The Good Doctor Season 4 Episode 5
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00:00it's just a migraine honey until we're completely sure is the pain a tight
00:05band or pulsating good question pulsating light bothers me nausea I get
00:11these all the time you said you didn't feel like uh what'd you call it uh
00:15Anora I know exactly how often do you get these symptoms I just asked and
00:21your boyfriend doesn't seem to recognize them Zane and I have only
00:29known each other for eight days you fast
00:37Ellie did you feel your foot twitch
00:51positive Babinski what does that mean it's not a migraine
01:21oh that I was performing due diligence on my new roommate who might be a
01:28violent maniac and look what I found in this closet it's cute you moved in with
01:33two suitcases you only have four pairs of underwear how the hell did a parrot
01:36make the cut I'm a parrot head Jimmy Buffett enthusiast the Margaritaville
01:41guy he has other far better songs but yes the Margaritaville guy that brings
01:45me luck I'm scared to think what your life would be like without it can I have
01:49it back it's fun getting to know you better worth every damn bit of sacrifice
02:03oh I was demonstrating a torch lift this morning and bang ballet master you're a
02:11dancer God no I'm like the CEO at my age I'd be the Betty White of the
02:16troupe is she a dancer I don't know much about culture I assume I just
02:25sprained something right we will need neuro and abdominal exams x-rays for
02:30fractures CBC for infection cultures to rule out a spinal abscess you're new
02:36aren't you it's my second week here it's actually only my first day seeing
02:46patients am I your first yes sorry but yes well that's impressive
02:56whoever's supervising you must really trust you I'm not sure that's true they
03:07won't let me join there's a stupid gym because I had high blood pressure how am
03:11I supposed to lower it if I can't work out 200 over 105 that is quite high I
03:15just told you it was high are you a smoker yeah pack or two a day more if I
03:24feel crappy do you have diabetes you're reading those questions out of a book
03:30yes have you ever done this before I told you you have to trust them I don't
03:40then act like you do go away
03:52nothing more romantic than spending one of your first dates in an ER
03:56stressful experiences release oxytocin same hormone that creates emotional
04:01bonds this might actually cement the relationship next to the hippocampus is
04:08that a tooth dermoid sis cool she's having a seizure secure her airway push
04:17to the ground out of it thank you for trusting us please report 58 year old
04:29male dancer with back pain I ruled out red flags like osteomyelitis and kidney
04:34infection but I did find evidence of a mild l2 compression fracture with
04:37moderate wedging and evidence of impingement on the neural canal you want
04:40to start beta blockers me yeah I think my patients a stroke risk he's 200 over
04:45105 it was the same at her gym earlier
04:58can you raise your arms okay now try to squeeze my hands I just did all these
05:04tests with her I thought you were gonna give me some stuff to lower my blood
05:07pressure that would kill you now push against my hands she's in danger of
05:12having a stroke he's not she's already having one smoking on estrogen put her
05:16at high risk loss of circadian blood pressure variation confirms it stick out
05:21your tongue we gotta get a CPA nope we're treating with IV tPA don't we need
05:28to locate the clot we just did right deviation means the right vertebral
05:32artery occlusion you can close your mouth now
05:42her seizure and coma were caused by a dermoid cyst it's a pocket of tissue
05:48with bits of teeth hair and fat she likely got it before she was born what
05:53can you do the less invasive option is to put in a drain to release some
05:57pressure treat with anti-seizure meds and steroids then basically watch to see
06:02if the swelling goes down and more invasive surgical removal but the cyst
06:08is deep inside and wrapped around major arteries so it is more likely to fix the
06:13problem but it carries risk of stroke or paralysis we need a decision quickly
06:22Ellie sister's on the paperwork but we haven't been able to reach her do you
06:26know where the parents live or any other siblings
06:35you might still be on a business trip but uh try her husband
06:45you
06:50if we can't reduce the swelling she will have permanent brain damage
07:03is that him
07:07Brendan we need you to make a decision yeah I'm not sure that I'm the right
07:15one to I mean right now
07:22I hate her
07:27you don't you're angry you're hurt because you love her
07:36you
07:4558 year old male dancer with back pain moderate vertebral wedging and
07:52impingement on the neural canal yes I think an l2 compression fracture
07:58prescribed anti-inflammatories a brace and PT then discharge him
08:06do you want to recheck anything
08:12no
08:24remember to floss your brain after every meal people aspirating do you think we
08:33should be doing this I know we have to legally but maybe her husband isn't the
08:38one who knows her best knows what she wants better than the guy who made her
08:42last weekend raccoon day that guy he's in love with him
08:47apparently well maybe she loves them both aren't you a romantic watch for
08:51perforators I've been polyamorous for years
08:57when I was monogamous I was jealous possessive egotistical our patient
09:01wasn't honest that's not cool other than that good margins all around let's dry
09:09up the field and close her up I never would have guessed I was your first
09:16patient felt more like a fourth by the way did I detect an accident
09:24I mean I had one but I worked really hard to lose it no one ever notices it
09:30anymore Eastern Europe Brooklyn Williamsburg I grew up
09:37possidic speaking Yiddish I left it a long time ago you left the religion the
09:43religion the culture my family it's not been easy growing up that way knowing
09:50you were a doctor excuse me my generation you could get bashed you can
10:00get thrown in jail we had to learn codes how to read each other you should thank
10:06your lucky stars you get to read each other's fortune you should thank your
10:10stars you get to live your life the way you want it I don't know what you went
10:16through please don't pretend to know what I went through
10:21sir my gut
10:27this surgery seems successful but we need a monitor of seizures over the next 24
10:32hours is this high enough I'm a little left but to the right
10:39yeah
10:46I'm sorry I'm sorry I'm sorry I'm sorry I'm sorry I'm sorry I'm sorry I'm sorry
10:57you never said anything was wrong can we have room for a moment I'm sorry but we
11:07really need to check you're worried about talking in front of them
11:10embarrassing me I didn't think anything was wrong when I met Zane it made me
11:24realize something was missing or at least I think that's what I'm feeling
11:31my building each other I'm sorry
11:36why couldn't you just talk to me or leave me I don't know
11:48oh
11:53were you happy with him
12:07I guess I should go
12:12Brendan
12:17Who are these people?
12:21L.A., do you know where you are?
12:23Why am I in the hospital?
12:33Suprarenal aortic aneurysm.
12:36It ruptured as he was being discharged.
12:38Clamping aorta now.
12:40How much blood is he down?
12:41We suctioned out two liters and gave six units on the rapid infuser.
12:45The aneurysm caused his back pain.
12:47Dr. Walke missed it.
12:50I did an abdominal exam.
12:52Aneurysms are very hard to catch.
12:54Experienced doctors miss them all the time.
12:56Hot scissors.
12:57The aneurysm is 6.5 centimeters.
13:01Dr. Walke should have felt it.
13:06It felt like normal musculature.
13:09I'm so sorry.
13:10We'll never know what you felt.
13:12There's no way to know if you or any doctor, for that matter, would have detected this.
13:17I would have.
13:19He asked me if I wanted to double-check if I had.
13:22I would have caught the aneurysm before the rupture.
13:24Stop it.
13:29He made a mistake.
13:31He might have, but you did, too.
13:33No, you told me to back off.
13:36I didn't tell you to abdicate responsibility.
13:43When a first-year asks if you want to recheck their work, your answer should always be yes.
13:51The fact they're asking is a warning sign.
13:57I didn't know that.
14:07It's called retrograde memory loss.
14:09Luckily, it seems to have been temporary. She's lucid again.
14:13We're running an MRI and lab tests to see what caused it.
14:17Thank you for telling me. I know I'm just the...
14:21You care.
14:25Maybe things with Ellie and I weren't always perfect, but...
14:29It was exciting.
14:32When I was with her, I never felt that way before.
14:37I took care of her when she was sick. I never strayed.
14:41It wasn't about the things we did. It was about...
14:45being with her.
14:49She stuck by me when I needed her.
14:53Last year, I was drinking way too much.
15:00It's hard to imagine being without her.
15:03I just can't imagine being without her.
15:07I'm sorry.
15:14She's stable. Q-hour neuro exams and monitor for signs of elevated ICP.
15:24I believe you're getting a call, Dr. Park.
15:31You're a peridot. We're proud.
15:34Can we just agree to have some limits? Maybe not everything I own is fair game?
15:38No.
15:40Perfect.
15:41Trust me. It'll be worth every damn bit of sacrifice.
15:47I've said that twice now.
15:49You've said a lot of things twice. You have limited creativity.
15:51Truth is, it wasn't creative at all. It's from Jimmy Buffett's Cheeseburger in Paradise.
15:54One of his big eight. So big even I know it.
15:57You, sir, are no parrot head.
16:00Mia does woodwork as a side hustle. She made it for me on our first trip to Hawaii.
16:03Lovely. Wait, no, that's not right. Pathetic.
16:06And do you toss away all mementos of past friends and jobs?
16:09If a job cheated on me, I might want to move on.
16:12When's the last time you dated someone?
16:14When's the last time you acted like a human being?
16:16So, years. Yeah, I definitely found the right word.
16:20See you at home.
16:30You can't sleep?
16:33You want some more milk?
16:36My mother has like 18 prescriptions for this. Some of them are actual prescriptions.
16:41I can sleep, but need to figure out how to supervise better.
16:45How many of these are you planning to read tonight?
16:48Just the relevant sections of each.
16:51Tech bros are always watching TED Talks on leadership. That could be quicker than those books.
17:00How about tomorrow we have a date night?
17:03Why would we need a date night if we're in a relationship and living together?
17:09Because it'll be fun.
17:11I'll schedule a date night for tomorrow.
17:13Great. Think of something for us to do.
17:18There is one thing that helps most people sleep that my mother did not tell me about.
17:25What makes a great manager?
17:28Some say it's all about planning. Others, charismatic leadership.
17:33A third group...
17:36Your temporary memory loss was caused by some fat that leaked from your cyst.
17:41We can remove it via a craniotomy, but there is a real risk of more memory loss.
17:46Maybe permanently.
17:49What will I lose?
17:51What will I lose?
17:53The time prior to the surgery. Days, weeks, possibly months.
17:58But if we don't operate soon, the risk of brain damage only grows.
18:04I can't do it.
18:10I don't even know what I want right now.
18:13But I do know that I don't want the decision about my marriage forced on me by an operation.
18:22Please, find another answer.
18:36You are not very good at your jobs, and I'm not very good at teaching you,
18:39so we are going to focus on one step at a time.
18:42You will master each skill separately. I've made a list of 400 skills.
18:46I didn't have time to finish it last night because...
18:49Dr. Walk, you will be focusing on physical exams.
18:52You will find a list of the seven post-op tests to be conducted on Carl.
18:55Dr. Jackson, you will find relevant seminars on conquering nerves in the workplace.
18:59What are good activities for a date?
19:02What does she like?
19:04Cars, coding, Zelda Breath of the Wild, Sauvignon Blanc, skittles, root balls, drag race, camping.
19:10I had a very romantic time camping in Big Sur.
19:13This is for tonight.
19:17I haven't gone on many dates.
19:22But everyone loves movies.
19:37Healing nicely. No redness or swelling.
19:42I'm going to palpate around it now.
19:48Look, I need to apologize for bringing up your personal life the other day.
19:56No. You have nothing to apologize to me for.
20:03So, what's next on your list?
20:06Checking for signs of infection inside your abdomen.
20:12Open your eyes wider.
20:19You have signs of jaundice.
20:22I think your liver is failing.
20:30The liver is being damaged by a new aneurysm.
20:32How? A genetic predisposition or...
20:35More likely, when we fix the first one, we increase the pressure upstream.
20:39Can we stent the celiac?
20:41Anatomy is too tricky.
20:43Aortic to celiac bypass.
20:45We just risk a new aneurysm forming upstream.
20:48Maybe. But it solves the problem in front of us. He'll die without an intervention.
20:52He'll probably die either way.
20:59Let's all take the time to research alternate solutions.
21:02If we can't come up with something better in 24 hours, we proceed with a bypass.
21:10She's saying no for emotional reasons.
21:15So, the answer isn't medical. It's emotional.
21:22We think Zane should talk to our lab.
21:25I don't know.
21:27I don't know.
21:29I don't know.
21:31I don't know.
21:33I don't know.
21:35I don't know.
21:37Zane should talk to Ellie.
21:39No. I don't want him anywhere near her.
21:42To convince her to do the craniotomy.
21:47From you, it's self-serving.
21:49From Zane...
21:51Wait, if she doesn't want it...
21:53You said you can't imagine life without her.
21:57If you meant that, you'd risk anything to keep her alive.
22:01Including her memories of you.
22:07I'm sorry.
22:18Well done, Shawnee.
22:24I really needed this.
22:26My system update yesterday went bananas.
22:29I've been flooded with complaints.
22:31Total nightmare.
22:34How's work? Did the videos help?
22:36Yes.
22:40Tell me more.
22:42One of my patients developed a secondary aneurysm.
22:46Now I need to find a surgical fix by tomorrow.
22:48Otherwise, he will probably die.
22:50I brought Skittles.
22:55Shouldn't you be at the hospital?
22:57Yes. After you go to bed, I plan to go back and do research.
23:02Shawnee, go to the hospital.
23:05Tomorrow, we made this schedule.
23:09Someone else needs you.
23:11More than I need you.
23:13It's a hospital.
23:15It's filled with sick people.
23:17But tomorrow, will someone need you to come up with a way to save their life?
23:22Maybe.
23:26Probably not tomorrow.
23:31Okay.
23:35Hmm.
23:39I am cancelling date night.
23:43That's rude.
23:45Oh, well.
23:54Then I should go to the hospital.
24:00Mm-hmm.
24:06They're prepping Ellie for surgery.
24:09Any last-minute questions?
24:14What should I do?
24:19Forgive her.
24:21Under the right circumstances, every human will stray.
24:24We're not hardwired for monogamy.
24:27I'm guessing you're not married.
24:29I'm not saying that it's wrong to feel angry.
24:32I'm not saying that it's wrong to feel angry.
24:35She wasn't honest with you.
24:39The alternative to forgiving her is losing someone that you love.
24:47Then what?
24:50If she comes back to me just because she forgets him,
24:56my marriage wouldn't be honest.
25:03I have an idea.
25:07We could remove more proximal aorta and extend the graft.
25:11And rebuild the celiac trunk with what?
25:14Dacron? Branches are too complex.
25:18This Lancet article on polymer materials doesn't work.
25:23But thin film might know.
25:33Did we break him?
25:40We have the material.
25:47It's his veins.
25:57Hey.
25:58Oh, I'm sorry. Did you hear?
26:00Hey.
26:01Oh, I'm sorry. Did we reestablish personal boundaries?
26:05This morning's presentation is on...
26:08Who's Not Moving On?
26:10Exhibit A.
26:11Canoodling on a very romantic hillside with...
26:14My gay best friend, can you leave?
26:17Exhibit B.
26:19A double XL Rob Gronkowski jersey.
26:22Just the latest fashion style from a woman who hates the Patriots or an ex-boyfriend.
26:27An ex I hooked up with Gronk. Seemed worth preserving.
26:33Rob? Or one of his brothers?
26:36Props, I guess.
26:38Exhibit Infinitum.
26:40Two ticket stubs to Quantum of Solace.
26:42Now, you once called Daniel Craig James Blond.
26:45And yet, 11 years later, these were in your drawer.
26:47On top of an instruction manual for a 2019 cell phone.
26:51Which means you dug them out within the last year.
26:53Why? I can only assume you are currently once again hooking up with a James Blond fan.
26:57How could you possibly deduce...
26:59How's it with your emails?
27:01You've been sleeping with an ex without asking for any commitment.
27:04It's just sex. It's not keeping me from anything.
27:06What's more likely to prevent someone from moving on?
27:08A parrot in a drawer or an ex in your bed?
27:11I'm at least getting something hot from the situation.
27:14You're just wallowing in failure.
27:17So, if your bag's empty, I'm naked and have to go to the bathroom.
27:30It's called a Y-shaped vein graft.
27:32Your aorta is damaged from the aneurysm right where it branches off.
27:35We're going to find a vein in your leg that's similar in size,
27:38cut it out, and use it to replace the damaged artery.
27:41How bad is it?
27:43How bad is it?
27:45This is an excellent solution.
27:47If it works...
27:49What are the actual chances that it doesn't?
27:52That I'm going to die?
27:54I don't want to give a number.
27:57I mean, I can't.
28:00I literally can't. There are too many factors.
28:02I can call in Dr. Murphy and...
28:03I don't need to hear numbers.
28:05How bad is this?
28:13Bad.
28:26Whatever happens, you're going to be an incredible doctor.
28:30And I am honored to have been your first patient.
28:35I screwed up.
28:39That first exam.
28:42I felt something.
28:46You should have known it was an aneurysm.
28:49We could have saved you before it got bad.
28:54Why?
28:58You know what?
29:00Why?
29:04You were my first patient.
29:13I need you to do something for me.
29:17I need you to pray.
29:20You must know a prayer for the sick.
29:26I'm not a believer anymore.
29:28Neither am I.
29:30But...
29:58I'm not a believer anymore.
30:01Neither am I.
30:03But...
30:05I'm not a believer anymore.
30:08Neither am I.
30:10I'm not a believer anymore.
30:26Ellie, do you know these men?
30:29Of course.
30:31Brendan.
30:35And...
30:38And are you a friend of Brendan's?
30:43Something like that.
31:00A lot has happened in the last week.
31:04So before you went under, the doctors made a video.
31:09It's sort of a message from your old self to your new one.
31:23I just want you to know...
31:26that I love you.
31:47Tell me about the day you met.
31:51I was in the middle of an art exhibit in Selma...
31:55and I noticed this guy...
31:58and he was looking at all the same paintings...
32:01I had been looking at and...
32:03Need another six-oh-loaded backhand for the arterial stump.
32:10Graft is secure.
32:12Take off the Satinsky clamp.
32:20Good perfusion to his lower body.
32:23Heart rate's spiking.
32:25There's no ST elevations.
32:31BP's tanking. Did he thrombose the graft?
32:36Distal anastomosis is pulsatile...
32:39but there is blood pooling in the left lower quadrant.
32:43The right, too.
32:46He's bleeding everywhere but the graft.
32:49It's DIC.
32:50Send a stat rhodamine quag profile.
32:54Start compressions. Give up anephrine and get the defib.
33:02Set it to 120.
33:04120. Clear.
33:07Compressions.
33:12No response.
33:15Pseudo-monophasic at 360.
33:18Clear.
33:31Clear.
33:38Why aren't you shocking again?
33:40He's in asystole.
33:44Dr. Lim.
33:47Come on.
33:59Belt or walk?
34:01He's dead.
34:04No.
34:13Time of death, 7.23 p.m.
34:23Take as much time as you need.
34:33Okay.
35:04I was in love with him.
35:06All those moments I had.
35:08Meeting at the gallery.
35:10Conversations.
35:14I don't remember any of them.
35:18But they were real.
35:22And they brought up feelings.
35:26Ones I don't remember having for a really long time.
35:33But all they made me think of was you, Brendan.
35:37Hearing how I met Zane just reminded me how you and I met.
35:42Chelsea's party and you showed up in that ugly bomber jacket.
35:46And Zane taking me to the hospital reminded me how you nursed me for months when I broke my femur in Aspen.
35:54And the whole time...
35:57I just...
35:59I couldn't stop thinking about how much I must have hurt you.
36:12And I don't...
36:14I don't know if you can forgive me.
36:22But I love you.
36:25But I love you.
36:35And I... I want to come home.
36:49You're wrong.
36:52You're wrong.
36:58That bomber jacket was really cool.
37:21I love you.
37:47He died.
37:52I tried stepping back.
37:55I tried brainstorming.
38:00And he died.
38:07I don't know what people are thinking or feeling.
38:11I can't communicate what I need.
38:14And more patients will die.
38:21You don't think your ASD had anything to do with your patient's death, do you?
38:26Because it didn't.
38:28It did.
38:30Asher wasn't sure about his abdominal exam.
38:35I should have known that.
38:37Sean, you're gonna do most things better than anyone else.
38:43And there are days when you're gonna fail like everyone else.
38:48Today might be one of those days.
38:52So...
38:57What do you do then?
39:04You go home. You be with the people you love.
39:11You take comfort in that, and then you wake up tomorrow and start all over again.
39:18Yeah.
39:41You can go home.
39:45I just...
39:48I don't want to be alone right now.
40:18I love you.
40:34I opened a Bumble account today.
40:40I swiped right three times today.
40:44Crocs jersey.
40:46Didn't have a tag in the back.
40:48It's symbolic.
40:51Do you have any idea how much the real one will be worth one day?
40:54Fair enough.
41:00Wasting away again in Margaritaville.
41:05Searching for my lost shaker of salt.
41:09My lost shaker of salt.
41:14Some people claim there's a woman to blame.
41:19But I know it's my own damn fault.
41:39Good night.
42:00I'm glad you're here with me.
42:02So am I.
42:09I love you.