The Good Doctor (2017–…): Season 6, Episode 7 - Boys Don't Cry - full transcript

You're smiling.

Why?

Well...

That is...

your menstrual cycle.

It's been a year since
we lost the baby,

and I finished my
anti-coagulants.

Which means...

We can try to conceive again.

Mm-hmm. I have an appointment
with Dr. Winkler today.

If she gives us the go-ahead...



A year was the minimum.

Good vibes, Shaun.

Send good vibes into the
universe, good things come back.

Vibe with me, babe.

I would very much like
to have a baby with Lea!

Okay.

Well, get ready to make one.

Okay. We are going
to make a baby!

Yeah.

Mmm.

Mmm.

Oh.

I have 23 minutes until
I need to leave for work.

Should we save your swimmy
guys until I ovulate?



Oh, recent research demonstrated

frequent ejaculation
improves sperm motility.

Oh! In that case...

Oh, yeah.

We can talk about it.
Okay? Thanks so much.

Isabel.

What are you doing here?

Gena Cooper. Pregnant
with sextuplets.

That's what all my calls
and texts were about.

So you would already
know if you'd answered.

You show up, ask
me for a consult,

like you're any other doctor?

Whatever the appropriate
approach is for ex-wives,

tell me, and I'll take it.

Couple couldn't conceive,
so I prescribed clomiphene.

Six babies just after one round.

They won the lottery. Or lost.

Two require immediate
surgical intervention.

At least. Know any surgeons?

Marcus, this family
needs your help.

If needed, I will
step off the case

and I will find
them another O. B.

Stay.

It wouldn't be fair
to the patient.

Each of your babies gets their
own dedicated team of doctors.

Now, since all of
the babies will be

under 2 pounds at birth,

they will all need a
lot of care, attention,

and time in our NICU,
maturing those lungs.

Once they're feeling strong
enough to make some demands,

you'll hear that beautiful cry.

A baby crying is a good thing.

It lets us know
the baby's healthy.

And that's when we name them,

once they've cried and
we know they're okay.

I wish they could stay inside
Mom longer and get bigger.

Baby F's airway mass
is already causing

severe narrowing of the trachea,

and her lungs aren't
developing properly.

A few more days, and
her heart could fail.

So we deliver today. Yes.

Everyone ready?

Baby A through Baby E

will all be born in
under three minutes.

Baby A.

At birth, they'll each
be given an Apgar score

to let us know how
they are doing.

7 or above is reassuring.

It's a girl.

Baby B.

Alright. Hello.

Baby A... Apgar 7.

It's a boy.

Surprise. Mono-di.

B and C share the same placenta.

Very rare. Identical twins.

Another boy, obviously.

Baby B... Apgar 5.

Baby C... Apgar 4.

Baby D.

It's... a boy.

Baby E.

Baby D... Apgar 6.

Spina bifida.

Baby E's a girl.

Baby E... Apgar 6.

Baby E
will go to the O. R.

For her spina bifida
surgery after delivery.

Exposing Baby
F to EXIT procedure.

Once Baby A through
Baby E are in the NICU,

Dr. Barnes will deliver
Baby F's arm and head

through the C-section incision,

leaving the placenta attached.

And, Mom, that allows you
to keep providing oxygen

to your daughter.

Nurse Denning, take Papa to
check on his other babies.

We're all good
here, Jack. Dr. Lim?

Then, Dr. Lim will perform
the EXIT procedure.

First time it's ever been
done in a multiple birth.

She's got this.

Moving through
the oropharynx cavity.

Baby F's umbilical cord
looks very thin and friable.

Placenta's still attached?

Yep. Mama's giving her
all the oxygen she needs.

At the larynx.
Approaching the trachea.

I've identified the cyst.

The pulse
is extremely faint.

The cyst is causing total
obliteration of the airway.

Microblator.

I've completely lost
the pulse in the cord.

We have less than a
minute to deliver.

Having trouble
visualizing the base.

Maybe you're not there yet?

Probing deeper. Keep going.

A little more. I see it.
You're two millimeters away.

Got it.

Cyst is decompressed.
Airway's open.

Placing E. T. tube.

Finally... Baby F.

It's a girl. Okay.

Good work.

Baby F... Apgar 5.

Thank you for taking this on.

The hard part's just beginning.

Okay.

Captions by VITAC...

Baby A's one and
five-minute Apgar?

Seven and nine.

Mom should be coming to.
Take her to meet her parents.

Keep B and C together.

We have two
different NICU rooms.

Neither boy is
crying, and co-bedding

identical-twin preemies
can be beneficial for both.

That's anecdotal. Risks
include poor thermoregulation,

increased... Just do it.

Baby D is not crying,

plus he has nevus simplex
and meconium-stained fluid.

Get the heel stick and go
tell the lab it's stat.

Spinal lesion covered
with sterile wet telfa.

Heading to O. R. 2.

Keep me posted.

And how's the star
of our show? Baby F.

Not singing yet,
but airway is clear.

Take her to NICU.
Hopefully she cries soon.

Hey. Hi.

My hero.

Where are my babies?

They're
in the NICU now.

Except for Baby A here.

She got a head
start on her siblings.

Listen to those healthy lungs.

Mm. First to cry.
She's an overachiever.

What do you think about Abigail?

Forever Baby A.

I love it. And her.

How 'bout it, B? Can we get
those lungs strong enough

to move you to a CPAP?

You hear those studies on
co-bedding identical preemies?

No. C's cyanotic. He's
tachypneic and retracting.

Check his liver.

The research is totally
shaded by confirmation bias.

Palpable three centimeters
below the costal margin.

If you'd been more assertive,
we wouldn't be stuck together.

Systolic murmur.

Why weren't you more assertive?

If I were a surgical
attending, I would have been.

I had to fight just
to be on this case.

You're gonna need an
echo, chest X-ray...

X-ray, BNP, and CBC to confirm
congestive heart failure.

I know.

Let's make a deal.

We only talk to each other
when medically necessary.

Fine.

Inset the needle in the
posterior iliac crest.

Later, I have to accompany
Lea to an OB-GYN appointment.

Dr. Andrews will supervise
you for a few hours.

Everything okay?

We don't know yet.

Last year, she
miscarried at 22 weeks.

Good precision.

When Baby D was first born,
you kinda took a moment.

That why?

Yes.

I think I've
penetrated the bone.

Syringe? No, you haven't.

You will hear and feel
a pop when you do.

Go a bit deeper.

Dr. Perez, you
need to be firmer.

More aggressive.

Go ahead.

Syringe?

Now? Yes.

As a surgeon, you must be
decisive and aggressive.

Aspirating the bone marrow.

Very good.

Get it to the lab for
microscopic analysis.

Good luck.

With the appointment.

You'll make a great dad.

You are not qualified
to make that prediction.

Incision immediately
lateral to the neural placode

into the epithelium.

Incision tight to the placode.

That method avoids leaving the
epithelials in the closure.

Is the play-by-play
really necessary?

It helps me to learn
by saying it out loud.

It helps me to do the
surgery if you don't.

You can talk. Just
not like Vin Scully.

Who's Vin Scully?
Alright, scrub out.

I'm kidding. Mostly.

The parents, Gena
and Jack? Heroes.

We might throw that word around
just a little too easily.

Think of the risk they took,

bringing six new
lives into the world.

Refusing to selectively reduce

is what got us here
in the first place.

Delivering 11 weeks pre-term

is a little bit less than ideal.

Like Dr. Andrews says,

we're going to beat the
odds and save them all.

Well, if we pull that off,
then we are the heroes.

Oxygenation dropped below 90.

We can't turn her over to
assess or treat her lungs.

We can't even do imaging.

We're gonna have to
tell the parents.

Prepare them.

I'll do it.

Are you sure?

You can't sugarcoat it.

Administer 2 mils
surfactant, prophylactically?

No indication of R. D. S.
She's on minimal settings.

I'd actually like to decrease
support and remove CPAP.

Yeah? No reason she
can't breathe on her own

now that her airway is clear.

Come on, Baby F.

Deep breaths.

Your basketball rival Clay
texted me, asked me out.

Get out.

I assure you, this guy
knows it's a real date.

If I go.

You're going.

That's our girl.

Baby E's lungs
are filled with fluid,

and she's in early
heart failure.

She may need to be reintubated,

which would mean
placing her on her back.

That would make it harder for
her surgical wound to heal.

That doesn't sound good.

She's very sick.

It's possible she
may not survive.

Mnh.

We'll pray for a miracle.

It wouldn't be our first.

I can arrange a visit from the
hospital chaplain if you like.

You can baptize the baby.

No.

You're asking me to let her
go. I'm not ready to do that.

You can't, either.

Please.

Of course.

O2 sats improving.

Way to go, Baby B.

You'll be shouting in no time.

Tell me you're not on Tinder.

You're in violation of the
medicine-only agreement

that you proposed.

And I'm not on Tinder.

My baby's on the mend.

Yours is the one with
the heart problem.

Don't be afraid to ask for help.

Then what's with all the
handsome dudes' faces

you're scrolling through?

Your screen is
reflected in the window.

Not that it's any of
your business, Columbo,

but they're not
dates. They're donors.

Organ donors? Finally
getting a heart?

Mm. Sperm.

Oh.

Yeah. "Oh."

Snowman sign on the chest X-ray.

It could be T. A. P. V. R.,

transposition of
the great vessels,

Ebstein anomaly, or
pulmonary atresia.

I don't see
differential cyanosis.

That rules out transposition
of the great vessels.

No boot-shaped heart, either.

Or gallop.

So it is T. A. P. V. R.

Which we can fix.

I'll get the parents' consent
and book an O. R. right away.

Thanks for the help.

Lucky I was a match. Yes.

As Baby D's father, there
was only a 38.5% chance

you'd be a bone-marrow match.

Why are you here?

Being on your feet
promotes blood flow,

and she wanted to
be with her husband.

I'm just glad I
can do something.

Gena's handled all the heavy
lifting for our family.

You have no idea how hard
this kind of stuff can be.

I do.

My wife and I have also
struggled to have a child.

Modern medicine's a miracle.

I hope you'll be
blessed like us.

I hope so, too.

But not as blessed.

I will insert the large bore
needle into your hip now.

Ugh. I hate needles.

How'd you two meet?

He was my prom date.

Been together ever since?

Uh, no.

Gena ran off to New York for a
decade to join the City Ballet.

Until I broke my ankle,
ended my career, came home.

We reconnected at our
10-year high-school reunion.

It was like no time had passed.

I never forgot her.

I never forgot you, either.

Done!

You get me yammering
on about Gena,

and I barely even notice a
needle going into my bone.

You did great. We'll
get this to the lab

and then transfuse it
into Baby D right away.

Nice work in there.

Baby C should be
crying in no time.

Are you sure you want to
raise a baby on your own?

Because I'm too careerist
to be a good mom?

Like I was too ambitious
to be a good girlfriend?

No.

You'll love your kid more
than any job or partner.

I sure do.

But if you don't have the
guy when you have the kid,

he might be tough to find.

I shouldn't have a kid 'cause
I may never find a man?

Okay, caveman.

Well, I never said I
wouldn't date a single mom,

but I am remarkably sensitive.

I want a kid, and
I'm done waiting.

See you back in the NICU.

She's improving. And hungry.

All ready for some colostrum.

Did you text Clay back yet?

After this, we can start
introducing a pacifier.

I didn't have sex for 17
months after I lost my leg.

And then, when I did, I thought,

"Oh, yeah. I remember
this. It's awesome."

It's a first date. I'm not
even thinking about sex.

Liar.

These make these chairs
that glide. And wedges.

This is not a death
sentence to your sex life.

Okay, I will text him back,

mostly to stop
this conversation.

Hm. But it's just dinner.

For now.

Damn. She's not
tolerating the colostrum.

I haven't started it yet.

So you guys ready to
start trying again?

Oh, yes. We put up a
calendar this morning.

And practiced.

I think she gets it, Shaun.

Visualizing the uterine wall.

That's scar tissue.

That sounds bad.

It's from the fetoscopic
surgery and D&C

after your miscarriage.

You should do a hysteroscopy
to remove the adhesions.

Thank you, Dr. Murphy.

He's right. Uh, we can
attempt that, but...

You have Asherman's Syndrome.

Most likely, yes.

Well, can... Can we
still start trying?

I wouldn't advise it.

How much longer do
we have to wait?

I recommend continuing
birth control.

Getting pregnant right now
wouldn't be safe for you...

or the baby.

When will it be safe?

Maybe another year? Maybe two.

Maybe never.

Severe edema,
fluid in the lungs,

but no obstructions,
just as we expected.

So we've eliminated
brain, spine, abdomen,

anything congenital.

I shouldn't have let
you talk to them.

Miracles? Really?

I was direct and honest.

How's that being honest?

They think there's
a chance here.

As long as she's breathing,
her heart is beating,

her brain is functioning,
there's still hope.

This infant is under two pounds,

11 weeks premature, with
a major birth defect.

She's more than likely
too small, too weak,

and too sick to survive.

Stop being a cheerleader.
Start being a doctor.

O2 sats and heart
rate are improving.

Come on, dude. Cry for me.

You got this.

Who's a star?

Baby B is. He's
coming off the vent.

Yes, you are. And then
you're gonna wail.

Those guys you were
looking at earlier...

How much do you really
know about them?

You'd be surprised.

Well, besides their
physical attributes

and what diseases they carry.

Genetics can also determine
your sense of humor,

your values...

You want me to
have the sperm bank

ask them all to write
a knock-knock joke

and an answer to
the trolley problem?

Or ask me.

I'm not suggesting
I'd be the kid's dad.

I just want to help.

No strings attached.

Uh, Baby B's on
CPAP. O2 sats rising.

Hope to hear a cry son.

Excellent. Still no
cry from C, either?

Okay. Scope the baby.

T.A.P.V.R. repair may have
caused vocal cord palsy.

No missed or new
obstructive issues.

Upper airway's clean.

Why are her O2 sats plummeting?

Could be some sort of fistula,

bronchopulmonary dysplasia.

R.D.S. Or it could
be neurological.

She's too fragile to
start testing blind.

I'll stay with her.
Put her back on CPAP.

I'll put together a
full differential.

Eat something
while you're at it.

Marrow transplant
seems to be working,

but I couldn't pass the
NG tube into the stomach.

How'd the appointment go?

Not well.

Are you okay?

No.

How long has he been drooling?

I don't know. I...
thought that was normal.

- It's not.
- Any luck with the NG tube?

No. That is a symptom.
This baby cannot swallow.

He has a congenial
tracheoesophageal fistula.

We need to operate.

Camera is in position.

Fistula's between
the distal esophagus

and the trachea.

You were right.

I know. Now reconnect
the esophagus.

Forceps.

Repositioning thoracoscope.

Got it.

Mobilizing the esophagus to
the level of the trachea.

Have you already
isolated the fistula?

Yes.

I didn't tell you to do that.

Uh... You should
have first mobilized

the proximal pouch
of the esophagus.

I'm s... I'm so... I'm sorry.

You have have interrupted
the blood supply.

The risk of anastomosis leaks

and tissue breakdown
are greater now.

Give
me the instrument.

Step back.

Move.

Take the camera.

Suturing.

Is he gonna be okay?

I don't know.

When I said "yes" to dinner,
I didn't mean tonight.

Patience is not my
greatest virtue.

I'm in the middle of
this preemie case.

So you fasting until it's done?

Brought your
favorite. Roast chicken.

Oh. It's like the first
time you asked me out.

Mm-hmm.

She's breathing on her own.

Nice.

I don't envy anyone
who has to try to sleep

in a house with six infants.

Mm-hmm.

No matter how cute they are.

I feel that way about one.

Oh.

Are... you opposed to kids?

I mean, not politically.

But...?

I'm not sure I
want any of my own.

Is that bad?

Being one of four, I...

I always saw myself
with a big family.

Being one of eight...

Pretty much why
I don't want one.

Ice Cube, Guy Fieri, Tom Hanks.

Everybody loves Hanks.

Not Tom Hanks.

Raider Nation is
deep and eclectic.

I promise I don't paint my
face. Unless it's the playoffs.

Oh. So only one
day per decade.

Okay.
Opposite sides of the Bay.

That's why they have a bridge.

I can't believe you were
actually there for "The Catch."

Were you sitting on
that side of the field

where Clark caught it?

Yep. You're distracted.

Want to walk me through
your case so far?

EXIT procedure for CHAOS.
Cyst was decompressed.

We weaned her off
CPAP, O2 sats improved,

then started crashing.

Not sure why.

Pass me the ghost
pepper sauce, would ya?

Ooh. Feel like that stuff's
gonna burn a hole in my chest.

What if your preemie's breathing
troubles aren't from above?

What if it's from below?

Diaphragmatic hernia.

Could allow the baby's
lower organs to protrude

into her chest, crowd her lungs.

If it started as a small
defect, we could easily miss it

on ultrasound with all
the crowding in that womb.

Mm-hmm.

Smart, handsome, and
you brought me food.

I might actually let you
take me out on a real date.

This is a real date.

I mean, it will be once we kiss.

Then we should
probably do that now.

My thought exactly.

Thank you for your offer.

But?

It would hurt too much
to see you every time

I looked at my kid.

The live birth
rate in pregnancies

after Asherman's
treatment is 67%.

She should have mentioned that.

Yeah. I guess so.

And hysteroscopy...

improves the odds of conception.

Our prognosis for conception
may still be very good.

I'm "sending good vibes
into the universe,

so good things come back."

Thank you, Shaun.

Maybe later.

Right now I'm just very sad.

I know.

O2 sats are falling. I need
suction and a ventilator.

Page Andrews.
She's bradycardic.

She's not getting enough oxygen.

O2 sats are rising.
Heart rate's normal.

She's fine.

Just forgot to breathe.

It happens when
they're this little.

I'm gonna go home.

You're giving up?

I'm accepting the situation.

There's still hope.

Stop with the hope
already, will ya?

It's not gonna save this child.

Hypnagogia.

Thomas Edison believed
the thoughts generated

as we drift off to sleep

were the most likely to
generate a breakthrough.

Alright, Thomas Edison,
the Wizard of Menlo Park,

the same guy who believed
that if he sat on a goose egg,

he could actually make
the goose egg hatch.

There was an experiment
published in Science.

Subjects tried to solve
a difficult math problem

late at night while
holding something heavy.

When they drifted off to
sleep, they dropped it,

and when they woke up,
they solved the problem.

Okay, when I go to bed tonight,

I'll cuddle with a barbell
while holding onto a light bulb.

How's that?

Any breakthroughs on Baby E?

We've exhausted all our options.

We're moving on to
"watch and wait."

We were just talking
about hypnagogia.

The Edison sleep theory
from Science magazine?

Thought we might stay all night

and take turns
waking each other.

Well, that's...

Absurd? Silly? Ridiculous?

I was gonna say that's
better than "watch and wait."

You were right. Baby F has
a diaphragmatic hernia.

It didn't show up in
the initial X-ray.

Anybody would have missed it.

It was Clay's idea.

I'm glad that I texted
him to bring you dinner.

You did not.

I did.

Well played.

After we get consent,
you can scrub in,

help me make that
little girl all better.

Hypnagogia! Ahh!

What?

The groin. What?

What? The groin?

If we can't access the baby's
chest, we can check the groin.

If she has bounding
femoral pulses...

It would indicate a
patent ductus arteriosus.

Which would explain the
fluid in her lungs and the...

The heart failure,
which could be fixed

with a Piccolo Occluder.

Go get consent.
And an aspirin.

Uh, wait.

What is it?

If we can't put the
baby on her back,

how are we gonna
insert the device?

I'll get comfortable.

You scream in my face this time.

He's swallowing now.

But still not crying.

Ready to show your
brother how it's done?

Very polite of you to
wait for your brother.

Maybe there was something to
that shady co-bedding research.

Maybe you being a wuss was
a blessing in disguise.

It would have hurt me,
too... Having a kid with you

and not being part
of your lives.

Gaining access through
the umbilical vessels...

That was inspiring.

I credit Thomas
Edison. As you should.

Seriously, thank
you for humoring

my crazy idea, Dr. Glassman.

Thank you for helping me
to not give up on hope.

Come on, buddy. Let
me hear that cry.

Heart rate 110 BPM.
Respiratory 65.

Look. I'm so sorry.

I thought I was...
being decisive.

You were.

It was the wrong decision.

He will be okay.

You should feel bad,
but not too bad.

Sextuplet births
are incredibly rare,

one in almost 4 billion,

and the odds of 100%
survival are even rarer.

But I'm happy to report
all six babies are healthy

and all six babies
will be going home.

It wasn't easy, but
because of all of you...

they made it.

Some of our friends...

Mnh-mnh. That's a
thicket of chest hair.

Mm. Chances are, his back...

Mnh.

Because of your hard
work, we're able to now...

Breakfast on me if you help me

make a list of
acceptable prospects.

I just wanted to
personally thank you.

And the parents, Gena and Jack,
they want to thank you, as well.

This is a time to celebrate.

B's competitive. He likes to do
everything before his brother.

And C's an empath,
waited until he knew

his brother would be okay
before doing his thing.

Hi.

Hi.

Byron and Christopher?

Yeah.

E.J. Her name is E. J.

It stands for Erin Jordan.

Thank you both.

Meet Baby F.

Hi.

Francesca?

But Gena and Jack
are first-time parents

who will be bringing
home six babies,

so they're gonna
need lots of help.

Now, for those of you who
are willing to continue,

once the babies are at home,

there's a volunteer sign-up
sheet at the check-in desk.

I'm sure Gena and
Jack would be grateful

for any help you're
willing to give.

So you had a goth mom?

She sang you "Boys Don't
Cry" as a lullaby, right?

Oh, yeah.

She'd pick me up at school
blasting Joy Division, too.

Humiliated me at the time.

But... she was a good mom.

My dad used to sing
"Ein Keloheinu"

louder than everyone in shul.

I... hated it.

Which was probably the point.

Could be fun to embarrass
our kids some day.

Far, far in the future.

Thank you. Okay.

I'm glad I brought
this case to you.

Me too.

Marcus. I'm sorry.

For giving up on
us. For cheating.

It's the worst
mistake I ever made.

It wasn't all you.

I don't know that I gave up,

but I certainly didn't
pay enough attention.

Gena and Jack grew apart...

but they found each other again.

It's a nice story.

Yeah.

Nice.

Derek.

Say "grilled cheese" six times!

Grilled cheese.