The Good Doctor Season 5 Episode 13
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00:00section techniques
00:03Please be home by 1130
00:07He's got you on a curfew sex schedule our window ends at midnight
00:19It's like I slept on gravel and that explains your snoring your mattress should be burned
00:31It's time to end the sleepovers
00:34And for you to ditch the bachelor pad
00:36You asking me to move into your place?
00:39I'm asking you to move into a new place
00:43With me
00:49No neutral zone to run to after a fight
00:53Making up is the best part
00:56Can't hurt to look
01:00I
01:07This is Trent his mother Carrie signs of severe infection on his left index finger
01:13I'm ordering a CT sutures are inconsistent and crude. It's a minor upgrade. I
01:19Installed a magnet in my finger
01:22I
01:25Haven't trouble holding forks
01:27It's body art. He's 17
01:30immune to common sense
01:32Art seems like a poor descriptor given the ugliness of the infection. The more appropriate term is biohacking. I
01:40Put neosporin on it and took ibuprofen for the swelling that's worked before before
01:47show them
01:51I
01:53I
02:18Wanted to see me dr. Glassman, this is Kayla Quinn
02:22She's been diagnosed with major depressive disorder as well as chronic neuropathic pain from a neck injury six years ago
02:28The pain and depression are besties
02:31Uninvited guests that travel together make it so I can't work. Can't get out of bed. Can't even think
02:38So I'd like to do this before their next visit
02:43An anterior cingulitis seems like the excuse me
02:52She is a smart charming successful woman who's nice ambush
02:56She's had over a decade of therapy five classes of antidepressants and non-invasive neuromodulation including CES and full-on ECT
03:04She's desperate for real relief from her pain and depression and she's well aware of the risks
03:12Give me a complete medical and psychological history in a couple of residents. We're just gonna talk about it
03:22I'm not sure who's struggling more the overwhelmed super critical mom or the sad self-harming teen
03:30Trent called it an upgrade. He's not trying to self-harm. He is trying to self-improve
03:36Whatever the terminology he cut into his finger with an exacto knife. Okay, his technique was
03:42Primitive but considering he lacks formal training and used only one hand. I am impressed. Don't be
03:51Pony marginal erosion if the infection spreads he could lose that finger
03:58For starters
04:05It's the modern equivalent of a lobotomy
04:07Modern being the operative word we'd be burning lesions into a key brain center that could alter a personality
04:13impair cognitive function for depression and reoccurring acute pain are already doing that
04:18Singulotomies are effective in 67% of patients with Kayla's symptoms with a 20% chance of adverse effects like loss of creativity
04:25It could be a big deal. This is Kayla claim
04:29She launched her own company at the age of 18 made millions designing scrunchies and bangles I
04:35Discussed this with her her focus is quality of life. I'm sure she feels that way now, but once it's done it can't be undone
04:42Are there any alternatives that Kayla hasn't tried or should try again?
04:48Okay
04:53Let's do the surgery
05:01Possible amputation the infection is in the bone beneath the magnet. It would have been better to have brought him in sooner
05:10I'm a single mom
05:12Trent
05:14Trans father isn't in the picture. You made sure of that
05:18I got divorced last year Trent and I were
05:21Adjusting, but then he started hanging out with these idiot biohackers. Thanks mom
05:28We should remove the infected implant and start Trent on IV antibiotics, what about the other implants?
05:35Shouldn't you take them all out? No, the other implants aren't infected. Okay, this is not a decision you get to make
05:42And
05:44Once a patient is 16, it is hospital policy not to perform a surgery that's been refused unless that surgery is medically necessary
05:53Leaving in the other implants means Trent still at risk for sepsis and septic emboli
06:01Dr. Walke is correct with your consent. We can physically compel the surgical removal of all your son's modifications
06:08Good luck. I'm out of here Trent
06:11Trent
06:18This is much easier than chasing him head frame is secure stand by with the gamma knife
06:32Dr. Glassman, please stop what you're doing
06:34This is Justin Quinn Kayla's conserved I have full authority over my sister's medical treatment and I won't allow this surgery
06:51Kayla
06:53Caesar psychiatrists weekly and I check in with her daily
06:56But clearly this is not a weekend getaway at a cabin in Tahoe a chance email from our insurance to me
07:02She's never lied to me like this. I was 12 when my parents died my memories. I don't seem real
07:08Just clips from a movie. It was our Greek therapist who first diagnosed her depression
07:12I was 22 and so out of my depth Justin. I used to do everything together. It was us against the world. I
07:21Called him bro, dad
07:23She was such a creative kid. So talented. She just had a vision. She had a vision. She had a vision
07:29She was such a creative kid so talented
07:31She just had a vision and wanted to run with it who knew scrunchies and glitter bangles could be a business
07:36Just took off 18 years old all that money and no guardrails
07:42She was out of control clubs every night the booze the drugs I
07:49Couldn't help her
07:52I can't stop her. It was during a blackout that I fell and injured my neck
07:56Everything just got worse after that the arrest piled up on her age drinking possession DUI. I
08:04Thought she was going to prison a judge agreed to a diversion program
08:08She nearly OD twice called me a danger to myself judge ruled. She was incompetent, but my brother in charge of everything
08:17She took away my life the conservatorship saved her life
08:26All
08:30I needed to piss off. My parents were fishnets and heavy eyeliner. Of course you were goth
08:36How many times did you see the cure for?
08:40Robert Smith was like leader of our tribe
08:44Every lonely team needs a tribe. I
08:48Was lonely but I was not a rebel my rebellion was just being honest
08:54My family preferred the lie
08:57Meanwhile Trent is damaging his relationship with his mom and his body
09:02That is not his fault. She is his mother mother should try to understand their children
09:08Nice thought but teenagers are asses
09:13Scientifically proven their prefrontal cortex is underdeveloped leading to excessive risk-taking and lack of impulse control
09:20Margins and soft tissue look good, but keep an eye out for the infection. That's close
09:41Mr. Quinn
09:44Your sister is suffering
09:47It's a rollercoaster with her
09:49Good days and bad days, but your solution is to fry part of her brain. She could lose her creativity her
09:56Personality her pain her depression. Maybe those other doctors read me through the risks and the numbers
10:03What if I could show you how Kayla's issues are hardwired in her brain?
10:07An fMRI could demonstrate how the part of Kayla's brain that handles emotional and pain response is functionally abnormal
10:14It'll assure you that frying her brain means only frying the part of her brain that isn't working
10:21And I'll get you both off of the rollercoaster
10:26The scans harmless
10:36Okay do it
10:47I've gotten Oh see I can spin around you need to do a post-op exam
10:53Well you have modifications
10:56I'm Dixie
10:58My right hand got messed up in a car accident
11:00I had RFID chips put in so I could unlock my front door store my medical info and do some pretty cool tricks
11:08or
11:09You attracted to Dixie. Are you concerned? You'll be less attractive to her without your implants
11:17We're just friends. I host a monthly biohacker meetup and trends become a regular the only people who get me
11:25you
11:26found your tribe
11:31Incision sites look good right wrist, please
11:34It was not until I came to work here at st. Bonaventure that I felt like I was part of a community
11:40I've read about implants that can operate prosthetics and an occipital lobe electrode that receives visual images for sightless people
11:46These technologies are very exciting so cool, right? I was thinking I should be an engineer and I can design tech for people like Dixie
11:54Oh
11:56How's he recovering dr. Murphy Oh
11:59Hello, the surgeries went well finger looks free of infection and bacterial cultures remain negative
12:04We still need to do an MRI to assess his joints, but I'm optimistic great
12:09Then once I'm 18, I can get all my mods back in by the pros of the Dixie's
12:14meaning the tattoo artist at the strip mall
12:17Tattoo parlors require a public health permit. Yes, that would be much safer than doing it himself
12:30Rain check for the night surgery a
12:35New patient reminded me I need to spend more time on my business ideas less time on the dance floor. I
12:41See a sparkle in your eyes. What is the product?
12:43My
12:46Ingestible sensor that monitors gut bacteria as it travels through the GI tract
12:50Girls, yeah, cool. How are you gonna collect the data ideally real-time monitoring?
12:56I'm looking at wireless open-source programs. You could connect the sensor with a smartphone via Bluetooth. That would be
13:03amazing
13:05But that could be pretty complicated to write
13:08But that could be pretty complicated to write not for me
13:16You'd have time for that on top of your IT work since the second year resident looking to disrupt the men tech business I
13:24Wouldn't be able to pay you at least not up front we could divvy up the spoils
13:287525 final offer. Hello guys partner. Welcome aboard
13:43Put this on your calendar May 2025 yacht shopping. Okay. Yes
13:52Dr. Murphy
13:55Please stop encouraging Trent
13:58Your interest in his body modifications comes across as an endorsement. Oh, I am interested
14:04Why would I pretend that I'm not not so long ago?
14:06We were talking about amputating fingers. Someone has to talk some sense into my son before he does this again
14:15I'm happy to have a chat with him
14:18He seems to connect with dr. Murphy if you talk to him
14:23he might listen I
14:27Would not be very good at that
14:38Kayla next I'm gonna ask you a series of prompts to help us map your brain activity. I'll do my best
14:44Think of a nice memory something from a happy time
14:50You didn't like any of the apartments I sent you
14:53As predicted altered limbic activity and the connections to the cingulate cortex
14:58The apartments are okay. I'm shocked here. So easy to please
15:03You're such a quibbler hate art deco those ceilings equal doom Barbara carpets hurt my feet
15:12Kayla now, I need you to think of an unpleasant memory
15:15Take it as a compliment that I'm so picky picky's fine passive and not so much send me some links
15:24More normal connectivity
15:27I'm getting motion artifacts. She's moving around Kayla. Can you try and hold still?
15:37I'm sorry, can we please stop?
15:39I'm sorry, can we please stop?
15:57You never came to bed we were supposed to have sex
16:01Sorry, our sensor keeps running out of power halfway through the digestive tract
16:06It's not on the schedule that we could have sex now I have to shower I shower first
16:15Okay, I will be flexible and make you coffee
16:35You
16:39Come on
16:51How's Kayla
16:52In pain and on the edge of a full depressive episode. I have to recap a pen and it started a low-dose ketamine IV
17:00smart
17:02Hmm
17:04You know, we'll have to get her off the ketamine before you take another shot at finishing the fMRI
17:12Do you not want to move in with me
17:15Well busy. I have other patients
17:18Allow me to present multitasking. Look at that three-bedroom two-baths courtyard building with a pool
17:24We'd have a guest room for Kellen a shared office and it's ten minutes from the hospital
17:29I don't looks like the master bedroom windows overlooking the courtyard. I know nice
17:34nice loud
17:39Then show me one you do like oh
17:43Hell no, I'm gonna update the brother
17:48You paged me good morning Sean Lee and I missed our sex night. It is not a good morning agreed
17:57Mine started with a distraught mother whose son you refuse to advise against biohacking what he chooses to do
18:04And he is 18 is up to him true, but you could advise him against the dangers of further mods
18:10Trent enjoys the connections he has made in the biohacking community
18:14You really think the emotional benefits of belonging outweigh the physical dangers for this kid
18:19Teens do many dangerous things if he injured himself skateboarding should I advise him never to skateboard again?
18:25Which could alienate him from his skateboarder friends?
18:28Is there potential for medical harm?
18:31Yes, then remind your patient of that you have no trouble being honest
18:39I'll do it only because you're my boss
18:44Case in point
18:47Just
18:54Since refusing to let me finish Kayla's fMRI
18:57He thinks her being in the hospital is what triggered this latest episode II
19:00He's totally dug in
19:02It's a judgment call legally. It's his judgment. I need you to talk to him get him to change his mind because
19:07You're the surgeon if medicine could persuade him we'd be in surgery right now, so I should just give up
19:13I don't know. Do you want to know okay, then don't go find another tactic
19:18Okay
19:20No no no I do the surgery you do the selling
19:28Okay fine
19:31Look at it this way
19:32The brother has been
19:34Cleaning up after his sister for years, right?
19:37so instead of
19:39Trying to change his feelings about the surgery maybe change his feelings about his sister
19:49Future modifications could result in sepsis severe arthritis pseudo tumor formation nerve damage and paralysis
19:56Suddenly you're a guy in a drug commercial side effects include insomnia rash dry cough and death
20:03Sounds like my mom got to you she tried it didn't work, but then she went to my boss that did work
20:10I think that it is nice your mother cares about you mine did not
20:20Mine used to
20:23My dad used to travel a lot for work
20:26He was always off pitching to investors conferences in Vegas
20:30And me and my mom would hang out all the time
20:33Every weekend she would take me to the boardwalk
20:35Never said no no matter how many times I wanted to ride the cyclone
20:40Cyclone made me nauseous
20:43Now she's just working all the time whenever we're together. She's angry
20:48Never stops nagging me
20:51She doesn't like you biohacking. I don't think she'd like anything I do
21:04Is it your finger no, it's my wrist
21:10Kayla's biggest trigger isn't being in the hospital. It's your control over her life. I
21:15Reviewed her history in detail and over the last five years Kayla's major depressive episodes coincide with major life decisions
21:23That you've made on her behalf
21:25Changing meds and moving homes making decisions for the business
21:29You're saying this is all my fault. She's saying that being in charge of my own life would be better for me
21:35Until you get drunk or OD
21:38That was years ago not that person anymore because I've been protecting you because the conservatorship works
21:46That argument means I'll be in this forever
21:50If I'm doing well proves you right if I'm a mess proves you, right?
21:55I'm tired of this Justin. I'm tired of living the life that you want me to
22:00You pick up my doctors you search my cabinets you test my urine for drugs you talk about relaxing some of those things
22:07No, no, I'm done negotiating over my own life
22:10I'm having what you think is best rammed down my throat Kayla acting like this is gonna change my mind about the surgery
22:15She didn't have to it's my life. It's my messed-up brain
22:18This place is bad for you. I need our discharge papers
22:37You
22:41Really delight you installed in your right wrist has irreversibly damaged the joint you will never regain full function in your hand
22:51You'll need physical therapy until you can compensate with your non-dominant hand damn it Trent
22:57How many times did I tell you thousands? Okay, but I'm such an idiot and I never listened
23:02I never said you were an idiot. I said to stop hurting yourself
23:04Maybe some family counseling could help. No, she's the only one who needs counseling. She's the one who failed as a parent
23:11Your choices are not my fault. I'm stuck with yours
23:14Okay, you toss that out. He walked out on us
23:25I didn't want you to hate him. I hadn't realized that the alternative was hating me
23:35You
23:39Your father was a schemer
23:43He kept flitting from one big idea to the next chasing fantasies instead of taking care responsibility, that's a lie
23:50You're a liar
23:53He was a self-absorbed narcissist who cared more about himself than us that's not true Trent leave me alone
24:00Get out
24:03Get out
24:21Light a cane to numb you figured you'd want me to feel every stitch
24:26I'm used to being the bad guy bad guys. Don't give up their lives to care for their little sisters
24:33Thanks for seeing that
24:37You feel that
24:44People
24:45Idealize and it's like being a kid, but really childhood blows being told what to do or to go
24:52How to behave
24:55Spoken like someone who had a terrible childhood. It wasn't my wheelhouse
25:01Or my parents
25:05Kayla's first try that growing up she flamed out doesn't she deserve a second shot
25:13Maybe
25:15Leave it to Kayla to choose elective brain surgery for a maiden voyage
25:19Scares the crap out of me
25:23Tell her that
25:34Jerome's birthday is coming up. I need to find him a great gift. Please don't distract me
25:38I am looking for a surgical solution for Trent's wrist. It's valiant, but he's about to be discharged
25:43I need a gift and I need a gift
25:46It's valiant, but he's about to be discharged I need a gift that says I'm really into you but
25:52Without ever doing it. We could attempt a partial wrist fusion not for another year Trent still growing
25:58Jordan mentioned you have some super cute race car pajamas. I can get Jerome a pair
26:03They are classic cars and I prefer not to discuss my sleepwear at work
26:07We could give Trent a course of methotrexate to come he'll adjust to the bad wrist
26:12The bigger problem is that mother and son act like they hate each other
26:16I have no idea how to fix that he's managing his feelings by turning himself into a cyborg
26:21Trent is not becoming a cyborg
26:24I
26:50Can fix Trent's wrist
26:53This experimental surgery uses a customized implant to replace his wrist joint
26:56He will have full use of his wrist. Also, he will be very happy because he'll have a one-of-a-kind body modification
27:03Experimental would it be covered by our insurance?
27:07No, it is quite expensive
27:11Which means I'm getting a second mortgage to pay for it
27:15If Trent keeps getting other modifications could that cause problems with this device?
27:23Yes, his body could reject the implants, okay
27:27But thank you Trent should be able to follow the post-op regimen including no further modifications
27:33Or he'll keep seeing it as a cool hobby, which allows him to stick it to his terrible and controlling mother
27:42I can fix your son's wrist
27:49With your consent
27:52I
28:00Know
28:14Looks like our sense is gonna poop out before it gets pooped out. Maybe if you take another look at the component specs
28:18I have drawn up a list of house rules that apply to dr. Allen when she is working at our apartment
28:23One no work on scheduled sex nights. I can get down with that to no brushing teeth in the kitchen sink
28:30Agreed three do not wear perfume for do not speak in a loud voice five. Please avoid eye contact. I'm not finished avoid eye contact
28:40Yes
28:43I
28:49Don't like having anyone other than Leah at the apartment with Leah I feel safe
28:55I am NOT obligated to follow the guidelines around social interactions by the time I'm done with work
29:01I have had enough of following guidelines
29:04Johnny I never knew
29:07We
29:09Can work someplace else the apartment is half Leah's I am very happy she has found a friend and partner
29:17Dr. Allen
29:24You are part of my tribe you are welcome in our home
29:32As long as you follow the rules including six I'm allowed to ignore you when you are there
29:37I
29:55Does it ever feel to you like we go around and round we always find our way back to this same sad place I
30:04Remember when we first got here
30:06You were 12 on a school field trip to the municipal garden
30:13And I got there and watched you sketch Rosa
30:16so confident
30:18at peace
30:22Innocent
30:26Then I had to tell you mom and dad were dead I
30:32Swore that I'd do everything I could to keep you from being hurt like that again
30:37I
30:39Know you're just trying to protect me
30:45I'm protecting me, too
30:53I'm just so scared that I could lose you
31:07During the fMRI dr. Resnick asked me to think of a happy memory
31:13Silver top, Nevada
31:16You and me on that river the canoe that cabin was such a don't
31:22Know we're only there cuz I screwed up and forgot to sign you up for that camp
31:28Yeah, I was the first summer after mom and dad died you had an excuse
31:34I was a good trip this vacation. I ever had I
31:44Want that again
31:46We can always go back
31:48not the trip
31:50the freedom
31:52that happiness
31:55Without the next bout of pain and depression letting go for me
31:58I
32:03This is my chance, please let me take
32:20Okay
32:29I
32:37I'm dying to take this next step with you. This is the guy who's sandbagging the search. It's the money
32:46Between Kellen's college tuition and my med school debt
32:50There's not much left at the end of the month
32:53on top of that
32:55My credits a mess
32:58This is just about money
33:01just
33:03If you can't afford it. I got you. I pay my own way always have always will
33:08Your financial issues are no reason to put our plans on hold
33:11Easy thing to say when you've never had to worry about money, but some of us have had to live in the real world
33:19And if you had the money, and I didn't you wouldn't want to improve both our situations
33:25This isn't about the real world
33:28It's about your pride
33:41I have your prescriptions and therapy referrals. I can do it and do it
33:50I
33:56I'm guessing this is my fault as well
34:00Okay, the way you behave is very confusing and frustrating it doesn't make sense at all
34:05You criticize every choice Trump makes and never ask why he's making them see you deliberately made choices
34:12You knew your mother wouldn't approve of and then we're very angry when she didn't approve even he thinks you took your biohacking too far
34:18She's been mad at me since dad left. Well. That's not true. Yes, it is
34:22You don't like me
34:24You don't like my friends. I don't understand your friends. You never tried to
34:29you're just mad at me because
34:32Stuck with me
34:42I have been mad, but not at you at your father for leaving
34:49I'm afraid I couldn't take care of you or support us
34:55He was so hurt when your father left all I wanted to do was make you feel better, but I just
35:02Was too damaged
35:06And jealous of your new friends when I should have been grateful, but I
35:13Was afraid of losing you to them
35:16After all you like them
35:20You're my mom
35:23I'm not supposed to like you
35:25You
35:41Can I do the surgery now
35:49You are gonna like this
35:55Time to prep you for surgery
36:00Before I go
36:13I got a little inspired
36:19I'll hang out over for you
36:26You ready
36:46Couple resection looks good. What did you say to change carry his mind?
36:53I'm not sure
36:55I tried to understand them
36:58Maybe you could do me my father next
37:01purple and radial bones prep for the upgrade
37:08I'd say you get the honors resolving conflict is a crucial skill for an attending nicely done
37:15You
37:23Placing carful ball onto the distal component
37:31For the next few days expect some headaches and fatigue that the post-op symptoms should quickly pass
37:37Kayla
37:39How do you feel?
37:42Strange
37:46Something's missing
37:55The pain
38:00And I think I'm still me
38:06Bro, dad
38:11I
38:15We have to go see a judge
38:21I'm always just your brother
38:34The arthroplasty fixed trance wrist like I said it would
38:39You will need significant therapy, but your prognosis is good. You better take this seriously
38:46Take your meds. Do your rehab?
38:50Invite that friend of yours Dixie over for dinner
38:53Really? She seems interesting
38:58These are the schematics of your wrist implant the engineering specifications are quite interesting
39:07Thanks, dr.
39:26My key still works
39:30It was about my pride
39:33And I use that as an obstacle instead of being honest with you, I'm sorry
39:45That's a big step
39:48But let's keep talking
39:51I'm sure I'll get over myself in time. Can you do it in a month?
39:55I
39:59Found a house that I love
40:04Gorgeous
40:07Price it should be I would be very grateful for a Sunday roommate who could cover the utility bills. What about rent? I
40:14Was thinking services rendered
40:17like
40:19Shirtless lawn mowing
40:21shirtless
40:22whole cleaning
40:24shirtless nail prep
40:28Certains deadly men would argue if we don't start on equal footing. It'll never be our house
40:36It'll be our home because we'll make it that
40:46Apple what about a hot tub?
40:48Our
40:52Power issue is a software issue because your data domain requirements mandate a specific chip that requires way more power that we can actually
41:09I could see
41:13Everywhere was like
41:16What if
41:19The sensor had bad manners
41:21Shuts down when it needs to rest ignores what doesn't matter. It works. It rests. It works
41:26It rests we could extrapolate between the data points that could double the sensors life
41:32Your pure inspiration showing I am ignoring you