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Heiress Drama
  • 5/23/2025
The Good Doctor Season 5 Episode 16
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Transcript
00:00🎵
00:18Morning.
00:20I made pancakes.
00:23Your lips are very shiny.
00:25Just my normal lip gloss.
00:27You don't normally have it on for breakfast.
00:31Mmm.
00:32Mmm, these are delicious.
00:35Mmm.
00:37Where is my apple?
00:39One of you move my apple.
00:41Uh, it was just blocking the shot.
00:43Try not to look directly into camera.
00:52So tell me about how you two met and fell in love.
00:54Uh, first we were neighbors.
00:57Then we became friends.
00:59Then roommates.
01:01We bonded over our love of pancakes and karaoke.
01:04And before we knew it we were having our first kiss.
01:08We were drunk from tequila and I vomited immediately after.
01:11Yeah.
01:13And Leah said we were just friends.
01:15And she said that was all we could be because of my autism.
01:17And I thought she was superficial and prejudiced.
01:20But I was wrong about her.
01:22And she was too.
01:23She could be happy and in love with me.
01:25So she asked me to marry her and I said yes.
01:28You sure did.
01:30I have to go.
01:41We need you to sign a release form.
01:42I don't want to be on TV.
01:43Well we can always just blur you out.
01:45You don't want to be blurred.
01:46Why? It'll be fun.
01:47We'll be the younger, more outrageous supporting character in the Sean show.
01:50It is not my show.
01:52It is not my show.
01:54All this for you.
01:57Oh, looks like Dr. Andrews is hoping for a special appearance by Bill Eng.
02:01I didn't expect to make it to California.
02:04San Jose St. Bonaventure Hospital has one of the most rigorous surgical training programs in the country.
02:08Only a select few make it through this rigorous five year residency,
02:12which traditionally culminates with a test to see if those residents are prepared to be attendings.
02:20Did I say rigorous twice? I could take that again.
02:22Don't worry. You're doing great.
02:24Can I get your autograph?
02:29Dr. Murphy and Dr. Park, today each of you will be put in charge of a surgical case and evaluated,
02:35based on your OR performance, your ability to delegate responsibility,
02:39to manage junior residents, and think on your feet.
02:43The next surgical cases that come through the ER will be all yours.
02:50Dana Bradley, 34, burns to her head and left forearm, at least 10% total body surface area.
02:59See areas of second degree burns, forehead, scalp, and cheek with associated burn blisters,
03:03likely mid to deep dermal partial thickness burns.
03:05Send blood for CBC urea, electrolytes, lactate, and get ETG and chest film.
03:11Give one milligram of dilaudid.
03:13Dana, it's okay. We're giving you some of this drama for the pain.
03:16Start IV antibiotics, capillary refill, it's sluggish.
03:19She needs acute surgery to debride.
03:21Let's go.
03:36Grant Furlan, 44-year-old firefighter, level 2 trauma, multiple injuries from a fall.
03:41What about burns?
03:42No burns. He saved the woman from the fire, then he got pinned by a beam.
03:45Sir, please go to the waiting room. We'll keep you updated.
03:48Dr. Park, this is your case.
03:54Villanueva, we need all hands on deck.
03:59He's tachycardic and hypotensive. He could be bleeding into his abdomen.
04:02Give me the ultrasound. Give me the ultrasound!
04:04Give me the ultrasound!
04:10It's peritoneal hemorrhage. We need to open him up.
04:13Let's go.
04:16Excision knife. Apply even pressure against the wound.
04:22Starting the tangential sequential excision.
04:26Sean would be an asset to any hospital.
04:29He views the world a bit differently and therefore sees patients a little bit differently.
04:38But we accept him just as he is.
04:41Did you always feel that way?
04:46There was a time where I didn't feel Sean belonged at this hospital.
04:54Luckily, I got my arm twisted. Sean's contributions have far outweighed his surgical gifts.
05:05She's in V-Tech.
05:10Is he okay? Why does he stop there?
05:12Sometimes he gets these ideas, more like visions. It's very effective.
05:20I'm not sure what that is.
05:23Your lights are in my eyes. Please turn them off. Step back.
05:32He's hypothermic. We need more aggressive fluid resuscitation.
05:36I'll place a femoral line using a re-warming catheter.
05:46Okay.
05:49We need to assess the duodenal rupture.
05:51I'll run the bowel. We'll let any of the perforations.
05:54I have coxsyn O.G. tube to suction.
05:58His surgical technique is really advanced. He has such command over the room.
06:04Shut up.
06:07Suction.
06:18I found the bleeder.
06:19Coagulating.
06:21Next, I'll repair the rupture site.
06:29Bleeding stopped.
06:35Let's close him up. Get a post-op CT to make sure we got everything.
06:42I've heard that Sean sometimes has visions. What are they like?
06:50Pretty good, huh?
06:53It's more like...
06:58Sorry, but you're no Sean.
07:02Nobody can do Sean's vision thingies but him.
07:06It's a superpower. He has an X-ray, MRI, and CT all in his head all at the same time.
07:13I'm never going to be able to do that.
07:15But what I've learned from watching Sean is, figure out what you're good at and lean into that.
07:22What's your superpower?
07:24How much time do you have?
07:28The surgery was a success.
07:31We were able to eliminate all non-viable tissue and use autograft over the entire burn surface area.
07:37We were able to eliminate all non-viable tissue and use autograft over the entire burn surface area.
07:45What are they doing here?
07:47They are taping me. They will blur out your face.
07:51When can I see my family?
07:53The nurse is bringing them. They should be here shortly.
07:59That hurts.
08:01You are on strong IV narcotics and the grafts should still be none.
08:08Please stop. Stop. It hurts.
08:12I am not touching you.
08:15There is significant swelling and edema. It is pulling on the graft anchor sites. That doesn't make sense.
08:24Mommy?
08:26Yes.
08:30Baby.
08:34I'm here.
08:37I want to go home.
09:01This is ridiculous.
09:12Hello. Dana's autografts were procured, placed, and secured perfectly.
09:16We started IV ANSEF before surgery, continued post-op, and confirmed none of the tissues removed had positive cultures.
09:21The grafts should not be failing.
09:23Did you keep her wound dressings moistened?
09:26Yes, and her edema is getting worse even after replacing dressings.
09:29You need to go double-check her labs.
09:32I know what I did. I memorized all data in my patient charts.
09:36Did you use proper sterile technique and prep on all autograft sites?
09:40Yes.
09:42Adequate fluid resuscitation and replacement for losses?
09:45I checked urine output and central venous pressure every hour, but she was really uncomfortable so I skipped one battle thing.
09:52No, you cannot skip steps. Go review every vitals check, all urine output ins and outs, and every CVP.
10:07Hey, my boys tell me you're a former brother in blue.
10:11Walked the beat for 15 years.
10:14Can we talk privately?
10:16Oh, we're all squad here.
10:19Grant, your CT showed you have an unstable lumbar fracture. You'll need extensive posterior fusion surgery to stabilize it.
10:29Well, how long before I'm back on the job?
10:32You'll be up and walking in a few days.
10:35But after this kind of fusion, your spine...
10:41You won't be able to be a firefighter anymore.
10:44You won't be able to be a firefighter anymore.
10:51Then you need to figure out a different plan.
10:54This is the safest surgery. Your abdominal injury poses too many risks for us to...
10:58We run into burning buildings for a living. I'm not afraid of risk.
11:05I trust you to get me back to my team.
11:14You okay?
11:17I'm just double-checking our patient's lab work.
11:20That's some emotional lab work.
11:24Sean thinks I caused our patient's graft issues, and he said so on camera.
11:31And I'm... I'm so angry at myself for skipping a step.
11:37I'm so angry at myself for skipping a step.
11:47But I don't think I caused the edema.
11:55Sorry about this morning. Rough day.
11:58It happens.
11:59I need approvals.
12:01We implemented a new system last week. You're working off the old one.
12:04I'm sorry. I didn't know.
12:06You were late on training day. Redo it.
12:09And maybe cool it when a person calls on the floor.
12:15Please, let this be an actual medical issue.
12:18My patient's refusing posterior fusion surgery. We 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.
12:30We could try ventral surgery through his abdomen.
12:32L3 is hard to get to ventrally, even if everything was perfect.
12:36But if we try a transpedicular approach, we could do a posterior cage placement and short segment surgery.
12:41There's a risk of catastrophic nerve injury or an uncontrollable bleed from placing too large a cage.
12:50Would you try it?
12:54Your patient, your call.
12:56What do I love most about Sean? I can't choose.
13:02He's brilliant. And he's so funny. He makes me feel safe.
13:09I know no matter what happens, he's there for me. And he's super cute.
13:16Sean, what do you love the most about Leah?
13:18Sean?
13:24I love that her eyes crinkle when she is happy or sad or angry or worried.
13:32And I know which one means what.
13:35You know my eye crinkles?
13:38That one means she is happy.
13:40I double-checked every recorded vital sign and hourly urine output.
13:44All suggest adequate blood pressure to maintain graft perfusion and no signs of fluid overload.
13:49I don't know what caused it, but Dana's edema and graft issues are not my fault.
14:11I need to see your footage.
14:16Stop. Play it from there.
14:28The grafts should not be failing. Something must have gone wrong.
14:32I need the answers to fix it. Please rewind.
14:41Stop.
14:44Okay. Play at half-speed.
14:55Right there.
14:58When I pressed that burn area, she did not feel it.
15:02If they were second-degree mid-dermis burns, it would have hurt.
15:06Dana has third-degree burns.
15:09The tissue is dying under the grafts because I did not debris deep enough.
15:17Dana's problem is my mistake.
15:29Sean has always been great with medicine, but romance is not for everyone.
15:33I took him through boot camp, and then he and Leah got together.
15:37I guess you could call me Cupid.
15:40You don't get credit for Sean and Leah getting together.
15:44You can barely get credit for us getting together.
15:47I have to go practice my surgery.
15:51Your first surgery did not work.
15:55I didn't debris deep enough. We need to fix it.
15:58I didn't debris deep enough. We need to fix it.
16:03How's your pain level?
16:07I'm a monster.
16:17No wonder Nicole ran away.
16:21We have to do another surgery, or you could become septic.
16:27Will it fix the way my face looks?
16:30No, your face will look worse because we have to debris deeper.
16:34I can't.
16:35We have to fix the mistake.
16:37How you look doesn't impact your health.
16:53Do you want me to get your husband?
16:54I'm sure he wants to see you before you go into surgery.
16:58No.
17:00Nicole needs him.
17:16That's not going to work.
17:19You need to get wider exposure and corpectomy before placing the cage.
17:25There is an easier solution.
17:28Tell your patient he's being an idiot.
17:31It's not worth risking his life for his career.
17:35I think he's right.
17:39When I left the force, I felt more alone than any other time in my life.
17:46I didn't just leave a job. I left a family.
17:54He wants to fight to keep his, so I'm going to do what I can to help him.
18:05I'll drill off the complete pedicle and L3 body.
18:08You can press on the lamina above and below.
18:11It'll allow for a safer cage placement.
18:19I don't think Dana is ready for the free tissue flat reconstruction.
18:22We can start with damaged tissue removal.
18:24No, we should not wait.
18:26Deeper debridement and parietal fascia surgery will clear her edema.
18:30It's a high-risk surgery with high risk of blood loss and flat necrosis.
18:34Before we do another big procedure, she needs to recover psychologically.
18:39She could develop infection and compartment syndrome if we wait.
18:44You missed what the patient was feeling in your initial diagnosis, and it affected her outcome.
18:52You could be wrong about this, too.
18:59The free tissue flap surgery will correct the damage from her burns.
19:07I am the attending. This is my decision.
19:23My patient... No.
19:31Sean, what's going on?
19:33My patient has to have another surgery. I thought she had second-degree burns.
19:36She also has third-degree burns.
19:38Okay, so do another surgery.
19:40If I had not been distracted by the cameras, I do not think I would have missed her reaction.
19:47Third-degree burns are always numb.
19:49So you can do another surgery?
19:51This is my test to prove I am ready to be an attending.
19:57Okay? I made a mistake.
19:59And you caught the mistake.
20:01But I shouldn't have missed it. Okay? It was my fault.
20:04Okay, so it was your fault.
20:06So, just like it was my fault when I was attending that I missed a subdural epiema
20:13and Park punctured a fungal nodule and cleared her edema,
20:16the patient didn't die, right?
20:18You can do another surgery. So let's just focus on that.
20:23I am different than you and Claire and Dr. Park.
20:28I do not get to make mistakes.
20:32Is this because this video crew has been following you around wherever you go?
20:37Yes. I made two mistakes.
20:40The burns and letting them in.
20:41Is this because this video crew has been following you around wherever you go?
20:43Yes. I made two mistakes.
20:45The burns and letting them film me.
20:48You know what? Get rid of them.
20:50If you don't want them around, just get rid of them.
20:52And another thing, Sean, you can't expect to be perfect all the time.
21:00It doesn't happen. Ever. For anyone.
21:12No.
21:14Again, it's helpful if you include the question in the answer.
21:19What was the question?
21:21Do you see yourself as Sean's protector?
21:24Oh, um, no. I don't see myself as Sean's protector anymore.
21:31How does that feel?
21:34How does it feel? I don't know.
21:37It feels great.
21:38I'm proud of him and relieved that he's going to make it.
21:47What changed?
21:52He did. He changed.
21:56You elaborate.
22:02He grew up.
22:05He grew up and met Leah.
22:10Do we need to talk?
22:13Turn the camera off.
22:15Sorry. No.
22:17Okay, then I'm going to have to say what I have to say naked.
22:23You can take five.
22:27You need to back off, Sean, a little bit.
22:30It's my job to ask questions.
22:31I was expecting wedding surprises and instead I feel like you're exploiting his autism.
22:36You knew Sean's ASD was going to be part of the show.
22:39I didn't expect you to make a highlight reel out of his most spectrum-y moments.
22:43I'm not manufacturing anything.
22:45Sean made a mistake on a very important case and now that could end up on your show.
22:49He's totally rattled.
22:51I know you want to protect him.
22:53It's not about protecting Sean. This is about the whole world seeing him as a collection of quirks and a single mistake.
22:58Since that is good TV.
23:11Dana has third-degree burns.
23:14Dana has third-degree burns.
23:17Dana has third-degree burns.
23:19Her tissue is dying under the graft because I did not debris deep enough.
23:23Because I did not debris deep enough.
23:26Dana's problem is my mistake.
23:29I'm not going to use any of the footage related to your mistake.
23:35It's not relevant.
23:37This is a wedding show.
23:39And Leah reminded me of that.
23:43I do not want to be dishonest.
23:48It's not dishonest.
23:50It's focused.
23:51On you and Leah.
23:53And your relationship.
23:55And your amazing career as a surgeon surrounded by all of these people who support you.
24:03That is what will give hope to people who feel different and alone.
24:11And that's why I'm doing this.
24:22Grant's case file.
24:26I've successfully completed the short segment posterior fusion on the skills dummy simulator.
24:32Once.
24:34With a partner.
24:36And you've successfully done it on real people over 50 times.
24:42You should take the lead.
24:44Which would mean removing yourself as the attending on this case.
24:48I'm not going to do that.
24:50I'm not risking my patient's life to pass a test.
24:54You're risking your own career to try to save his.
25:00Grant deserves the best shot to get back to his crew.
25:06That's you.
25:15Any cold feet?
25:17Sean is my person.
25:19I know that beyond a shadow of a doubt.
25:26Do you think I should let Sophie remove my mistake from the show?
25:35I think that is up to you.
25:37How do you feel about it?
25:40It feels like a lie.
25:43But is it more important to give people truth or hope?
25:47That's a tough question.
25:49Yes.
25:51I say we stick to the two of you.
25:54We're getting married in just a few days.
25:57Any nerves about that?
25:59No, she is also my person.
26:01I have known that for a long time.
26:03I have to go prep for my surgery.
26:06Okay, I have to go prep for my surgery.
26:07Okay, I have to go prep for my surgery.
26:15It took you longer to be sure that Sean was the one.
26:19In fact, you said you couldn't get involved with him because of his ASD.
26:23What changed?
26:38I offered to take out the mistake because you were right.
26:41I crossed a line.
26:43Instead of embarrassing Sean, now you're zeroing in on me?
26:46I'm not trying to embarrass anyone.
26:49Can you please slow down?
26:52As a little person, the world doesn't accommodate me.
26:55That's why representation matters.
26:57But when it's real.
26:59I'm not asking you to make us look like a fairy tale.
27:02Fairy tales have obstacles and conflict.
27:04The story you want me to tell?
27:06You two met and fell in love and everything's great?
27:09It's boring.
27:11So you want me to play the wicked witch?
27:13You are not defined by your lowest moment.
27:16But you can't deny it either.
27:19I am here to tell the real story of you as a couple.
27:24Do you still trust me to do that?
27:27Do you still trust me to do that?
27:38Your vitals are good and your volume status is stable.
27:41The nurse will come get you for surgery soon.
27:56I'm so sorry the camera's added to your pain.
28:04I was going to have to see myself eventually.
28:08My daughter will have to look at me every day.
28:13And pretend she doesn't see a monster.
28:17She won't see you that way forever.
28:19Other people will.
28:22Other kids will tease and bully her.
28:27Because of what her mother looks like?
28:31People have teased and bullied me my whole life.
28:35And it hurt for a long time.
28:38And I was too ashamed to tell anyone.
28:44I finally told my mom.
28:46She taught me how to stick up for myself.
28:49You can be an example of how to get back up when life knocks you down.
28:57Your strength will make her more compassionate than most people.
29:04And more powerful than any bully.
29:22Scalpel.
29:27I'll come get you as soon as your mom is awake.
29:32I don't want to see your daddy.
29:40It's okay to be scared.
29:42You know what helps me whenever I'm scared?
29:46A big hug.
29:49The best ones are from my mom.
29:51Do your mom's hugs make you feel better?
29:58I know mommy looks different.
30:01But her hugs are the same.
30:04They're full of the same love as always.
30:22We are doing Dana's fascial flap surgery.
30:27Are you here because I am the attending or because you trust my judgment?
30:33Mostly the latter.
30:36Even after my earlier mistake?
30:45You're a great doctor.
30:47You're a great doctor.
30:49I hope one day I'm even close to as good as you.
30:55Your mistake just made you more inspirational.
31:00It gave me the confidence that I'll find my superpower too.
31:17You cannot film this surgery.
31:20I cannot be distracted while I am working.
31:24Let's go.
31:29I've drilled most of the pedicle and vertebral body.
31:32What's next?
31:33We need to place the cage.
31:36Good decompression. One above, one below.
31:39Good.
31:45Placing the expandable cage.
31:50Heart rate's way up. BP's dropping.
31:53Vessel's torn.
31:55It's detracted away from the field.
31:58What about giving TXA and bipolar to pull the vessel into view?
32:02BP's still dropping.
32:04BP's 41 over 23. I'll arrest if we don't stop things now.
32:08Vascular clip.
32:10We could try completing the corpectomy from the other side.
32:22I'm sorry.
32:24We're close.
32:26I can't.
32:28I'm sorry.
32:31I'm so sorry.
32:33I'm so sorry.
32:35I'm so sorry.
32:36♪♪♪♪
32:38No.
32:40It's not working.
32:42We're changing course.
32:44Let's do the long segment L1 to 5 without a cage.
32:47♪♪♪♪
32:51You sure?
32:53My patient.
32:55My goal.
32:57♪♪♪♪
33:12Excision knife.
33:14♪♪♪♪
33:33You need more sponges.
33:35The suction's turned up.
33:37She's losing too much blood.
33:39♪♪♪♪♪
33:42She's severely tachycardic, blood pressure dropping.
33:45♪♪♪♪♪
33:52♪♪♪♪♪
33:57This holding pressure isn't durable.
33:59She's gonna bleed out.
34:01We have to debride deeper.
34:03The excision blade is causing too much bleeding.
34:05Should we try the microdissection electrocautery?
34:07♪♪♪♪♪♪
34:21Electrocautery won't work.
34:23We need to preserve as much normal tissue as we can.
34:25A VersaJet will debride the appropriate plane with less bleeding.
34:28♪♪♪♪♪♪
34:43We repaired your lumbar fracture.
34:49But we had to switch surgeries.
34:55You can't do the job anymore.
34:58♪♪♪♪♪♪
35:02Your body was giving out.
35:05I couldn't let you die.
35:07♪♪♪♪♪♪
35:10Grant...
35:14I trusted you.
35:16♪♪♪♪♪♪♪
35:45This surgery was a success.
35:48He had one of his visions.
35:50Saved the day. Again.
35:52I missed it.
35:53I'll do the imitation again.
35:56You can use all your footage.
35:59Even my mistake.
36:03Great surgeons can make mistakes.
36:06And still be inspirational.
36:09♪♪♪♪♪♪♪♪♪
36:22Knock on door.
36:25Close the door.
36:33You're writing me up?
36:35Is this about the charts?
36:37and coming in late and taking personal calls,
36:40calling off last minute.
36:42I mean, I need to be able to count on you,
36:44and right now, I can't.
36:48I haven't been my best.
36:51Things at home...
37:08If...
37:11If I don't answer his calls, he gets mad.
37:16He checks my mileage and my phone
37:19and how much makeup I wear.
37:23I helped a patient go through a domestic violence checklist
37:27and realized...
37:30it was me, too.
37:37♪
37:42We'll figure this out.
37:50My regrafting surgery was a success.
37:53With restorative surgery,
37:55you'll have an adequate aesthetic outcome.
38:00Mommy?
38:07♪
38:22I look different, huh?
38:26Your eyes are the same.
38:31They look like mine.
38:33♪
38:59I saw them.
39:03♪
39:10And you passed your test.
39:12♪
39:18♪
39:27For a long time,
39:29I didn't think I could be with someone like Sean.
39:32I thought we were too different.
39:35That I would have to compromise too much.
39:41And I worried about what people would think of us.
39:46Of me.
39:50And I didn't want to be seen...
39:53as different.
39:56What changed?
39:59Me.
40:01Because of how Sean saw me,
40:03he made me believe that I am stronger
40:05than I give myself credit for.
40:09And that, together,
40:11we are enough.
40:14More than enough.
40:16That was very nice.
40:21Is it time for the surprise?
40:24And... take them off.
40:28Surprise!
40:33Sophie, it's beautiful.
40:35The lights are very soothing.
40:37And I like karaoke.
40:39This is a very nice surprise.
40:43Okay.
40:45I'm going to go get my phone.
40:47I'm going to go get my phone.
40:49I'm going to go get my phone.
40:51I'm going to go get my phone.
40:54Are you sure you're okay?
40:56I'm okay.
40:58Sean.
41:02Congratulations, Sean and Leah.