The Good Doctor (2017–…): Season 6, Episode 8 - Sorry, Not Sorry - full transcript
Time to get up already?
Mm, for me.
Early department meeting.
You should stay in
bed a while longer.
So should you.
Mm.
How about I put a
call in to Rosalia's,
breakfast burrito, latte
for pickup.
20 minutes saved.
If I get back in that bed,
it's gonna be for
more than 20 minutes.
Oh.
I can be late.
I told you
to put on a jacket.
And I told you I'd be fine.
Are you fine?
No. I'm freezing.
It's San Jose.
"Winter" is a relative term.
Eh.
Thanks. Mm-hmm.
Weren't you wearing
that yesterday?
I crashed at her place.
We were working on a research
project and finished late,
and he slept on the couch.
Didn't you have a date?
I rescheduled it.
I gotta get inside and shower
or I'll be late for my call.
See you.
Alright. See ya.
He's bread crumbing you.
Excuse me?
He's flirtatious, non-committal.
He's giving you just
enough attention
to keep you on the hook.
He's dropping crumbs.
You'll never get the full slice.
We're just friends.
I'm fine with that.
Hm. Or maybe you're settling
for whatever he'll give you.
When did the stomach pain begin?
A couple weeks ago.
I'm on my tenth day of Lupron,
so it could be the side effects.
We're hoping for
an embryo transfer
at the end of the month.
Gotta take care of this mama.
Other than the
pain, any other...
Emesis, fever, sweats.
Some tenderness and distension.
A scar on the right
lower quadrant.
That's a first date souvenir.
Unofficial first date.
A McBurney's incision.
You had an open appendectomy.
She had a ruptured appendix.
I'm an RN.
Oh, it was a medical meet-cute.
I'm okay.
You are not.
There is an
irregularly shaped mass
in the right-side pelvic region.
You need a CT, stat.
Can I help you?
Are you okay?
Um, I fell and hit my head.
Come here.
Possible head trauma.
Can you give me your
name and date of birth?
Um, Toni Rhodes,
Aug... August 7, 1995.
Slowly reactive pupils.
Any drugs or alcohol use?
No. No.
Uh, yes.
I... I had a couple
drinks last night.
How did I get here?
And we need a head CT
to check for brain bleed
or skull fractures.
Oh, my stomach is...
How did you get this?
Okay, her abdomen is
rigid and distended.
Significant
intraperitoneal hemorrhage
at left upper quadrant.
You're bleeding
from your spleen.
We need to get you into surgery.
Captions by VITAC...
I reviewed your
patient's ultrasound.
The appearance of that
mixed-echogenic mass is unusual.
Yes.
We... Keep me posted.
Ooh, you went to Rosalia's?
The breakfast burrito
with the spicy chorizo...
Try molten chorizo.
Totally worth the ulcer
I'm probably getting.
Hard stan.
I have never been to Rosalia's.
I recommend it.
Your images are
ready, Dr. Murphy.
There is the mass.
There's a ton of free fluid
surrounding the lesion.
Possible active bleeding and
invasion into adjacent organs.
She needs surgery immediately
for resection of the lesion.
How long have you had these?
My monster horns?
A few years.
But now they're making it hard
for my glasses to stay on.
I keep them hidden with my hair.
You are beautiful, and
you have nothing to hide.
But those glasses
do need to stay put,
so I think we should
remove these growths.
Without shaving my hair
or leaving big scars?
Those are the only options
other doctors have given me.
Those doctors don't
know my technique.
I'll make a tiny incision here.
It minimizes scars, and
it'll leave your hair intact.
Okay. Okay?
Put Gwendolyn on my
schedule in the morning.
Thank you, Dr. Andrews.
Yes.
Toni's CT came back clean.
No fractures or
intracranial bleeding,
so she's clear for surgery.
Hm.
We need to finish our
research for tomorrow?
I'll spring for pizza.
Have you ever heard
of bread crumbing?
Does it involve pigeons?
No.
It's when two people
hang out a lot.
One wants to be
more than friends,
and the other isn't clear.
Question is, what should
the first person do...
Be patient or move on?
Asking for a friend.
I'd say real personal connection
can be rare, invaluable,
whether the context is
romantic or platonic.
I'll see you inside.
There are
tentacles of scar tissue
reaching into every organ.
Multiple abscesses
and infection burden.
We will need several drains.
100 cc already. This
infection is crazy.
So, things with you and Lim
are still sorta awkward?
Dr. Lim and I have a
professional relationship
centered on medicine.
The mass is adherent
to the pelvic wall,
colon, bladder, uterus.
But you guys used to be closer.
Do you miss that?
Cutting through more tissue.
Dr. Lim is Chief of Surgery,
I am an attending.
A medical focus is
logical and productive.
We've reached the mass.
Cutting into the capsule.
Wait.
Oh, my God, is that...?
A surgical towel.
Have my special
ex lap tray ready.
Transfuse two units
and stay two ahead.
Place a Foley catheter now.
Her hematocrit's in the toilet.
A fall shouldn't have
caused this much damage.
She was high
when she came in.
No telling what
could've happened.
How about we hold that judgment
till her tox results come back?
Placing arterial line now.
Sluggish pupils, memory loss,
confusion... she's using.
Not judgment, just recognize
certain behavior when I see it.
She's hemodynamically
unstable. Debate later.
Right now, we need
to stop this bleed.
Dr. Allen, why aren't
you placing the catheter?
There's severe bruising
and signs of major trauma
in her pelvic region.
I think she was raped.
We were able to
save your spleen,
but you bled a lot
during the surgery
for reasons we don't
understand yet.
We need to run more tests.
When we were placing
your catheter,
we discovered some bruising
and signs of trauma
in your pelvic region.
We're worried you may have
been sexually assaulted.
No, that's...
just not possible.
Your urine testing also came
back positive for Rohypnol.
It's often associated
with date rape.
No, I-I...
I went out for drinks
with my friend.
We were celebrating his new job.
I watched the bartender
mix my drinks.
I was tipsy, but I wasn't drunk.
The bruises must be
from when I tripped.
I would remember if what
you're saying happened.
Rohypnol can cause
short-term amnesia.
I'm sure this
information is a shock.
We're here to support you.
The best way to gather evidence
as to what happened
is to do a rape kit.
No, I... I don't need that.
I was with my friend.
He wouldn't let
anything happen to me.
You don't have to
decide right now.
Get some rest.
We'll let you know when
your latest labs come back.
A retained surgical item?
It's a towel that was left
in you after a procedure.
It is adherent to
several vital organs.
We could not remove it without
irreversibly damaging...
Left behind by who?
My doctor?
Let's focus on getting it
out first, and then we can...
Who performed my appendectomy?
Broder, I think. But...
The count of sponges
and other items
inside the surgical cavity is
done by the lead scrub nurse.
But you may discuss this later.
Okay. So who was the
lead scrub nurse?
Gomez, maybe, or Kraus.
I really don't remember.
But you were definitely there.
Are you blaming this on me?
You were one of the nurses.
I mean, shouldn't
you have noticed?
I was circulating, not scrub.
No way I was the
one who did this.
A minute ago you can't remember,
but now you're sure
you didn't do it.
Maybe we should move on to...
Why are you attacking me?
I just found out I have an
infected towel in my gut
that will require major surgery,
and you're making
this about you.
You're acting like
this was my fault.
It doesn't matter
whose fault it was.
We will approach the
towel like a sarcoma...
Perform an en bloc resection,
bypass any intertwined
vital arterial structures,
and finish with a
thorough debridement.
I think that's a
reasonable option.
Well, right now, your
opinion doesn't mean a lot.
I just need a minute.
I'll be out in the hall.
She's... not conscious.
She's syncopal.
She fainted?
Naveen. BP spiking.
Oh, my God. Heart rate's up.
Possible bleed or septic shock.
Crash airway tray!
An additional abscess cavity
in the towel may have ruptured.
We need to get her
back to the O. R.
You wanted to see me? Hey.
Yeah, I'm double
booked tomorrow.
You'll be scrubbing
in with Dr. Annanian
for Gwendolyn's surgery.
But she was so
impressed with you.
She's really excited to
have you as her surgeon.
Well, it's a meeting
I can't miss.
But Dr. Annanian has
my surgical plan.
I'll check in afterwards.
The rupture caused
widespread peritonitis.
This infection is way
worse than before.
Aggressively irrigate,
debride, and suction.
We need to control
the infection.
Send tissue and fluid
to the micro lab
so we can focus her antibiotics.
Big drop in BP.
Heart rate spiking.
She isn't tolerating surgery.
We need to close her again.
Sutures.
Wait, what about the towel?
We can't operate until her BP
and O2 sats are under control.
She'll need to remain
sedated and intubated
until she stabilizes.
And we need to find a new
approach to removing the towel.
Once she's closed, I
can dive into research.
I will consult with Dr. Lim.
I would like a surgical consult.
The Mukherjee case?
The mass on the CT was a
retained surgical towel.
And is acutely infected and
adherent to vital organs.
The patient blames her wife,
who was a surgical nurse
during the appendectomy...
Circulating, not scrub.
If we could stick
to the medical...
The patient didn't understand
the count was not her
wife's responsibility.
They argued quite a...
The most pressing
issue is the towel
poisoning her from the inside.
What is your plan to remove it?
That...
is what I am here to discuss.
You are an attending,
Dr. Murphy.
And your patient has a few hours
before she's stable
enough for any procedure.
Research RSIs and brainstorm
possible solutions with your team.
Then, if you still need a
consult, my door is open.
How's Toni's platelet count?
Still dropping.
Did you do an
anti-platelet antibody?
Waiting on results.
Order another PRBC transfusion
to get her hematocrit up.
Any progress on the rape kit?
She doesn't want
to talk about it.
I can't blame her.
It's an invasive process
that only serves to prove
something horrible happened
that she doesn't remember.
Her brain may not be able to
remember, but her body does.
And chances are, eventually,
it will all come back.
Shouldn't we respect her wishes?
I mean, we don't
want her to feel like
she's being assaulted
all over again.
Denying what happened
doesn't change the fact
that it happened.
It's Toni... Code Gray.
No,
please, please, stop!
She woke up screaming,
and she pulled out her IV.
Just stay away from me!
We just want to help you.
Toni, you're okay.
We're here with you.
It's not real.
Can you breathe with me?
You're okay.
You're not in danger anymore.
I...
had a nightmare.
Her gown.
I need to take a look at that.
Okay?
The spleen repair didn't work.
Over
the course of your long career,
you have removed five
retained sponges.
That is statistically higher
than any surgeon in the region.
Special skill on my résumé
right under juggling.
My patient has a retained towel
that has caused sepsis with
multi-organ involvement.
I would like a surgical consult.
Perfect request for
your department head.
Dr. Lim said I should tackle
the problem on my own.
Well, that's interesting.
She is right.
I am an attending.
But your RSI experience would
be very helpful on this case.
Alright, I'll take a look.
Thank you.
Nurse Villanueva,
why is Gwen's surgery
still on my schedule?
She panicked when I told
her it'd be another surgeon.
She really wants you.
Assure the patient
she's in great hands
with Dr. Annanian,
and take her off my rotation.
No.
You told her you'd
do the surgery.
You can tell her that
you're not going to do it.
What about a minimally
invasive surgery...
Cutting up the towel,
removing it piece by piece
through a single port?
That won't work.
Where it's stitched
to the organs,
the infected tissue
puts her at high risk.
An aggressive gross total
resection of all organs invaded
by the towel plus all
infected and necrotic tissue
is the best option for
long-term survival.
That procedure
risks major bleeds,
and we'd have to
remove her uterus.
They're planning a family,
and Naveen is supposed
to carry the baby.
That will also be
impossible if she is dead.
That's elegantly put.
The wife of the
patient is here, right?
Explain the options to her,
and see how she
wants us to proceed.
They had an argument
before her last surgery.
She will not be pleased with
her wife making that decision.
Just go talk to her.
We figured out why
you've been bleeding.
You have a condition
known as ITP.
Your immune system is
destroying your platelets.
Can you fix it?
There is medication
that can help.
And we need to
remove your spleen.
Why didn't you just do that
during my earlier surgery?
We weren't aware of your ITP.
It's a condition that can
be triggered by trauma.
The ITP complicates
our approach.
Usually, we'd remove your
spleen through your abdomen,
but that risks a
catastrophic bleed.
We can remove your
spleen vaginally
with minimal incisions.
There's less risk of bleeding.
Okay, let's do it.
I'm hoping you'll let us do a
rape kit before the procedure.
I already told you, no.
The transvaginal
approach will destroy
all evidence of
the sexual assault.
No.
I don't care.
Without the kit,
you'll have no proof.
You're right.
I believe that something
terrible happened to me.
But that is true whether or not
I go chase down the boogeyman.
But it could help.
Nothing will help.
Don't let whoever did this
to you get away with it.
He already has.
Doing a rape kit is
not going to unrape me.
Go ahead with the surgery.
We need your decision.
Is there any way to
do the total resection
without removing
Naveen's uterus?
No.
She's dreamed of being
pregnant her whole life.
I can't choose this for her.
You can.
We understand how
difficult this is.
She'll never forgive
me. She will.
I mean, it's obvious
Naveen loves you.
She already blames me
for what's happening.
If I'm the one that takes away
her chance to carry a child...
You are right.
If you choose the
gross resection
and your wife loses her uterus,
it is likely she will
never forgive you.
But that is irrelevant.
This is your decision.
You have to make it.
Whatever happens next.
Do the total resection.
I haven't seen you around
here for a while, huh?
Forgot how relationships can
eat into discretionary time.
Doesn't exactly sound
like a complaint.
It's not.
Shaun came to me with
a surgical consult.
Your RSI record. Smart.
He did it because
you sent him away.
Well, part of the Chief's job
is to empower their attendings
to find their own solutions.
Sounds like Shaun did.
A lot of ways to
empower an attending.
And I chose one.
Because you're still
angry with Shaun?
Okay.
How long are you
gonna keep that up?
How about as long as I want?
Okay, you be as mad at Shaun
for as long as you need to be.
Thanks for the permission.
Just so you know, it's toxic.
And not just for Shaun.
Spare me.
You're not concerned for
anyone other than Shaun.
I have to get back to work.
Dr. Andrews.
I rescheduled my
finance meeting.
But in the future,
I'm requesting a scrub
nurse who respects my role
as surgeon and
hospital president.
When I was in the hospital,
you sat at my bedside.
You helped me recover when
I wasn't sure I wanted to.
That meant a lot.
Personal attention with
patients is important
even when you're president.
The laparoscopic splenectomy
is a great alternative
to the transvaginal...
Toni's surgery is already
scheduled for this evening.
And she asked that you
be removed from her case.
She may regret not
taking action on this
for the rest of her life.
That's her decision, not yours.
I got your message, Shaun.
What's so urgent?
I have added you to
Naveen's surgical team.
Please get ready to
scrub in in 30 minutes.
You have a surgical
plan in place, Shaun.
You're perfectly capable
of executing that plan.
It is my responsibility
as attending to create
the conditions most likely to
result in a positive outcome.
Which you've done.
Which include the presence of
a surgeon with RSI experience.
Shaun, you're... you've
always been confident
in... in the O. R.
What is this about?
Having a surgeon with
relevant experience present
in case I need advice.
Well, what if I'm
busy? You're not.
What exactly about this
case is so concerning...
You have more RSI experience
than any surgeon
in this hospital.
That is why I would like
you in this surgery.
Please?
Alright, fine. I'll be there.
Please get changed.
I can't reach the
highest point from here.
Best way to hide the scars is
to go in above her hair line.
We'll need to shave
some of her hair.
Maybe not.
Someone get me a comb.
Moving on to the hysterectomy.
Please clamp the uterine horns.
Grasping round ligament,
midway to the inter...
Internal inguinal...
Infection of the muscular layer
of the uterine wall has reduced.
Maybe we can save her uterus.
Shaun?
Come on.
Shaun.
Stick to the plan.
You cannot save the uterus.
Okay.
You are right.
Necrosis is too advanced.
Transfixion sutures
and hemoclip.
Hey.
I wanted to see
how you're doing.
Naveen is recovering well.
The surgery turned
out as expected.
You hesitated in the O. R.
What was that about?
I wanted to save her uterus.
Why'd you get stuck on not
doing the hysterectomy?
The patient wants
to carry a child.
Well, that's very empathetic.
I guess you... you developed
a personal connection?
Luna made the right decision
even if her wife will
never forgive her.
Are you worried that this
will hurt their marriage?
It doesn't matter,
okay? It doesn't matter.
What matters is
that she is alive.
We saved her life.
Well, that is one
thing that matters.
So is losing a
personal connection...
No, the medicine is...
Shaun, is this about Lim?
What... What about her?
I don't know. I
just... It's...
Lim is still up...
upset with you.
She's still mad at you.
D-Does that bother you?
Dr. Lim and I have a
professional relationship...
No. No, you don't.
And you need to fix that.
The two of you need
to sort that out.
I don't know what
you want me to do.
I want you and Lim to
talk to each other.
She does not want to talk to me.
That depends on what
you have to say.
I have nothing to say.
Shaun, Lim is hurting, okay?
You are hurting.
Tell her that.
I mean, maybe... Maybe
she'll forgive you.
Maybe... Maybe she won't.
I don't know.
But the two of you
have to resolve this
for both of your sakes and mine.
Dr. Lim and I have a
professional relationship.
I do not need to talk to her.
I have to finish my op note now.
I've never done a
splenectomy that way either.
Cool surgery, not the
coolest circumstances.
Our patient went through
something terrible
and my initial reaction
was to judge her...
same way people judge me.
Don't beat yourself up.
You didn't know.
You're a good friend.
I know.
But...
I've been waiting to
be more than that,
and I don't think I
should do that anymore.
I'm gonna take a rain
check on research
and reschedule my date.
I think that's good.
You deserve to be happy.
I have to go prep Toni.
I owe you an apology
for pressuring you.
I didn't do a rape kit.
And I've always regretted it.
And I didn't want
you to feel the same.
I was in medical school.
He was a friend of a friend.
Somewhere along the way,
he became a stalker.
One night he showed
up at a bar I was at.
He followed me home.
I hated the idea of
being seen as a victim...
so I never told anyone.
I let that creep go.
And now I'll never know how
many other women he hurt.
But that's my regret.
And it's not fair
to put that on you.
I knew he liked me.
I should have made sure
that he knew it wasn't a date.
I shouldn't have had a drink.
I...
I don't even know
if I told him to stop.
What if I didn't?
It is not your fault.
He took away your choice.
And now you have to do
what's best for you,
whatever that is.
Toni, time for surgery.
Not yet.
There's still a little swelling,
but you'll have
minimal scarring.
They're gone.
Now those glasses will stay put.
Nice job with my braids.
Wasn't me.
Always wanted a daughter,
so I learned to braid.
Well, you might've found
a nice side hustle.
Thank you, Dr. Andrews.
You're welcome.
Are you okay to continue?
Yes.
Are you okay to continue?
Yes.
Are you okay to continue?
Are you okay to continue?
Are you okay to continue?
Are you okay to continue?
Naveen, in the process
of removing the towel,
we also had to take your uterus.
We're so sorry.
There was no other way?
Yes, but I told them...
I told them to do it.
I needed you to survive.
Because you mean
everything to me.
And I failed at my
most important job...
Keeping you safe.
I failed you five
years ago in the O. R.
And again yesterday.
I was so focused on
defending myself,
I wasn't thinking about
what you were going through,
how scared you were.
And I'm so, so sorry.
Whatever you need, if...
if you want me here
every step of the way, or...
out of the picture completely...
You better be here
every step of the way...
because I love you more
than anything, too.
I'm sorry.
How's she doing?
Surgery went well.
Her platelet count is turning
in the right direction.
Good.
And beyond the physical?
Too early to tell.
Recovery's a process.
All that time we were together,
why didn't you tell me?
Because I don't
need anyone's pity,
yours included.
It's in the past.
What you did for Toni,
that was really brave.
I'm here if you ever need
someone to be brave for you.
Thank you.
I need to talk to you
about your surgery.
I can't change what happened,
and I do not owe you an apology.
Dr. Murphy.
But I am sorry for other things.
In my RSI surgery today, the
medical choice was clear,
but I did not want to proceed
because I knew what the
consequences would be.
In your surgery, the
medical choice was clear,
and I did proceed,
but I did not know what
the consequences would be.
I saved your life,
but my decision also
caused you harm.
When I saw you hurt
and bleeding...
I saw my brother
Steve, when he died.
When I thought I might lose you
the way I lost him,
I did not like that.
I am sorry...
this...
has been very hard for you.
A medicine-only relationship
is... is not easy.
I...
It is not what I want.
I have missed your friendship.
I have missed you.
This has been...
really hard.
And my life is in
a good place now.
I'm happy.
But
still angry sometimes.
It may take a while
to let that go.
But...
I've missed you, too, Shaun.
Hey.
You know, I love being the boss,
but connecting with patients
is the reason I got into
medicine in the first place.
And you made me remember that.
Thank you.
You're welcome.
Could I buy you a drink
as an apology for
being a pompous ass?
No.
Unless you throw in
some wings and fries.
Tough negotiator.
You know it.
Shaun came to see me.
We talked.
Thank you.
You're welcome.
Join me?
I'm sure we can find
some cucumber water
around here somewhere.
Late dinner with Clay.
Good night.
Hey.
Hey.
Good night.
What was that?
I don't know.
You're back. Yes.
You told me I was isolating
myself in my other office.
Shaun, there's something
you should know.
Lim, when she was in her chair
and adjusted her position,
there was flexion and rotation
in the psoas and in the glutes.
There was movement.
She could walk again.
Mm, for me.
Early department meeting.
You should stay in
bed a while longer.
So should you.
Mm.
How about I put a
call in to Rosalia's,
breakfast burrito, latte
for pickup.
20 minutes saved.
If I get back in that bed,
it's gonna be for
more than 20 minutes.
Oh.
I can be late.
I told you
to put on a jacket.
And I told you I'd be fine.
Are you fine?
No. I'm freezing.
It's San Jose.
"Winter" is a relative term.
Eh.
Thanks. Mm-hmm.
Weren't you wearing
that yesterday?
I crashed at her place.
We were working on a research
project and finished late,
and he slept on the couch.
Didn't you have a date?
I rescheduled it.
I gotta get inside and shower
or I'll be late for my call.
See you.
Alright. See ya.
He's bread crumbing you.
Excuse me?
He's flirtatious, non-committal.
He's giving you just
enough attention
to keep you on the hook.
He's dropping crumbs.
You'll never get the full slice.
We're just friends.
I'm fine with that.
Hm. Or maybe you're settling
for whatever he'll give you.
When did the stomach pain begin?
A couple weeks ago.
I'm on my tenth day of Lupron,
so it could be the side effects.
We're hoping for
an embryo transfer
at the end of the month.
Gotta take care of this mama.
Other than the
pain, any other...
Emesis, fever, sweats.
Some tenderness and distension.
A scar on the right
lower quadrant.
That's a first date souvenir.
Unofficial first date.
A McBurney's incision.
You had an open appendectomy.
She had a ruptured appendix.
I'm an RN.
Oh, it was a medical meet-cute.
I'm okay.
You are not.
There is an
irregularly shaped mass
in the right-side pelvic region.
You need a CT, stat.
Can I help you?
Are you okay?
Um, I fell and hit my head.
Come here.
Possible head trauma.
Can you give me your
name and date of birth?
Um, Toni Rhodes,
Aug... August 7, 1995.
Slowly reactive pupils.
Any drugs or alcohol use?
No. No.
Uh, yes.
I... I had a couple
drinks last night.
How did I get here?
And we need a head CT
to check for brain bleed
or skull fractures.
Oh, my stomach is...
How did you get this?
Okay, her abdomen is
rigid and distended.
Significant
intraperitoneal hemorrhage
at left upper quadrant.
You're bleeding
from your spleen.
We need to get you into surgery.
Captions by VITAC...
I reviewed your
patient's ultrasound.
The appearance of that
mixed-echogenic mass is unusual.
Yes.
We... Keep me posted.
Ooh, you went to Rosalia's?
The breakfast burrito
with the spicy chorizo...
Try molten chorizo.
Totally worth the ulcer
I'm probably getting.
Hard stan.
I have never been to Rosalia's.
I recommend it.
Your images are
ready, Dr. Murphy.
There is the mass.
There's a ton of free fluid
surrounding the lesion.
Possible active bleeding and
invasion into adjacent organs.
She needs surgery immediately
for resection of the lesion.
How long have you had these?
My monster horns?
A few years.
But now they're making it hard
for my glasses to stay on.
I keep them hidden with my hair.
You are beautiful, and
you have nothing to hide.
But those glasses
do need to stay put,
so I think we should
remove these growths.
Without shaving my hair
or leaving big scars?
Those are the only options
other doctors have given me.
Those doctors don't
know my technique.
I'll make a tiny incision here.
It minimizes scars, and
it'll leave your hair intact.
Okay. Okay?
Put Gwendolyn on my
schedule in the morning.
Thank you, Dr. Andrews.
Yes.
Toni's CT came back clean.
No fractures or
intracranial bleeding,
so she's clear for surgery.
Hm.
We need to finish our
research for tomorrow?
I'll spring for pizza.
Have you ever heard
of bread crumbing?
Does it involve pigeons?
No.
It's when two people
hang out a lot.
One wants to be
more than friends,
and the other isn't clear.
Question is, what should
the first person do...
Be patient or move on?
Asking for a friend.
I'd say real personal connection
can be rare, invaluable,
whether the context is
romantic or platonic.
I'll see you inside.
There are
tentacles of scar tissue
reaching into every organ.
Multiple abscesses
and infection burden.
We will need several drains.
100 cc already. This
infection is crazy.
So, things with you and Lim
are still sorta awkward?
Dr. Lim and I have a
professional relationship
centered on medicine.
The mass is adherent
to the pelvic wall,
colon, bladder, uterus.
But you guys used to be closer.
Do you miss that?
Cutting through more tissue.
Dr. Lim is Chief of Surgery,
I am an attending.
A medical focus is
logical and productive.
We've reached the mass.
Cutting into the capsule.
Wait.
Oh, my God, is that...?
A surgical towel.
Have my special
ex lap tray ready.
Transfuse two units
and stay two ahead.
Place a Foley catheter now.
Her hematocrit's in the toilet.
A fall shouldn't have
caused this much damage.
She was high
when she came in.
No telling what
could've happened.
How about we hold that judgment
till her tox results come back?
Placing arterial line now.
Sluggish pupils, memory loss,
confusion... she's using.
Not judgment, just recognize
certain behavior when I see it.
She's hemodynamically
unstable. Debate later.
Right now, we need
to stop this bleed.
Dr. Allen, why aren't
you placing the catheter?
There's severe bruising
and signs of major trauma
in her pelvic region.
I think she was raped.
We were able to
save your spleen,
but you bled a lot
during the surgery
for reasons we don't
understand yet.
We need to run more tests.
When we were placing
your catheter,
we discovered some bruising
and signs of trauma
in your pelvic region.
We're worried you may have
been sexually assaulted.
No, that's...
just not possible.
Your urine testing also came
back positive for Rohypnol.
It's often associated
with date rape.
No, I-I...
I went out for drinks
with my friend.
We were celebrating his new job.
I watched the bartender
mix my drinks.
I was tipsy, but I wasn't drunk.
The bruises must be
from when I tripped.
I would remember if what
you're saying happened.
Rohypnol can cause
short-term amnesia.
I'm sure this
information is a shock.
We're here to support you.
The best way to gather evidence
as to what happened
is to do a rape kit.
No, I... I don't need that.
I was with my friend.
He wouldn't let
anything happen to me.
You don't have to
decide right now.
Get some rest.
We'll let you know when
your latest labs come back.
A retained surgical item?
It's a towel that was left
in you after a procedure.
It is adherent to
several vital organs.
We could not remove it without
irreversibly damaging...
Left behind by who?
My doctor?
Let's focus on getting it
out first, and then we can...
Who performed my appendectomy?
Broder, I think. But...
The count of sponges
and other items
inside the surgical cavity is
done by the lead scrub nurse.
But you may discuss this later.
Okay. So who was the
lead scrub nurse?
Gomez, maybe, or Kraus.
I really don't remember.
But you were definitely there.
Are you blaming this on me?
You were one of the nurses.
I mean, shouldn't
you have noticed?
I was circulating, not scrub.
No way I was the
one who did this.
A minute ago you can't remember,
but now you're sure
you didn't do it.
Maybe we should move on to...
Why are you attacking me?
I just found out I have an
infected towel in my gut
that will require major surgery,
and you're making
this about you.
You're acting like
this was my fault.
It doesn't matter
whose fault it was.
We will approach the
towel like a sarcoma...
Perform an en bloc resection,
bypass any intertwined
vital arterial structures,
and finish with a
thorough debridement.
I think that's a
reasonable option.
Well, right now, your
opinion doesn't mean a lot.
I just need a minute.
I'll be out in the hall.
She's... not conscious.
She's syncopal.
She fainted?
Naveen. BP spiking.
Oh, my God. Heart rate's up.
Possible bleed or septic shock.
Crash airway tray!
An additional abscess cavity
in the towel may have ruptured.
We need to get her
back to the O. R.
You wanted to see me? Hey.
Yeah, I'm double
booked tomorrow.
You'll be scrubbing
in with Dr. Annanian
for Gwendolyn's surgery.
But she was so
impressed with you.
She's really excited to
have you as her surgeon.
Well, it's a meeting
I can't miss.
But Dr. Annanian has
my surgical plan.
I'll check in afterwards.
The rupture caused
widespread peritonitis.
This infection is way
worse than before.
Aggressively irrigate,
debride, and suction.
We need to control
the infection.
Send tissue and fluid
to the micro lab
so we can focus her antibiotics.
Big drop in BP.
Heart rate spiking.
She isn't tolerating surgery.
We need to close her again.
Sutures.
Wait, what about the towel?
We can't operate until her BP
and O2 sats are under control.
She'll need to remain
sedated and intubated
until she stabilizes.
And we need to find a new
approach to removing the towel.
Once she's closed, I
can dive into research.
I will consult with Dr. Lim.
I would like a surgical consult.
The Mukherjee case?
The mass on the CT was a
retained surgical towel.
And is acutely infected and
adherent to vital organs.
The patient blames her wife,
who was a surgical nurse
during the appendectomy...
Circulating, not scrub.
If we could stick
to the medical...
The patient didn't understand
the count was not her
wife's responsibility.
They argued quite a...
The most pressing
issue is the towel
poisoning her from the inside.
What is your plan to remove it?
That...
is what I am here to discuss.
You are an attending,
Dr. Murphy.
And your patient has a few hours
before she's stable
enough for any procedure.
Research RSIs and brainstorm
possible solutions with your team.
Then, if you still need a
consult, my door is open.
How's Toni's platelet count?
Still dropping.
Did you do an
anti-platelet antibody?
Waiting on results.
Order another PRBC transfusion
to get her hematocrit up.
Any progress on the rape kit?
She doesn't want
to talk about it.
I can't blame her.
It's an invasive process
that only serves to prove
something horrible happened
that she doesn't remember.
Her brain may not be able to
remember, but her body does.
And chances are, eventually,
it will all come back.
Shouldn't we respect her wishes?
I mean, we don't
want her to feel like
she's being assaulted
all over again.
Denying what happened
doesn't change the fact
that it happened.
It's Toni... Code Gray.
No,
please, please, stop!
She woke up screaming,
and she pulled out her IV.
Just stay away from me!
We just want to help you.
Toni, you're okay.
We're here with you.
It's not real.
Can you breathe with me?
You're okay.
You're not in danger anymore.
I...
had a nightmare.
Her gown.
I need to take a look at that.
Okay?
The spleen repair didn't work.
Over
the course of your long career,
you have removed five
retained sponges.
That is statistically higher
than any surgeon in the region.
Special skill on my résumé
right under juggling.
My patient has a retained towel
that has caused sepsis with
multi-organ involvement.
I would like a surgical consult.
Perfect request for
your department head.
Dr. Lim said I should tackle
the problem on my own.
Well, that's interesting.
She is right.
I am an attending.
But your RSI experience would
be very helpful on this case.
Alright, I'll take a look.
Thank you.
Nurse Villanueva,
why is Gwen's surgery
still on my schedule?
She panicked when I told
her it'd be another surgeon.
She really wants you.
Assure the patient
she's in great hands
with Dr. Annanian,
and take her off my rotation.
No.
You told her you'd
do the surgery.
You can tell her that
you're not going to do it.
What about a minimally
invasive surgery...
Cutting up the towel,
removing it piece by piece
through a single port?
That won't work.
Where it's stitched
to the organs,
the infected tissue
puts her at high risk.
An aggressive gross total
resection of all organs invaded
by the towel plus all
infected and necrotic tissue
is the best option for
long-term survival.
That procedure
risks major bleeds,
and we'd have to
remove her uterus.
They're planning a family,
and Naveen is supposed
to carry the baby.
That will also be
impossible if she is dead.
That's elegantly put.
The wife of the
patient is here, right?
Explain the options to her,
and see how she
wants us to proceed.
They had an argument
before her last surgery.
She will not be pleased with
her wife making that decision.
Just go talk to her.
We figured out why
you've been bleeding.
You have a condition
known as ITP.
Your immune system is
destroying your platelets.
Can you fix it?
There is medication
that can help.
And we need to
remove your spleen.
Why didn't you just do that
during my earlier surgery?
We weren't aware of your ITP.
It's a condition that can
be triggered by trauma.
The ITP complicates
our approach.
Usually, we'd remove your
spleen through your abdomen,
but that risks a
catastrophic bleed.
We can remove your
spleen vaginally
with minimal incisions.
There's less risk of bleeding.
Okay, let's do it.
I'm hoping you'll let us do a
rape kit before the procedure.
I already told you, no.
The transvaginal
approach will destroy
all evidence of
the sexual assault.
No.
I don't care.
Without the kit,
you'll have no proof.
You're right.
I believe that something
terrible happened to me.
But that is true whether or not
I go chase down the boogeyman.
But it could help.
Nothing will help.
Don't let whoever did this
to you get away with it.
He already has.
Doing a rape kit is
not going to unrape me.
Go ahead with the surgery.
We need your decision.
Is there any way to
do the total resection
without removing
Naveen's uterus?
No.
She's dreamed of being
pregnant her whole life.
I can't choose this for her.
You can.
We understand how
difficult this is.
She'll never forgive
me. She will.
I mean, it's obvious
Naveen loves you.
She already blames me
for what's happening.
If I'm the one that takes away
her chance to carry a child...
You are right.
If you choose the
gross resection
and your wife loses her uterus,
it is likely she will
never forgive you.
But that is irrelevant.
This is your decision.
You have to make it.
Whatever happens next.
Do the total resection.
I haven't seen you around
here for a while, huh?
Forgot how relationships can
eat into discretionary time.
Doesn't exactly sound
like a complaint.
It's not.
Shaun came to me with
a surgical consult.
Your RSI record. Smart.
He did it because
you sent him away.
Well, part of the Chief's job
is to empower their attendings
to find their own solutions.
Sounds like Shaun did.
A lot of ways to
empower an attending.
And I chose one.
Because you're still
angry with Shaun?
Okay.
How long are you
gonna keep that up?
How about as long as I want?
Okay, you be as mad at Shaun
for as long as you need to be.
Thanks for the permission.
Just so you know, it's toxic.
And not just for Shaun.
Spare me.
You're not concerned for
anyone other than Shaun.
I have to get back to work.
Dr. Andrews.
I rescheduled my
finance meeting.
But in the future,
I'm requesting a scrub
nurse who respects my role
as surgeon and
hospital president.
When I was in the hospital,
you sat at my bedside.
You helped me recover when
I wasn't sure I wanted to.
That meant a lot.
Personal attention with
patients is important
even when you're president.
The laparoscopic splenectomy
is a great alternative
to the transvaginal...
Toni's surgery is already
scheduled for this evening.
And she asked that you
be removed from her case.
She may regret not
taking action on this
for the rest of her life.
That's her decision, not yours.
I got your message, Shaun.
What's so urgent?
I have added you to
Naveen's surgical team.
Please get ready to
scrub in in 30 minutes.
You have a surgical
plan in place, Shaun.
You're perfectly capable
of executing that plan.
It is my responsibility
as attending to create
the conditions most likely to
result in a positive outcome.
Which you've done.
Which include the presence of
a surgeon with RSI experience.
Shaun, you're... you've
always been confident
in... in the O. R.
What is this about?
Having a surgeon with
relevant experience present
in case I need advice.
Well, what if I'm
busy? You're not.
What exactly about this
case is so concerning...
You have more RSI experience
than any surgeon
in this hospital.
That is why I would like
you in this surgery.
Please?
Alright, fine. I'll be there.
Please get changed.
I can't reach the
highest point from here.
Best way to hide the scars is
to go in above her hair line.
We'll need to shave
some of her hair.
Maybe not.
Someone get me a comb.
Moving on to the hysterectomy.
Please clamp the uterine horns.
Grasping round ligament,
midway to the inter...
Internal inguinal...
Infection of the muscular layer
of the uterine wall has reduced.
Maybe we can save her uterus.
Shaun?
Come on.
Shaun.
Stick to the plan.
You cannot save the uterus.
Okay.
You are right.
Necrosis is too advanced.
Transfixion sutures
and hemoclip.
Hey.
I wanted to see
how you're doing.
Naveen is recovering well.
The surgery turned
out as expected.
You hesitated in the O. R.
What was that about?
I wanted to save her uterus.
Why'd you get stuck on not
doing the hysterectomy?
The patient wants
to carry a child.
Well, that's very empathetic.
I guess you... you developed
a personal connection?
Luna made the right decision
even if her wife will
never forgive her.
Are you worried that this
will hurt their marriage?
It doesn't matter,
okay? It doesn't matter.
What matters is
that she is alive.
We saved her life.
Well, that is one
thing that matters.
So is losing a
personal connection...
No, the medicine is...
Shaun, is this about Lim?
What... What about her?
I don't know. I
just... It's...
Lim is still up...
upset with you.
She's still mad at you.
D-Does that bother you?
Dr. Lim and I have a
professional relationship...
No. No, you don't.
And you need to fix that.
The two of you need
to sort that out.
I don't know what
you want me to do.
I want you and Lim to
talk to each other.
She does not want to talk to me.
That depends on what
you have to say.
I have nothing to say.
Shaun, Lim is hurting, okay?
You are hurting.
Tell her that.
I mean, maybe... Maybe
she'll forgive you.
Maybe... Maybe she won't.
I don't know.
But the two of you
have to resolve this
for both of your sakes and mine.
Dr. Lim and I have a
professional relationship.
I do not need to talk to her.
I have to finish my op note now.
I've never done a
splenectomy that way either.
Cool surgery, not the
coolest circumstances.
Our patient went through
something terrible
and my initial reaction
was to judge her...
same way people judge me.
Don't beat yourself up.
You didn't know.
You're a good friend.
I know.
But...
I've been waiting to
be more than that,
and I don't think I
should do that anymore.
I'm gonna take a rain
check on research
and reschedule my date.
I think that's good.
You deserve to be happy.
I have to go prep Toni.
I owe you an apology
for pressuring you.
I didn't do a rape kit.
And I've always regretted it.
And I didn't want
you to feel the same.
I was in medical school.
He was a friend of a friend.
Somewhere along the way,
he became a stalker.
One night he showed
up at a bar I was at.
He followed me home.
I hated the idea of
being seen as a victim...
so I never told anyone.
I let that creep go.
And now I'll never know how
many other women he hurt.
But that's my regret.
And it's not fair
to put that on you.
I knew he liked me.
I should have made sure
that he knew it wasn't a date.
I shouldn't have had a drink.
I...
I don't even know
if I told him to stop.
What if I didn't?
It is not your fault.
He took away your choice.
And now you have to do
what's best for you,
whatever that is.
Toni, time for surgery.
Not yet.
There's still a little swelling,
but you'll have
minimal scarring.
They're gone.
Now those glasses will stay put.
Nice job with my braids.
Wasn't me.
Always wanted a daughter,
so I learned to braid.
Well, you might've found
a nice side hustle.
Thank you, Dr. Andrews.
You're welcome.
Are you okay to continue?
Yes.
Are you okay to continue?
Yes.
Are you okay to continue?
Are you okay to continue?
Are you okay to continue?
Are you okay to continue?
Naveen, in the process
of removing the towel,
we also had to take your uterus.
We're so sorry.
There was no other way?
Yes, but I told them...
I told them to do it.
I needed you to survive.
Because you mean
everything to me.
And I failed at my
most important job...
Keeping you safe.
I failed you five
years ago in the O. R.
And again yesterday.
I was so focused on
defending myself,
I wasn't thinking about
what you were going through,
how scared you were.
And I'm so, so sorry.
Whatever you need, if...
if you want me here
every step of the way, or...
out of the picture completely...
You better be here
every step of the way...
because I love you more
than anything, too.
I'm sorry.
How's she doing?
Surgery went well.
Her platelet count is turning
in the right direction.
Good.
And beyond the physical?
Too early to tell.
Recovery's a process.
All that time we were together,
why didn't you tell me?
Because I don't
need anyone's pity,
yours included.
It's in the past.
What you did for Toni,
that was really brave.
I'm here if you ever need
someone to be brave for you.
Thank you.
I need to talk to you
about your surgery.
I can't change what happened,
and I do not owe you an apology.
Dr. Murphy.
But I am sorry for other things.
In my RSI surgery today, the
medical choice was clear,
but I did not want to proceed
because I knew what the
consequences would be.
In your surgery, the
medical choice was clear,
and I did proceed,
but I did not know what
the consequences would be.
I saved your life,
but my decision also
caused you harm.
When I saw you hurt
and bleeding...
I saw my brother
Steve, when he died.
When I thought I might lose you
the way I lost him,
I did not like that.
I am sorry...
this...
has been very hard for you.
A medicine-only relationship
is... is not easy.
I...
It is not what I want.
I have missed your friendship.
I have missed you.
This has been...
really hard.
And my life is in
a good place now.
I'm happy.
But
still angry sometimes.
It may take a while
to let that go.
But...
I've missed you, too, Shaun.
Hey.
You know, I love being the boss,
but connecting with patients
is the reason I got into
medicine in the first place.
And you made me remember that.
Thank you.
You're welcome.
Could I buy you a drink
as an apology for
being a pompous ass?
No.
Unless you throw in
some wings and fries.
Tough negotiator.
You know it.
Shaun came to see me.
We talked.
Thank you.
You're welcome.
Join me?
I'm sure we can find
some cucumber water
around here somewhere.
Late dinner with Clay.
Good night.
Hey.
Hey.
Good night.
What was that?
I don't know.
You're back. Yes.
You told me I was isolating
myself in my other office.
Shaun, there's something
you should know.
Lim, when she was in her chair
and adjusted her position,
there was flexion and rotation
in the psoas and in the glutes.
There was movement.
She could walk again.