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