The Good Doctor Season 5 Episode 16
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00:00🎵 I see trees of green with roses too. I feel good for me and you. I think to myself, what a wonderful world. 🎵
00:27Morning.
00:29Oh, I made pancakes.
00:32Your lips are very shiny.
00:35It's just my normal lip gloss.
00:37You don't normally have it on for breakfast.
00:42Mmm, these are delicious.
00:47Where is my apple? One of you move my apple.
00:51It was just blocking the shot. Try not to look directly into camera.
00:56🎵
01:02So tell me about how you two met and fell in love.
01:05First we were our neighbours, then we became friends, then roommates.
01:11We bonded over our love of pancakes and karaoke and before we knew it we were having our first kiss.
01:18We were drunk from tequila and I vomited immediately after.
01:22Yeah.
01:23And Leah said we were just friends and she said that was all we could be because of my autism and I thought she was superficial and prejudiced.
01:30But I was wrong about her and she was too. She could be happy and in love with me.
01:36So she asked me to marry her and I said yes.
01:39You sure did.
01:41I have to go.
01:43Okay.
01:53We need you to sign a release form.
01:54I don't want to be on TV.
01:55Well we can always just blur you out.
01:57You don't want to be blurred.
01:58Why? It'll be fun. We'll be the younger, more outrageous supporting character in the Sean show.
02:02It is not my show.
02:04All this for you.
02:08Looks like Dr. Andrews is hoping for a special appearance by billing.
02:11I didn't expect to make it to California.
02:14San Jose St. Bonaventure Hospital has one of the most rigorous surgical training programs in the country.
02:18Only a select few make it through this rigorous five year residency which traditionally culminates with a test to see if those residents are prepared to be attendings.
02:29Did I say rigorous twice? I could take that again.
02:32Don't worry. You're doing great.
02:34Can I get your autograph?
02:37Dr. Murphy and Dr. Park, today each of you will be put in charge of a surgical case and evaluated based on your OR performance,
02:47your ability to delegate responsibility, to manage junior residents, and think on your feet.
02:53The next surgical cases that come through the ER will be all yours.
02:58Dana Bradley, 34, burns to her head and left forearm. At least 10% total body surface area.
03:06C areas of second degree burns. Forehead, scalp, and cheek with associated burn blisters.
03:10Likely mid to deep dermal partial thickness burns.
03:12Some blood for CBC urea electrolytes lactate and get EKG and chest film.
03:19One milligram of dilaudid.
03:21Dana, it's okay. We're giving you some of this drama for the pain.
03:24Start IV antibiotics, capillary refill. It's sluggish. She needs acute surgery to debride.
03:28Let's go.
03:43Grant Furlan, 44-year-old firefighter. Level 2 trauma, multiple injuries from a fall.
03:48What about burns?
03:50No burns. He saved the woman from the fire, then he got pinned by a beam.
03:53Sir, please go to the waiting room. We'll keep you updated.
03:56Dr. Park, this is your case.
04:02Villanueva, we need all hands on deck.
04:07He's tachycardic and hypertensive. Could be bleeding into his abdomen.
04:10Give me the ultrasound. Give me the ultrasound!
04:14Inch peritoneal hemorrhage.
04:16We need to open him up.
04:17Let's go.
04:21Excision knife. Apply even pressure against the wound.
04:26Starting the tangential sequential excision.
04:31Sean would be an asset to any hospital.
04:34He views the world a bit differently and a little bit different.
04:39Would we accept him just as he is?
04:42Did you always feel that way?
04:47There was a time where I didn't feel Sean belonged at this hospital.
04:56Luckily, I got my arm twisted.
04:59Sean's arm was twisted.
05:01He was in a wheelchair.
05:04Luckily, I got my arm twisted.
05:07Sean's contributions have far outweighed his surgical gifts.
05:14She's in VTech.
05:19Is he okay? Why does he stop there?
05:21Sometimes he gets these ideas.
05:24More like visions. It's very effective.
05:30I'm not sure what that is.
05:33Your lights are in my eyes.
05:35Please turn them off. Step back.
05:41He's hypothermic. We need more aggressive fluid resuscitation.
05:46I'll place a femoral line. He's in a re-warming catheter.
05:56Okay.
05:58We need to assess the duodenal rupture.
06:01I'll run the bowel. I won't let any of the perforations.
06:04I have coxsyn O.G. tube to suction.
06:09His surgical technique is really advanced.
06:12He has such command over the room.
06:14Shut up.
06:17Suction.
06:28I found the bleeder. Coagulating.
06:32Next, I'll repair the rupture site.
06:40Bleeding stopped.
06:47Let's close him up. Get a post-op CT to make sure we got everything.
06:53I've heard that Sean sometimes has visions.
06:56What are they like?
07:05Pretty good, huh?
07:08It's more like...
07:12Um...
07:13Sorry, but you're no Sean.
07:17Nobody can do Sean's vision thingies but him.
07:20It's his superpower.
07:22Like, he has an X-ray, MRI, and CT all in his head all at the same time.
07:28I'm never going to be able to do that.
07:31But what I've learned from watching Sean is...
07:34figure out what you're good at and lean into that.
07:38What's your superpower?
07:40How much time do you have?
07:45The surgery was a success.
07:47We were able to eliminate all non-viable tissue and use autograft over the entire burn surface area.
07:54What are they doing here?
07:56They are taping me. They will blur out your face.
08:01When can I see my family?
08:03The nurse is bringing them. They should be here shortly.
08:09That hurts.
08:11You are on strong IV narcotics and the grafts should still be none.
08:18Please stop. Stop! It hurts!
08:22I am not touching you.
08:25There is significant swelling and edema. It is pulling on the graft anchor sites.
08:31That doesn't make sense.
08:34Mommy?
08:36Yes.
08:40Baby.
08:44I'm here.
08:47I want to go home.
09:11I'm sorry.
09:22Hello. Dana's autografts were procured, placed and secured perfectly.
09:26We started IV ANSEF before surgery, continued post-op and confirmed none of the tissues removed had positive cultures.
09:31The grafts should not be failing.
09:34Did you keep her wound dressings moistened?
09:36Yes, and her edema is getting worse even after replacing dressings.
09:39You need to go double-check her labs.
09:41I know what I did. I memorized all data in my patient charts.
09:46Did you use proper sterile technique and prep on all autograft sites?
09:50Yes.
09:51Adequate fluid resuscitation and replacement for losses?
09:54I checked urine output and central venous pressure every hour, but she was really uncomfortable so I skipped one battle thing.
10:03No, you cannot skip steps. Go review every vitals check, all urine output ins and outs, and every CVP.
10:18Hey, my boys tell me you're a former brother in blue.
10:21Walked the beat for 15 years.
10:25Can we talk privately?
10:27We're all squad here.
10:30Grant, your CT showed you have an unstable lumbar fracture. You'll need extensive posterior fusion surgery to stabilize it.
10:42Well, how long before I'm back on the job?
10:44You'll be up and walking in a few days.
10:47But after this kind of fusion, your spine, you won't be able to be a firefighter anymore.
11:00Then you need to figure out a different plan.
11:03This is the safest surgery. Your abdominal injury poses too many risks for us to...
11:07We run into burning buildings for a living. I'm not afraid of risk.
11:15I trust you to get me back to my team.
11:29You okay?
11:31I'm just double checking our patient's lab work.
11:34That's some emotional lab work.
11:38Sean thinks I caused our patient's graft issues, and he said so on camera.
11:45And I'm... I'm so angry at myself for skipping a step.
11:51But I don't think I caused the edema.
11:58Sorry about this morning. Rough day.
12:01It happens.
12:02I need approvals.
12:05We implemented a new system last week. You're working off the old one.
12:08I'm sorry. I didn't know.
12:10You were late on training day. Redo it.
12:13And maybe cool it with the new system.
12:15Please, let this be an actual medical issue.
12:18My patient's refusing posterior fusion surgery.
12:21We need an alternative that'll get him back on his feet.
12:24Well, posterior fusion would get him on his feet. He just wants to carry someone on his back.
12:31We could try ventral surgery through his abdomen.
12:33L3 is hard to get to, ventral.
12:35It's hard to get to, ventral.
12:37It's hard to get to, ventral.
12:39It's hard to get to, ventral.
12:41It's hard to get to, ventral.
12:43It's hard to get to, ventral.
12:44It's hard to get to, ventrally. Even if everything was perfect.
12:46But if we try a transpedicular approach, we could do a posterior cage placement and short segment surgery.
12:51There's a risk of catastrophic nerve injury or an uncontrollable bleed from placing too large a cage.
13:01Would you try it?
13:05Your patient, your call.
13:08What do I love most about Sean?
13:12I can't choose.
13:15He's brilliant.
13:17And he's so funny.
13:19He makes me feel safe.
13:22I know no matter what happens, he's there for me.
13:25And he's super cute.
13:29Sean, what do you love the most about Leah?
13:31Sean, what do you love the most about Leah?
13:37Sean.
13:43I love that her eyes crinkle when she is happy or sad or angry or worried.
13:52And I know which one means what.
13:54You know my eye crinkles?
13:56That one means she is happy.
13:58I double checked every recorded vital sign and hourly urine output.
14:01All suggest adequate blood pressure to maintain graft perfusion and no signs of fluid overload.
14:06I don't know what caused it, but Dana's edema and graft issues are not my fault.
14:19I need to see your footage.
14:24Stop.
14:26Stop.
14:28Play it from there.
14:38The grafts should not be failing.
14:40Something must have gone wrong.
14:41I need the answers to fix it.
14:43Please rewind.
14:53Stop.
14:55Okay.
14:56Play at half speed.
15:07Right there.
15:10When I pressed that burn area, she did not feel it.
15:13If they were second degree mid-dermis burns, it would have hurt.
15:19Dana has third degree burns.
15:21The tissue is dying under the grafts because I did not debride deep enough.
15:30Dana's problem is my mistake.
15:42Sean has always been great with medicine, but romance, not so much.
15:46I took him through boot camp and then he and Leah got together.
15:49I guess you could call me Cupid.
15:51You don't get credit for Sean and Leah getting together.
15:56You can barely get credit for us getting together.
15:58I have to go practice my surgery.
16:03Your first surgery did not work.
16:07I didn't debride deep enough. We need to fix it.
16:12How's your pain level?
16:16I'm...
16:17I'm...
16:19a monster.
16:27No wonder Nicole ran away.
16:29Okay.
16:31We have to do another surgery or you could become septic.
16:37Will it fix the way my face looks?
16:39No, your face will look worse because we have to debride deeper.
16:43No, I can't.
16:44We have to fix the mistake.
16:47How you look doesn't impact your health.
16:53Okay.
17:03Do you want me to get your husband?
17:05I'm sure he wants to see you before you go into surgery.
17:08No.
17:11Nicole needs him.
17:17Okay.
17:28That's not going to work.
17:31You need to get wider exposure and corpectomy before placing the cage.
17:37There is an easier solution.
17:40Tell your patient he's being an idiot.
17:43It's not worth risking his life for his career.
17:47You're right.
17:50When I left the force, I felt more alone than any other time in my life.
17:57I didn't just leave a job, I...
18:02I left a family.
18:04He wants to fight to keep his, so I'm going to do what I can to help him.
18:08Beep. Beep. Beep. Beep.
18:15I'll drill off the complete pedicle and L3 body.
18:17You decompress on the lamina above and below.
18:21It'll allow for a safer cage placement.
18:29I don't think Dana is ready for the free tissue flat reconstruction.
18:32We can start with Dana tissue removal.
18:34No, we should not wait.
18:36Deeper debridement and parietal fascia surgery will clear her edema.
18:40It's a high-risk surgery with high risk of blood loss and flat necrosis.
18:44Before we do another big procedure, she needs to recover psychologically.
18:48She could develop infection and compartment syndrome if we wait.
18:55You missed what the patient was feeling in your initial diagnosis and it affected her outcome.
19:02You could be wrong about this too.
19:05Sigh.
19:10The free tissue flap surgery will correct the damage from her burns.
19:17I am the attending. This is my decision.
19:20This is my decision.
19:35My patient...
19:37No.
19:44Sean, what's going on?
19:45My patient has to have another surgery. I thought she had second-degree burns.
19:48She also has third-degree burns.
19:50Okay, so do another surgery.
19:52If I had not been distracted by the cameras, I do not think I would have missed her reaction.
19:59Third-degree burns are always numb.
20:01So you can do another surgery.
20:07This is my test to prove I am ready to be an attending.
20:12Okay? I made a mistake.
20:14And you caught the mistake.
20:16I shouldn't have missed it. Okay? It was my fault.
20:19Okay, so it was your fault.
20:21So, just like it was my fault when I was attending that I missed a subdural epima
20:27and Park punctured a fungal nodule and Claire missed a PE, the patient didn't die. Right?
20:33You can do another surgery. So let's just focus on that.
20:38I am different than you and Claire and Dr. Park.
20:43I do not get to make mistakes.
20:47Is this because this video crew has been following you around wherever you go?
20:52Yes. I made two mistakes. The burns and letting them film me.
20:57You know what? Get rid of them.
20:59If you don't want them around, just get rid of them.
21:01And another thing, Sean, you can't expect to be perfect all the time.
21:10It doesn't happen. Ever. For anyone.
21:16Ever.
21:25No.
21:27Again, it's helpful if you include the question in the answer.
21:31What was the question?
21:33Do you see yourself as Sean's protector?
21:36Oh, um, no. I don't see myself as Sean's protector anymore.
21:44How does that feel?
21:47How does it feel? I don't know.
21:50It feels great.
21:52I'm proud of him.
21:54And relieved.
21:59That he's gonna make it.
22:01What changed?
22:06He did.
22:08He changed.
22:10You elaborate.
22:16He grew up and met Leah.
22:21Do we need to talk?
22:23Turn the camera off.
22:25Sorry, no.
22:28Okay, then I'm gonna have to say what I have to say naked.
22:34You can take five.
22:37You need to back off Sean a little bit.
22:40It's my job to ask questions.
22:41I was expecting wedding surprises and instead I feel like you're exploiting his autism.
22:46You knew Sean's ASD was gonna be part of the show.
22:49I didn't expect you to make a highlight reel out of his most spectrum-y moments.
22:52I'm not manufacturing anything.
22:54Sean made a mistake on a very important case and now that could end up on your show.
22:59He's totally rattled.
23:00I know you want to protect him.
23:01It's not about protecting Sean.
23:03This is about the whole world seeing him as a collection of quirks and a single mistake.
23:10But since that is good TV.
23:16Sean.
23:23Dana has third degree burns.
23:26Dana has third degree burns.
23:29Dana has third degree burns.
23:31Her tissue is dying under the graft because I did not debris deep enough.
23:37Dana's problem is my mistake.
23:39I'm not gonna use any of the footage related to your mistake.
23:46It's not relevant.
23:48This is a wedding show.
23:50Leah reminded me of that.
23:54I do not want to be dishonest.
23:58It's not dishonest.
24:00It's focused on you and Leah and your relationship and your amazing career as a surgeon surrounded by all of these people who support you.
24:12That is what will give hope to people who feel different and alone.
24:20And that's why I'm doing this.
24:35Grant's case file.
24:36Grant's case file.
24:40I've successfully completed the short segment posterior fusion on the skills dummy simulator.
24:46Once.
24:48With a partner.
24:50You've successfully done it on real people over 50 times.
24:55You should take the lead.
24:56Which would mean removing yourself as the attending on this case.
25:01I'm not risking my patient's life to pass the test.
25:03You're risking your own career to try to save his.
25:10Grant deserves the best shot to get back to his crew.
25:16That's you.
25:25Any cold feet?
25:27Sean is my person.
25:29I know that beyond a shadow of a doubt.
25:34Do you think I should let Sophie remove my mistake from the show?
25:44I think that is up to you.
25:46How do you feel about it?
25:48It feels like a lie.
25:52But is it more important to give people truth or hope?
25:57That's a tough question.
25:59Yes.
26:00Yes.
26:02I say we stick to the two of you.
26:05We're getting married in just a few days.
26:08Any nerves about that?
26:10No. She is also my person. I have known that for a long time.
26:14I have to go prep for my surgery.
26:17Okay, I have to go prep for my surgery.
26:25It took you longer to be sure that Sean was the one.
26:28In fact, you said you couldn't get involved with him because of his ASD.
26:32What changed?
26:50I offered to take out the mistake because you were right. I crossed a line.
26:53Instead of embarrassing Sean, now you're zeroing in on me?
26:56I'm not trying to embarrass anyone.
26:59Can you please slow down?
27:02As a little person, the world doesn't accommodate me.
27:05That's why representation matters.
27:07But when it's real.
27:09I'm not asking you to make us look like a fairy tale.
27:12Fairy tales have obstacles and conflict.
27:15The story you want me to tell?
27:17You two met and fell in love and everything's great?
27:19It's boring.
27:21So you want me to play the wicked witch?
27:23You are not defined by your lowest moment.
27:26But you can't deny it, either.
27:29I am here to tell the real story of you as a couple.
27:34Do you still trust me to do that?
27:45You're invited to my wedding.
27:47Your vitals are good and your volume status is stable.
27:51The nurse will come get you for surgery soon.
28:05I'm so sorry the cameras added to your pain.
28:12I was going to have to see myself eventually.
28:17My daughter will have to look at me every day.
28:22And pretend she doesn't see a monster.
28:26She won't see you that way forever.
28:28Other people will.
28:31Other kids will tease and bully her.
28:36Because of what her mother looks like.
28:41People have teased and bullied me my whole life.
28:44And it hurt for a long time.
28:47And I was too ashamed to tell anyone.
28:53I finally told my mom.
28:55She taught me how to stick up for myself.
28:58You can be an example of how to get back up when life knocks you down.
29:05Your strength will make her more compassionate than most people.
29:11And more powerful than any bully.
29:30Scalpel.
29:35Scalpel.
29:40I'll come get you as soon as your mom is awake.
29:44I don't want to see your daddy.
29:52It's okay to be scared.
29:54You know what helps me whenever I'm scared?
29:59A big hug.
30:01The best ones are from my mom.
30:05Do your mom's hugs make you feel better?
30:11I know mommy looks different.
30:14But her hugs are the same.
30:17They're full of the same love as always.
30:32We are doing Dana's fascial flap surgery.
30:37Are you here because I am the attending or because you trust my judgment?
30:43Mostly the latter.
30:46Even after my earlier mistake?
30:55You're a great doctor.
30:56You're a great doctor.
30:59I hope one day I'm even close to as good as you.
31:05Your mistake just made you more inspirational.
31:10It gave me the confidence that I'll find my superpower too.
31:27You cannot film this surgery.
31:30I cannot be distracted while I am working.
31:34Let's go.
31:39I've drilled most of the pedicle and vertebral body.
31:42What's next?
31:43We need to place the cage.
31:46Good decompression. One above, one below.
31:49Good.
31:55Placing the expandable cage.
32:00Heart rate's way up. BP's dropping.
32:03Vessel's torn.
32:05It's detracted away from the field.
32:08What about giving TXA and bipolar to pull the vessel into view?
32:12BP's still dropping.
32:14BP's 41 over 23. I'll arrest if we don't stop things now.
32:18Vascular clip.
32:20We could try completing the corpectomy from the other side.
32:22I'll arrest you if we don't stop things now.
32:24Vascular clip.
32:41We could try completing the corpectomy from the other side.
32:49No.
32:50It's not working.
32:53We're changing course.
32:54Let's do the long segment L1 to 5 without a cage.
33:01You sure?
33:04My patient, my goal.
33:22Excision knife.
33:43I need more sponges.
33:44And the suction's turned up.
33:47She's losing too much blood.
33:52She's severely tachycardic, blood pressure dropping.
34:07This holding pressure isn't durable. She's going to bleed out.
34:10We have to debride deeper.
34:12The excision blade is causing too much bleeding.
34:14Should we try the micro-dissection electrocautery?
34:23No.
34:31Electrocautery won't work.
34:32We need to preserve as much normal tissue as we can.
34:35A VersaJet will debride the appropriate plane with less bleeding.
34:53We repaired your lumbar fracture.
34:59But we had to switch surgeries.
35:05You can't do the job anymore.
35:12Your body was giving out.
35:15I couldn't let you die.
35:17Grant.
35:20I trusted you.
35:47Oh.
35:48This surgery was a success.
35:51He had one of his visions.
35:53Saved the day.
35:54Again.
35:55I missed it.
35:56I'll do the imitation again.
35:59You can use all your footage.
36:02Even my mistake.
36:06Great surgeons can make mistakes.
36:09And I can't.
36:11I'm sorry.
36:13Great surgeons can make mistakes.
36:16And still be inspirational.
36:35Close the door.
36:43You're writing me up?
36:46Is this about the charts?
36:47And coming in late?
36:48And taking personal calls?
36:50Calling off last minute?
36:52I need to be able to count on you and right now I can't.
36:58I haven't been my best.
37:01Things at home...
37:13If...
37:16If I don't answer his calls, he gets mad.
37:21He checks my mileage and my phone.
37:24And how much makeup I wear.
37:28I helped a patient go through a domestic violence checklist.
37:32And realized...
37:35It was me too.
37:38I'm sorry.
37:40It was me too.
37:52We'll figure this out.
38:00My regrafting surgery was a success.
38:03With restorative surgery, you'll have an adequate aesthetic outcome.
38:10Mommy?
38:33I look different, huh?
38:37Your eyes are the same.
38:39They look like mine.
39:09I saw them.
39:20You passed your test.
39:22For a long time, I didn't think I could be with someone like Sean.
39:27I thought we were too different.
39:30That I would have to compromise too much.
39:37I'm sorry.
39:39I'm sorry.
39:41I'm sorry.
39:43I'm sorry.
39:45I'm sorry.
39:47I'm sorry.
39:49I'm sorry.
39:51And I worried about what people would think of us.
39:56Of me.
40:00And I didn't want to be seen as different.
40:05What changed?
40:10Me.
40:12Because of how Sean saw me, he made me believe that I am stronger than I give myself credit for.
40:19And that together, we are enough.
40:24More than enough.
40:26That was very nice.
40:31Is it time for the surprise?
40:41And take them off.
40:45Surprise!
40:48Surprise!
40:51Sophie, it's beautiful.
40:54The lights are very soothing, and I like karaoke.
40:58This is a very nice surprise.
41:02Okay.
41:05Are you sure you're okay?
41:07I'm okay.
41:13Congratulations, Sean and Leah.