tell me.
You asked why
no one had come to get you.
If you were fine with Shaun's
call, why would you care?
I was worried about you.
Thank you.
But if you were fine with
the call, why would you care?
- I got angry.
- You didn't say angry in the M&M.
You said, "Concerned."
You're slicing the salami
pretty thin right now.
Why not just say you were angry?
My precise emotional state
is not medically relevant.
Unless you were angry
because Shaun made a bad call.
Shaun saved your life.
What?
Folding the shirt in thirds
allows them
to be stored vertically.
Sure, but I'd rather...
Storing them vertically
saves space
and makes them easier to find.
Well, why don't you
fold the shirts?
That is an excellent idea.
Good night.
Good night.
Not a bad way
to spend a dinner break.
I'm going to go crash for a
while before my call starts.
Okay.
Hey, we need Dr. Park
or security.
- What's wrong?
- I-I went home to get a change of clothes...
I must've fallen asleep.
She's gone.
Cady couldn't sleep with,
with the restraints.
She was upset and uncomfortable.
I took them off.
I asked her to. It's my fault.
It's not your job
to enforce hospital protocol.
Security's been alerted.
They're working top-down.
You guys cover the east wing.
We'll take the west.
Start down that hall.
I'll check the patient rooms.
Resecting the final
aspect of the tumor.
Lea and I took Julianne's advice
and divided and conquered
last night.
I started with the dishes and
then moved on to folding laundry.
More irrigation.
And Lea, what did she conquer?
I was very open and pointed out her
shirt-folding errors, and then she went to bed.
It was quite successful.
You sure about that?
- Did she... kiss you good night?
- Yes.
- Cheek or lips?
- Cheek.
I got all of the tumor.
Remove the patties and line
the resection bed with Fibrillar.
You think maybe
it was not a success with Lea?
- Sounds like maybe...
- You bombed.
She's in V-tach.
No carotid pulse. No
detectable BP on the art line.
Check the brain
for herniation or hematoma.
No bleeding or signs of edema...
No increased ICP.
Maybe she threw a PE?
Her EKG was normal. Give one
milligram of epi and stand by with more.
Clear!
Her brain looked good.
Her vitals were stable.
No history of heart disease.
Could be an adverse reaction
to the anesthesia?
Do an echo, send trops, and put her
on telemetry to rule out cardiac issues.
Cady.
Hey.
Okay?
Seems like you're feeling
a bit better.
I'm working on my solo.
I know. I heard.
It's lovely.
Would you sing it to me while
we walk back to your room?
Do I have to lie down?
It makes my head hurt.
You can sit up in your bed.
Okay. Come on.
Attagirl.
Cady, do your feet hurt?
No. They're just sticky.
They put glue on them
to keep me from running.
- We need to get a head CT.
- Yeah.
The ventricular enlargement,
that's fluid built up
inside her brain.
Cady has hydrocephalus.
It explains a lot of her
symptoms, shuffling her feet,
the headaches
when she lies down, and...
possibly,
her psychiatric issues.
Cady might not be bipolar?
We'll know more
once we insert a shunt
and drain the fluid
from her brain.
I noticed the shuffling
a year ago.
I-I didn't even mention it
to the doctor.
I just thought it was
another... delusion.
All the doctors we brought
her to, they all missed it.
We almost locked her up.
She could've died in there.
We removed all of the tumor.
The surgery
was successful, although...
I died.
I saw you.
It was like
I was out of my body.
I saw you doing compressions
and there were alarms going off.
And then I saw my husband
in these quick flashes.
He was waiting for me,
somewhere.
Tell me what you saw.
There were vivid colors
everywhere.
It was unlike
anything I had ever seen.
But it felt like home.
What kind of colors?
I... can't describe them.
My husband
was reaching out to me...
and I almost touched him.
Then you pulled me back.
You had a near-death experience.
Ah.
No. She had a symptom.
There is something else
wrong with your brain.
We need to find out what it is.
She didn't have
an out-of-body experience!
She accurately described us
trying to save her.
No, she described a code,
which only proves
that she watches
medical shows on television.
And the heaven that she told
us about, it's all recycled cliches...
The peace, nice colors,
your loved ones waiting.
And maybe those cliches exist
because that's what
the afterlife is like.
- You're a believer.
- Please be quiet!
Julianne must have
a multifocal tumor,
most likely
in her occipital lobe.
A tumor there could've caused a
subclinical, nonconvulsive seizure,
which would explain her
hallucination and cardiac arrest.
A tumor there would make sense.
Then where is it?
It must be hidden by the edema
from the previous tumor.
We need more images
at a higher resolution.
All right, I'll book the MRI
and get Julianne.
Oh, are you
a one almighty God type
or more spiritual,
but not religious?
I'm just asking for a friend.
You're off-target.
Position the catheter toward the
nasion and tragus skull landmarks.
If Cady hadn't wandered off,
we may have never noticed
the foot dragging.
A good outcome doesn't
cancel out a bad decision.
The chain of command
exists for a reason.
I'm in.
Attach the manometer
to check her brain pressure.
Oh, no.
I'd guess about 40 centimeters.
Must've been
building up for years.
The brain damage
could be irreversible.
I'm gonna place the valve,
start draining fluid
into the abdomen.
I got your text.
Is everything okay?
Were you mad last night when
I took over folding the shirts?
Shaun, at some point
we need to define
what qualifies
as an important matter
that needs to be discussed
as soon as possible.
Yes. Okay. Were you mad?
I was frustrated.
But I'm over it.
Why were you frustrated?
Didn't you want to know
the right way to do it?
There's no right way
to do it, Shaun.
There's my way,
there's your way,
and a thousand other ways.
And I don't need you to think
that my way is right.
Especially since your way
is fully research supported.
But knowing you think I'm wrong
about so many things,
sometimes it feels like
you're watching me
and holding a big sign
that says,
"You're doing
everything wrong."
That's why I was frustrated.
And I know
you didn't mean it that way,
and I know
it's important for you
to have things a certain way.
Because of my ASD.
I love your brain, Shaun.
And I really don't care
about laundry and dishes.
I'll find something else to be in
charge of like grocery shopping.
Maybe you could check
the apples better for bruises.
The store will not
take them back.
Right.
There's something wrong
with Julianne's brain.
I don't see anything.
Me neither.
We'll know a lot more
about her prognosis when she wakes up.
For now, we're keeping her
under sedation
and giving mannitol to keep
her brain pressure down.
Well, whatever happens,
we'll get through it.
You're in for the long haul now?
You threatened
to walk out on us.
I was upset.
I just... I was trying to do what
was best for her and for... for you.
By leaving us?
Your symptoms point to another
tumor in your occipital lobe.
No tablet this time?
The tumor doesn't show up
on imaging, but I know it is there.
We can see an irregular and
distinct pattern of edema in that region.
If the tumor's there, it will
very likely stop your heart again.
I've been dead before.
It was pretty great.
I don't want the surgery.
No, the bright colors you couldn't
describe, that's color agnosia.
Your husband being just out
of reach, that's optic ataxia.
You did not see Heaven.
You had a seizure
caused by your tumor.
Dr. Murphy,
you and I are both cursed
with being very good
at fixing things.
When Scott was alive,
I could have made a list of a hundred
ways to improve my marriage, my husband.
But when I saw him again...
I couldn't think
of a single thing I'd change.
I just want to be
with my husband again.
You will be.
Uh, I think
what you experienced was real.
What you saw, it's...
It's not going anywhere.
And there are still a lot of
people here who need your insight.
I know that matters to you
because even with a tumor...
Two brain tumors.
Two brain tumors
and a broken ankle,
you still made a point of
helping half your medical team.
Eternity is a long time.
Your husband will be waiting
for you whenever you get there.
He better.
Let's see if you're right.
She's a GCS of eight,
has most
of her brain stem reflexes.
But no signs that she's ready
to come off the vent.
She always took
forever to wake up.
I saw Paul
in the cafeteria just now
surrounded by empty coffee cups.
If you'd like some company...
No, I'm fine.
Thank you, Doctor.
I used to be a lieutenant
on an aircraft carrier.
The first time
I saw a plane land,
I thought for sure this sucker is going to
skid right off the other end into the ocean.
I promise there's a point
to this.
But they never do.
Because the planes,
they have these tail hooks that catch
on these giant, inch-thick steel wires.
These wires, they can stop
a 50,000-pound aircraft
traveling 150 miles per hour
in two seconds.
And they almost never break...
until they do.
One swung across the deck
and hit my leg, sent me flying.
I was in a coma for weeks.
My parents, they had to decide
whether or not
to amputate my leg,
and they disagreed.
It got ugly.
But my mom won.
And I went to med school
on one leg.
And my parents, they celebrated
45 years last month.
When a family member is sick,
everybody gets a pass.
Hi, there.
After Shaun committed to the
angioembolization, my collateral vessels bled,
causing my blood pressure
to bottom out.
Audrey, it's late...
That loss of BP led to my cord
ischemia, which led to my paralysis.
- Do you agree?
- Yes, as I said in the report, yes.
The report is facts.
It's just facts.
Audrey, what exactly
do you want from me?
I am sitting in this chair
because of that surgery.
And everybody here
seems completely fine with it.
Fine with Shaun's decision,
fine with him going rogue.
I'm not fine with it.
- I'm not fine with it.
- Well, that is not what you said in the M&M.
What Shaun did was headstrong,
it was risky,
and it's not
what I would have done, okay?
But let's just be clear.
He didn't make a mistake,
he did what he thought was best,
and it shouldn't be a mark
on his career as a surgeon.
- That is not your decision.
- And I'm angry, okay?
I'm angry. So what?
It's irrelevant.
I'm so angry I could scream.
It keeps me up every night.
What if Andrews
didn't call me away?
What if I had come back
just five minutes sooner?
What if? What if? What if?
Well, what would you have done?
Come on, Aaron.
What would you have done?
Would you have told Shaun
to go back to the original plan?
Yes.
Thank you.
Because everything's fixed now?
Because you're gonna
walk again soon?
Because you're with me.
Finally somebody sees my side
instead of Shaun's.
It's not either-or.
I'm not so sure.
There's just something sexy
about the closet.
Maybe it's the symbolism. You
know, like coming out of the closet.
- I get it. I just don't approve of it.
- Why?
From the coffee shop
that's on my way in.
Number two on your list of
top-ten food and beverage items
within walking distance
of the hospital.
The almond croissant.
Thanks. I'll pay you back.
Don't you dare.
I'll see you in surgery.
Oh.
Okay, I feel something.
A crush.
A massive, all-consuming, "my
stomach rolls over when I see him" crush
because he is gorgeous
and thoughtful and smart and
apparently eats carbs, and I'm only human.
- Happy now?
- Yeah.
Are you gonna eat that?
I'm so screwed.
Just a minute. Dr. Murphy.
Don't worry too much
about the wet cement.
It's clear how important your
wife and your marriage is to you.
Just keep letting Lea know that,
and you'll keep being
a great husband.
Count backwards from ten.
Ten.
Nine.
Eight.
BIS is at 50.
CO2 is normal. Ready, Doctor.
Making the first incision.
Stand by with the periosteal
for skull dissection.
Heart rate's 125.
BP is 195 over 132.
- Another seizure?
- It's the tumor.
Give another 500 of Keppra
and high-dose propofol.
She's in v-tach.
No pulse.
One milligram of epi.
Clear!
It's been 12 minutes.
Time of death, 12:43 p.m.
They're together again,
somewhere.
Probably not.
But that would be nice.
Hey.
Hey, sweetie.
I'm here.
Mom? What's going on?
Why am I here?
You're in the hospital,
but you're okay now.
Where's Paul?
Hey, Cady-Cat.
Hey, Papa Paul.
Get in here.
Yeah, get in here.
We missed you so much.
I think you should do the
dishes before I have to go.
Really?
Are you gonna teach me
your technique?
No.
I am going to get ready
for my night call.
Go ahead.
I love you, too, Shaun.
It's okay if you can't watch.
You can leave.
Hey, Cady's latest neuro exam
showed no deficits.
And the alignment
from her ex fix looks great.
Um, I'm sorry.
Chain of command was never
my strong suit. I'm working on it.
Thank you...
for your service, Lieutenant.
Was anybody
ever gonna ask about my limp?
Shaun wanted to, but we
told him he wasn't allowed.
You lost a patient today,
Dr. Murphy?
She seized on the table
before the first incision.
Autopsy confirmed she had a
high-grade occipital lobe tumor
which would have killed her
in three to six months.
Your advice was good.
I talked to Lea about habits
and learned she doesn't
appreciate when I wash the dishes
after she washes the dishes,
even though
she is doing it wrong.
Shaun, I can't hear this.
Your advice was good.
I talked to Lea about...
I mean, I don't want to hear it.
I'm having complicated feelings
about my surgery.
- What you did.
- I saved your life.
This...
This is a struggle.
You put me here, and
I'm really angry about that.
As your boss,
I need to set my feelings aside,
be professional, and I will.
But that's all.
I don't want you to ask me
about my personal life,
and I don't want
to hear about yours.
From now on, our relationship
is medicine only.
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---
I love...
our married people plates
so much. Don't you?
They have a pleasant heft
and no rough surfaces.
No. Hmm.
You finished?
We should have a dinner party.
We have six smooth, beautiful
married people plates.
We can invite Frank and Morgan.
That sounds not fun and like we
might have fewer plates by the end.
What about Jordan and Asher?
That could be fun.
But if we invite Asher and
not Jerome, is that offensive?
Okay, best idea yet,
skip the dinner party, skip the
awkwardness, see our friends at work.
I'll be ready in a minute.
It will be closer
to four minutes, possibly five.
Both are acceptable.
-== [ www.OpenSubtitles.org ] ==-
I need
the M&M report on my surgery.
And by your surgery, you mean?
The one Shaun performed on me.
The committee found no evidence
that Shaun did anything wrong.
Inconclusive.
They decided the evidence
was inconclusive.
I would like to do
my own review.
Do you really think
you can be impartial,
or will you just be searching
for a reason to punish Shaun?
I don't know why I would,
unless something in the report
suggests Dr. Murphy made a mistake.
I'll email you the file.
How are you?
I'm fine.
Mm. So brave,
pretending not to be hurt
after your crush shot you down!
I asked Perez to drinks
to be nice
because I was mean
to him all day.
- I do not have a crush.
- Yeah, whatever.
Sorry. Forgot these.
That was extraordinary.
I feel nothing.
Help me!
Cady Stinson, 24, history of
bipolar and depressive disorder.
Came in with cuts, abrasions,
and likely right distal radial fracture.
She jumped out of our car
while it was moving.
They're kidnapping me!
Have five milligrams
of haloperidol ready, in case.
Cady, you're safe.
I'm Dr. Park.
I'm here to help. I need to
examine your wrist, okay?
We were on our way
to an inpatient psych facility.
She's so worked up
because she doesn't want to go.
She hasn't even recognized us
in at least two months.
No, no, no. Don't talk to them!
- They're liars!
- Cady, Cady, Cady, please hold still.
You... You can't trust them.
Please, please, Dr. Park.
- No! No! Get that away from me!
- Cady, Cady, Cady.
- Careful with the arm.
- No! No, no!
Don't touch me! Don't touch me!
- Aah!
- Aah! Aah!
Radial artery's lacerated.
We need to get her to an OR.
This is Dr. Shaun Murphy,
one of our surgical attendings.
This is Julianne.
She fractured her ankle
falling off a curb.
The tibiotalar joint
may be an issue.
I got dizzy from hypoglycemia.
Must've mistimed my insulin.
No idea how that happened.
Is it time to check
my blood sugar?
No, not yet.
Oh, that is a very shiny
wedding ring.
How long has it been,
Dr. Murphy?
Lea and I have been married
for three months
and seven days and 13 hours.
Wet cement year. Oh.
I wish I met more
of my clients at that stage.
I'm a marital therapist.
And best-selling author,
host of one of my
favorite podcasts,
and probably the reason
why Jay-Z
and Beyonce are still together.
Full plantar and dorsiflexion
range of motion.
The first year of marriage
is crucial
for cultivating good patterns
and weeding out bad ones
before they can harden
into habits
that will define
your entire relationship.
What habits define
your marriage?
I'm afraid all our habits
are in the past.
My husband died recently.
I'm so sorry for your loss.
How long has he been gone?
A little over five months.
Is it time to check
my blood sugar?
You asked her
about a minute ago.
- It was longer than that.
- No, it wasn't.
And I know, from your podcast,
your husband died
several years ago.
You need surgery on your ankle,
but we should MRI your brain.
We've repaired the laceration
to her radial artery,
but there's still
a decision to be made
on treating her wrist fracture.
There's a choice between
external or internal fixation.
The external fix at or involves
attaching a metal frame
to her forearm and hand.
It requires a longer stay
and frequent adjustments
for eight to twelve weeks.
Internal gets Cady
out of the hospital sooner,
but has a high risk
of complications,
like nerve damage or infection.
Uh, I don't like the sound
of those complications.
The treatment center will only
hold her spot for a week.
What happens if they can't
handle those adjustments?
I can reach out to them.
I-I-I'm not certain
about sending Cady
away for treatment
at this point.
She nearly killed herself
rather than go to that place.
She's a danger to
herself. She's a danger to others.
She needs more help
than we can give her.
We'll leave you two
alone to talk.
As Cady's mother,
it's my decision.
Moira!
I love Cady like a daughter.
But if she comes home...
I'm not sure I can.
Please do the external fix at or.
Thank you, doctors.
I gave Lim a copy
of the M&M report today.
She was very insistent.
She come see you?
Not yet.
- Uh, I'll clear out.
- Please stay.
I am interested
in your opinion, as well.
Must be a real doozy of a case
if you called all of us,
the chief included.
I am treating
a 51-year-old woman
with a fractured ankle
and a distorted sense of time.
It is too soon to tell
if it is a doozy.
Now, we can begin.
Please describe all of the
bad habits that developed
during the first year of your
respective failed marriages.
Or good habits, if you had any.
So, we're all here because...
As an attending,
I no longer have time to talk
to you all individually,
so, I called a meeting
of the divorced.
Dr. Glassman, you have
the most failed marriages.
Park's split-up was much
more recent. You go first.
Well, that was a break-up,
not a divorce.
You and Dr. Reznick
seemed pretty serious.
Um, don't get involved
with a pathologically ambitious
narcissist and, uh...
be as emotionally open
as possible,
which you're already great at.
And that goes for everything.
Nothing is too small to discuss.
Except for the infinite number
of differences of opinion.
And how do you know
which ones don't matter?
Dr. Murphy, if you have
concerns about your marriage,
talk to your wife.
Meeting adjourned.
Julianne's brain MRI.
Check out the parietal lobe.
Dr. Andrews!
You have a grade 2
oligodendroglioma
centered in your parietal lobe.
It's disturbing
your precuneus region.
May I?
Looked at a lot of brains during
my doctoral psych program.
It's close to the motor
and primary sensory cortex.
We will need to map out
the critical structures
of your brain
to determine
a surgical approach.
There are risks,
but if we can get all of it,
the prognosis is excellent.
Or we could
try to shrink the tumor
with chemo and radiation,
but there's an increased chance
the tumor will progress
to a grade 4 glioma.
I want the surgery.
My life's work has been
to help people find
what my husband and I had.
I'm not done yet.
That is... very good to hear.
This transcranial
magnetic stimulation
will pinpoint the pathways
of your motor cortex
and help us resect
your brain tumor.
And this is my wife, Lea.
- Hey.
- Lea, met Julianne.
She is a marriage therapist
and told me to be careful
of the habits we set.
Great to meet you,
but under the circumstances...
Chatting with you two
is much better
than contemplating those
circumstances.
Stay.
I made a list of small habits
that could become
larger problems.
"Snoring, minor tardiness."
- Is that supposed to happen?
- Yes.
A disconcerting tolerance
for dust.
- These are all my habits.
- Yes.
Do I have habits
you would like me to change?
At this point,
you better just say it, hmm?
The dishes.
You take them
out of the dishwasher
and rerinse them
after I've already done it.
Because you are doing it wrong.
Try to hold still.
We just need to make sure that your
wound's clean for surgery tomorrow.
My head hurts.
I-I need to sit up.
Hey.
Please, just let me see my mom.
She wouldn't like
what you're doing to me.
We're all trying
to help you feel better.
You hungry?
Paul went to get you some food.
I want to go home.
Okay, wound looks good.
Now, let's pack it with gauze.
We can give her something
to try to help her relax.
No. No more poison.
She doesn't need to be
drugged. She's uncomfortable.
Please, just let her out.
I can't. I'm sorry.
On all three fundamentals,
water temperature, choice of
equipment, and application of force,
your technique is lacking.
Shaun, we have a dishwasher.
This is just
a preliminary rinse.
Shaun, um, instead
of offering a critique,
try stating a positive need.
You know, something like, "I wish
the situation was more like this..."
I wish the situation
was more like
Lea knew how to wash the dishes.
We're done with the mapping.
Lea, do you enjoy
doing the dishes?
Does anyone?
I do.
Then forget finding
common ground on this, huh?
Divide and conquer.
He went three for four, two doubles,
three RBIs, and struck out the side!
Well, wait until he's 16
and can throw a curve.
Oh, I-I think I can
get back from here.
Oh, please.
I'm enjoying the company.
Ohh!
You're so sweet.
- I feel nothing. Leave me alone.
- Fine.
What have you two been
fighting about?
- Everything.
- Just little stuff.
Yeah, because you're so crabby.
Because you're so distracted.
It's always like this
when I'm on night shifts.
Why do you think night shifts
are a problem?
We have less time together
to hang out and...
Sex! There's no sex.
Because he's too tired
when he gets home.
Hmm.
Why do you have to wait
until he gets home?
Five more on this side,
then switch.
I'm going to get a heat pad.
You wanted to do
a hemihepatectomy,
but Shaun changed
your surgical plan.
Is that right?
Would you like me to put my
hand on a Bible, counselor?
I thought removing a lobe
was the safest choice.
After I left, the parameters
changed. Shaun adjusted.
A resident overruled
your judgment,
without bothering
to consult you,
and you were fine with that?
That resident was days away
from becoming an attending,
and he did exactly
what you trained him to do:
He made a tough decision,
a hard call,
with limited data.
Would you have made that call?
When I got back,
I evaluated the progress,
and I decided
that it was safe to continue.
It was safe?
Or you had no choice?
Clearly, you read the report.
You tell me.
You asked why
no one had come to get you.
If you were fine with Shaun's
call, why would you care?
I was worried about you.
Thank you.
But if you were fine with
the call, why would you care?
- I got angry.
- You didn't say angry in the M&M.
You said, "Concerned."
You're slicing the salami
pretty thin right now.
Why not just say you were angry?
My precise emotional state
is not medically relevant.
Unless you were angry
because Shaun made a bad call.
Shaun saved your life.
What?
Folding the shirt in thirds
allows them
to be stored vertically.
Sure, but I'd rather...
Storing them vertically
saves space
and makes them easier to find.
Well, why don't you
fold the shirts?
That is an excellent idea.
Good night.
Good night.
Not a bad way
to spend a dinner break.
I'm going to go crash for a
while before my call starts.
Okay.
Hey, we need Dr. Park
or security.
- What's wrong?
- I-I went home to get a change of clothes...
I must've fallen asleep.
She's gone.
Cady couldn't sleep with,
with the restraints.
She was upset and uncomfortable.
I took them off.
I asked her to. It's my fault.
It's not your job
to enforce hospital protocol.
Security's been alerted.
They're working top-down.
You guys cover the east wing.
We'll take the west.
Start down that hall.
I'll check the patient rooms.
Resecting the final
aspect of the tumor.
Lea and I took Julianne's advice
and divided and conquered
last night.
I started with the dishes and
then moved on to folding laundry.
More irrigation.
And Lea, what did she conquer?
I was very open and pointed out her
shirt-folding errors, and then she went to bed.
It was quite successful.
You sure about that?
- Did she... kiss you good night?
- Yes.
- Cheek or lips?
- Cheek.
I got all of the tumor.
Remove the patties and line
the resection bed with Fibrillar.
You think maybe
it was not a success with Lea?
- Sounds like maybe...
- You bombed.
She's in V-tach.
No carotid pulse. No
detectable BP on the art line.
Check the brain
for herniation or hematoma.
No bleeding or signs of edema...
No increased ICP.
Maybe she threw a PE?
Her EKG was normal. Give one
milligram of epi and stand by with more.
Clear!
Her brain looked good.
Her vitals were stable.
No history of heart disease.
Could be an adverse reaction
to the anesthesia?
Do an echo, send trops, and put her
on telemetry to rule out cardiac issues.
Cady.
Hey.
Okay?
Seems like you're feeling
a bit better.
I'm working on my solo.
I know. I heard.
It's lovely.
Would you sing it to me while
we walk back to your room?
Do I have to lie down?
It makes my head hurt.
You can sit up in your bed.
Okay. Come on.
Attagirl.
Cady, do your feet hurt?
No. They're just sticky.
They put glue on them
to keep me from running.
- We need to get a head CT.
- Yeah.
The ventricular enlargement,
that's fluid built up
inside her brain.
Cady has hydrocephalus.
It explains a lot of her
symptoms, shuffling her feet,
the headaches
when she lies down, and...
possibly,
her psychiatric issues.
Cady might not be bipolar?
We'll know more
once we insert a shunt
and drain the fluid
from her brain.
I noticed the shuffling
a year ago.
I-I didn't even mention it
to the doctor.
I just thought it was
another... delusion.
All the doctors we brought
her to, they all missed it.
We almost locked her up.
She could've died in there.
We removed all of the tumor.
The surgery
was successful, although...
I died.
I saw you.
It was like
I was out of my body.
I saw you doing compressions
and there were alarms going off.
And then I saw my husband
in these quick flashes.
He was waiting for me,
somewhere.
Tell me what you saw.
There were vivid colors
everywhere.
It was unlike
anything I had ever seen.
But it felt like home.
What kind of colors?
I... can't describe them.
My husband
was reaching out to me...
and I almost touched him.
Then you pulled me back.
You had a near-death experience.
Ah.
No. She had a symptom.
There is something else
wrong with your brain.
We need to find out what it is.
She didn't have
an out-of-body experience!
She accurately described us
trying to save her.
No, she described a code,
which only proves
that she watches
medical shows on television.
And the heaven that she told
us about, it's all recycled cliches...
The peace, nice colors,
your loved ones waiting.
And maybe those cliches exist
because that's what
the afterlife is like.
- You're a believer.
- Please be quiet!
Julianne must have
a multifocal tumor,
most likely
in her occipital lobe.
A tumor there could've caused a
subclinical, nonconvulsive seizure,
which would explain her
hallucination and cardiac arrest.
A tumor there would make sense.
Then where is it?
It must be hidden by the edema
from the previous tumor.
We need more images
at a higher resolution.
All right, I'll book the MRI
and get Julianne.
Oh, are you
a one almighty God type
or more spiritual,
but not religious?
I'm just asking for a friend.
You're off-target.
Position the catheter toward the
nasion and tragus skull landmarks.
If Cady hadn't wandered off,
we may have never noticed
the foot dragging.
A good outcome doesn't
cancel out a bad decision.
The chain of command
exists for a reason.
I'm in.
Attach the manometer
to check her brain pressure.
Oh, no.
I'd guess about 40 centimeters.
Must've been
building up for years.
The brain damage
could be irreversible.
I'm gonna place the valve,
start draining fluid
into the abdomen.
I got your text.
Is everything okay?
Were you mad last night when
I took over folding the shirts?
Shaun, at some point
we need to define
what qualifies
as an important matter
that needs to be discussed
as soon as possible.
Yes. Okay. Were you mad?
I was frustrated.
But I'm over it.
Why were you frustrated?
Didn't you want to know
the right way to do it?
There's no right way
to do it, Shaun.
There's my way,
there's your way,
and a thousand other ways.
And I don't need you to think
that my way is right.
Especially since your way
is fully research supported.
But knowing you think I'm wrong
about so many things,
sometimes it feels like
you're watching me
and holding a big sign
that says,
"You're doing
everything wrong."
That's why I was frustrated.
And I know
you didn't mean it that way,
and I know
it's important for you
to have things a certain way.
Because of my ASD.
I love your brain, Shaun.
And I really don't care
about laundry and dishes.
I'll find something else to be in
charge of like grocery shopping.
Maybe you could check
the apples better for bruises.
The store will not
take them back.
Right.
There's something wrong
with Julianne's brain.
I don't see anything.
Me neither.
We'll know a lot more
about her prognosis when she wakes up.
For now, we're keeping her
under sedation
and giving mannitol to keep
her brain pressure down.
Well, whatever happens,
we'll get through it.
You're in for the long haul now?
You threatened
to walk out on us.
I was upset.
I just... I was trying to do what
was best for her and for... for you.
By leaving us?
Your symptoms point to another
tumor in your occipital lobe.
No tablet this time?
The tumor doesn't show up
on imaging, but I know it is there.
We can see an irregular and
distinct pattern of edema in that region.
If the tumor's there, it will
very likely stop your heart again.
I've been dead before.
It was pretty great.
I don't want the surgery.
No, the bright colors you couldn't
describe, that's color agnosia.
Your husband being just out
of reach, that's optic ataxia.
You did not see Heaven.
You had a seizure
caused by your tumor.
Dr. Murphy,
you and I are both cursed
with being very good
at fixing things.
When Scott was alive,
I could have made a list of a hundred
ways to improve my marriage, my husband.
But when I saw him again...
I couldn't think
of a single thing I'd change.
I just want to be
with my husband again.
You will be.
Uh, I think
what you experienced was real.
What you saw, it's...
It's not going anywhere.
And there are still a lot of
people here who need your insight.
I know that matters to you
because even with a tumor...
Two brain tumors.
Two brain tumors
and a broken ankle,
you still made a point of
helping half your medical team.
Eternity is a long time.
Your husband will be waiting
for you whenever you get there.
He better.
Let's see if you're right.
She's a GCS of eight,
has most
of her brain stem reflexes.
But no signs that she's ready
to come off the vent.
She always took
forever to wake up.
I saw Paul
in the cafeteria just now
surrounded by empty coffee cups.
If you'd like some company...
No, I'm fine.
Thank you, Doctor.
I used to be a lieutenant
on an aircraft carrier.
The first time
I saw a plane land,
I thought for sure this sucker is going to
skid right off the other end into the ocean.
I promise there's a point
to this.
But they never do.
Because the planes,
they have these tail hooks that catch
on these giant, inch-thick steel wires.
These wires, they can stop
a 50,000-pound aircraft
traveling 150 miles per hour
in two seconds.
And they almost never break...
until they do.
One swung across the deck
and hit my leg, sent me flying.
I was in a coma for weeks.
My parents, they had to decide
whether or not
to amputate my leg,
and they disagreed.
It got ugly.
But my mom won.
And I went to med school
on one leg.
And my parents, they celebrated
45 years last month.
When a family member is sick,
everybody gets a pass.
Hi, there.
After Shaun committed to the
angioembolization, my collateral vessels bled,
causing my blood pressure
to bottom out.
Audrey, it's late...
That loss of BP led to my cord
ischemia, which led to my paralysis.
- Do you agree?
- Yes, as I said in the report, yes.
The report is facts.
It's just facts.
Audrey, what exactly
do you want from me?
I am sitting in this chair
because of that surgery.
And everybody here
seems completely fine with it.
Fine with Shaun's decision,
fine with him going rogue.
I'm not fine with it.
- I'm not fine with it.
- Well, that is not what you said in the M&M.
What Shaun did was headstrong,
it was risky,
and it's not
what I would have done, okay?
But let's just be clear.
He didn't make a mistake,
he did what he thought was best,
and it shouldn't be a mark
on his career as a surgeon.
- That is not your decision.
- And I'm angry, okay?
I'm angry. So what?
It's irrelevant.
I'm so angry I could scream.
It keeps me up every night.
What if Andrews
didn't call me away?
What if I had come back
just five minutes sooner?
What if? What if? What if?
Well, what would you have done?
Come on, Aaron.
What would you have done?
Would you have told Shaun
to go back to the original plan?
Yes.
Thank you.
Because everything's fixed now?
Because you're gonna
walk again soon?
Because you're with me.
Finally somebody sees my side
instead of Shaun's.
It's not either-or.
I'm not so sure.
There's just something sexy
about the closet.
Maybe it's the symbolism. You
know, like coming out of the closet.
- I get it. I just don't approve of it.
- Why?
From the coffee shop
that's on my way in.
Number two on your list of
top-ten food and beverage items
within walking distance
of the hospital.
The almond croissant.
Thanks. I'll pay you back.
Don't you dare.
I'll see you in surgery.
Oh.
Okay, I feel something.
A crush.
A massive, all-consuming, "my
stomach rolls over when I see him" crush
because he is gorgeous
and thoughtful and smart and
apparently eats carbs, and I'm only human.
- Happy now?
- Yeah.
Are you gonna eat that?
I'm so screwed.
Just a minute. Dr. Murphy.
Don't worry too much
about the wet cement.
It's clear how important your
wife and your marriage is to you.
Just keep letting Lea know that,
and you'll keep being
a great husband.
Count backwards from ten.
Ten.
Nine.
Eight.
BIS is at 50.
CO2 is normal. Ready, Doctor.
Making the first incision.
Stand by with the periosteal
for skull dissection.
Heart rate's 125.
BP is 195 over 132.
- Another seizure?
- It's the tumor.
Give another 500 of Keppra
and high-dose propofol.
She's in v-tach.
No pulse.
One milligram of epi.
Clear!
It's been 12 minutes.
Time of death, 12:43 p.m.
They're together again,
somewhere.
Probably not.
But that would be nice.
Hey.
Hey, sweetie.
I'm here.
Mom? What's going on?
Why am I here?
You're in the hospital,
but you're okay now.
Where's Paul?
Hey, Cady-Cat.
Hey, Papa Paul.
Get in here.
Yeah, get in here.
We missed you so much.
I think you should do the
dishes before I have to go.
Really?
Are you gonna teach me
your technique?
No.
I am going to get ready
for my night call.
Go ahead.
I love you, too, Shaun.
It's okay if you can't watch.
You can leave.
Hey, Cady's latest neuro exam
showed no deficits.
And the alignment
from her ex fix looks great.
Um, I'm sorry.
Chain of command was never
my strong suit. I'm working on it.
Thank you...
for your service, Lieutenant.
Was anybody
ever gonna ask about my limp?
Shaun wanted to, but we
told him he wasn't allowed.
You lost a patient today,
Dr. Murphy?
She seized on the table
before the first incision.
Autopsy confirmed she had a
high-grade occipital lobe tumor
which would have killed her
in three to six months.
Your advice was good.
I talked to Lea about habits
and learned she doesn't
appreciate when I wash the dishes
after she washes the dishes,
even though
she is doing it wrong.
Shaun, I can't hear this.
Your advice was good.
I talked to Lea about...
I mean, I don't want to hear it.
I'm having complicated feelings
about my surgery.
- What you did.
- I saved your life.
This...
This is a struggle.
You put me here, and
I'm really angry about that.
As your boss,
I need to set my feelings aside,
be professional, and I will.
But that's all.
I don't want you to ask me
about my personal life,
and I don't want
to hear about yours.
From now on, our relationship
is medicine only.
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