LEA: Previously on The Good Doctor...
Coming back to California and moving in with you,
it's been harder than I anticipated.
Hershey meant everything to me, Shaun.
I took the biggest chance of my life going back there.
(VOICE BREAKING) And then it just went away.
Deep brain stimulation was used to treat anorexia.
You want to use brain surgery for a psychiatric disorder?
DBS isn't FDA-approved for anorexia treatment here.
It's not a real option.
My wife's decided against the valve-repair surgery,
at least until she's tried the deep brain stimulation.
You won't be a part of the surgery.
Or any of my surgeries.
You went around me, directly to the patient.
CLAIRE: You're booting me off your service?
(FEIST'S I FEEL IT ALL PLAYS)
(PUPPY SQUEALING)
(CHUCKLES)
Oh, he's very affectionate.
Ooh. Yeah.
* The wings are wide The wings are wide
(SMOOCHING)
* Wild card in sight Wild card in sight
Cats are smart and independent.
I don't think my first pet should be something I'm allergic to.
Oh.
(KITTEN MEOWS)
Did you know constrictors don't crush their prey?
They induce arterial circulatory collapse.
* Ohh, ohh, ohh, ohh, ohh
* I feel it all, I feel it all
* Ha, I feel it all I feel it all
He looks like a Hubert.
The pH should be maintained within a range of 7.1 to 7.3.
And we're supposed to add three drops of Klor-out to neutralize the tap water.
Don't worry, Hubert. Daddy just shows his love in a different way.
* Ohh, ohh, ohh, ohh, ohh *
(EXHALES HEAVILY) Mmm-mmm, no.
You don't come by for a month,
and then you think a store-bought pie is gonna make it all right?
It's from the farmer's market.
Uh-huh. Mmm-hmm.
Fine. Hand it over.
Bring it in. (CHUCKLES)
Hey. Thanks for coming.
How is she?
Why didn't you tell me things were getting so bad?
I would have come. You're busy.
I will always make time for you, Kay. (LAUGHS)
Good, 'cause you're not leaving
until the three of us finish a bottle of Merlot.
Did you call that oncologist doing the new ovarian cancer PARP-I trial?
The intake doctor said I don't have the right tumor markers.
Then you need to go back to your hos...
My... My team put me on hospice last week.
(GROANS)
Do you want a dose of morphine?
No. I got it.
(EXHALES SHARPLY) Just give it a minute to pass.
Her doctors keep upping the dosage,
but it's not helping anymore.
Nothing is. Ohh.
(GROANS LIGHTLY)
**
(INDISTINCT CHATTER)
Hey, um...
Um, my college roommate was diagnosed
with stage 4 ovarian cancer a year ago.
She's had six cycles of Carbo-Taxol
without cyto-reductive surgery due to widespread disease.
They stopped chemo when she stopped responding.
She has a month at most.
Wow. I'm so sorry to hear that, Claire. As am I.
And I assume you're not here just seeking sympathy.
I have reviewed her scans and she can't be cured,
but this metastatic lesion extending through her diaphragm
is causing most of her pain.
Her surgeon has ruled out removing it
due to vascular complexity.
But I think laparoscopic debulking is possible.
Difficult, but possible.
I know you're upset with me,
but she... She's my friend and she's in pain.
I need your help.
I'll take a look at her today.
Thank you.
We need a surgeon over here!
He fell down the stairs at a construction site while holding a nail gun.
Portable head X-ray, stat. Any other injuries?
Nah. Just yank it off and slap a Band-Aid.
Any weakness? No.
All right. On my count.
One, two, three.
(GROANING)
**
Let's get you that Band-Aid.
(CHUCKLES)
We could have done that for free at home
with a pair of vise grips.
You don't pay for our equipment.
You pay for me to tell you that he got lucky.
It's superficial. (GROANS)
His pressure's dropping.
(HEART MONITOR BEEPING RAPIDLY)
You feeling faint? (WEAKLY) A little banged up.
All right, something else is going on. Let's log-roll him.
ARMANDO: What's wrong with my brother?
I see a puncture wound in his flank.
There's a nail in his abdomen, too.
Let's get him up to the OR.
**
(EXHALES SHARPLY)
(GASPS) How bad is the pain?
Maybe a six. DASH: She's lying.
She, uh, hides it well, but she's in terrible pain all the time.
But Claire said you're not out of options
until Dr. Melendez says you are.
So, am I?
I think we can make things a little easier for you.
How soon?
Dr. Park and I will do it today.
What about Claire?
I came here because of her.
Dr. Park is excellent.
You're in very capable hands.
When my doctors gave up on me, Claire found a way.
I trust her. I won't do this surgery without her.
Dr. Park and Dr. Browne will prep you for surgery.
**
(WHIRRING)
**
Now try that again.
Show me.
Straight. Straight.
Straight. Yeah.
Oh, almost.
And pull back up.
That's good.
Thank you.
DR. REZNICK: The nail completely ruptured the kidney.
DR. LIM: Renal hilum's blown, too. 4-0 on a driver.
(SIGHS)
This isn't working. Clamp the renal vessels.
He's gonna have to live without it.
Expose the other kidney, make sure it's got that new-car smell.
SHAUN: The adrenal gland is low-lying.
You won't find the left kidney there.
You expect her to find it on the right?
No. The most likely reason
for the gland to be lower is unilateral renal agenesis.
**
He was born with one kidney.
**
(HEART MONITOR BEEPING)
**
DR. PARK: Is that the vena cava?
CLAIRE: There's so much tumor in there,
it's hard to tell what anything is.
I need to free this segment without nicking that vein or...
Park, pull on that fragment very carefully.
Got it.
All right. Claire, I need you to tilt...
Exactly.
The tumor's invaded the vessel wall.
(BREATHES SHAKILY)
**
I think you got it.
**
Why isn't there tumor tissue penetrating her diaphragm?
DR. MELENDEZ: Hmm.
The CT scan showed...
The segment we removed was displacing the diaphragm upward,
giving the appearance of chest infiltration.
If the cancer's just in her abdomen,
she could be a candidate for HIPEC treatment.
Treatment?
Not pain relief?
We may be able to give her a little more time.
(CHUCKLES)
DR. MELENDEZ: It's called HIPEC surgery.
I'd remove as much tumor as possible,
and then we'd infuse your abdomen
with a chemotherapy solution for 90 minutes.
It could give you another six months.
DR. MELENDEZ: It comes with a big risk.
This is a major operation, and your body's frail.
You could die on the table.
Uh... I... I want more time.
But her pain is finally manageable.
I... I'm afraid to press our luck anymore.
The thought of gambling away your last few weeks
terrifies me, too, but this wasn't luck.
Dr. Melendez has proved that despite all of the challenges
of your cancer, he can safely navigate inside your abdomen.
I think it's worth putting your trust in him again.
Okay.
We'll start with a complete PET-CT scan
so we can plan our approach.
**
DR. REZNICK: He has extensive vein thrombosis.
There's a clear segment we can use for an AV dialysis graft.
It's short, but we can attach it to the brachial artery...
(CELL PHONE VIBRATING) Ohh.
Hello, Lea.
I'm sorry, but I can't talk right...
There's a problem with Hubert.
Oh, okay.
Yeah. The pH is exactly 7.2,
temp's 73, everything is perfect.
Perfect.
He looks bored.
(QUIETLY) Bored?
He can't be bored.
He's a fish.
He's just floating there with nothing to do.
I thought you were working today.
I was, from home.
Now I'm procrastinating with Hubert.
You should work.
Okay, can you pick up one of those little castles?
Mmm.
Okay.
I'm not sure who's being domesticated,
you or the fish.
Uh, yes, I'm still here.
(SIGHS)
Call us if anything changes.
(KEYPAD BEEPS) Due to his tissue type,
UNOS doesn't expect to locate a match in time.
We'll need to find a living donor.
DR. BLAIZE: You did a great job today.
Ooh! You want some pirate booty and a juice box with that?
(LAUGHS SARCASTICALLY)
You keep me waiting for hours on end.
Now at least I have something to do.
Cancer is keeping you waiting.
Yeah. We're ready for you.
Here you go. Oh, you can keep that.
Oh. Oh, thank you.
Bye.
That story is not gonna end well, is it?
Mmm.
You know, the yo-yo has been around
for 1,400 years, since ancient China. Watch this.
(YO-YO RUMBLES)
You're not my only patient.
Remembering and executing these tricks
will help with my sequential memory
and protect my brain against your radiation.
With this new targeted therapy, I can better focus
on just knocking the things out of your head that I want to.
Of course I'm also making a little wish list
about other things I might want to get rid of.
(SIGHS)
KAYLA: I'm worried.
Whether it's tomorrow or a few months from now, Dash is gonna lose me.
And he'll be devastated.
He's an amazing, loving husband.
I want you to go out with him.
(LAUGHING) What?
You two get along. You even have chemistry.
No. We're friends.
If Dash is gonna move on with his life,
he needs something to live for.
I think that could be you.
(STAMMERS)
DR. PARK: (OVER INTERCOM) We need to begin now.
Okay.
(KEYS CLACKING)
(MOUSE CLICKS)
Don't say a word.
It's none of my business.
(KEYS CLACKING)
Dash seems like a nice guy. Shut up.
You're a perfect match.
Great. We just need you to sign the consent forms.
Donation carries several risks,
including blood clots, infection, hemorrhage,
lung collapse, and possibly death.
There are also lifelong risks, such as high blood pressure,
which can cause a heart attack,
and protein-losing nephropathy,
which can impair your remaining kidney,
leading to the need for a transplant yourself.
It's a big ask.
Yes, it is.
I'm happy to sign the forms on one condition.
I'm not selling the business.
(HEART MONITOR BEEPING)
I told you 10 times.
We're not taking that offer.
Either sell or buy me out at the same price.
You know I can't afford that.
I can't afford anything.
Look, Dad left you in charge,
but all of my money is tied up in it.
I got investment opportunities.
I got things that I'm excited about.
Dad left me in charge because when things got tough,
you took off to college while we rebuilt.
And now you want to cash in? We'll both cash in.
The deal I negotiated is way over-market.
I don't care how good the deal is.
I like what I do. And I like my kidney.
It seems we both need to make a sacrifice.
I'm not selling.
**
(PEN CLICKS)
CLAIRE: Kayla's back in her room.
We finished her staging, and everything supports our operative plan.
Do you have any questions about her upcoming surgery?
Uh...
Did Kay bring up anything about, uh...
Us?
(STAMMERS, CHUCKLES)
(SIGHS) Oh, my God. I'm so sorry.
I told her not to do that.
I mean, it's, uh...
(CHUCKLING) It's nuts, you know?
Well, that's a little insulting.
Uh...
(LAUGHS) I'm kidding. It's insane.
(BOTH LAUGH)
Uh... Just, you know...
We'll just forget she mentioned it, okay?
Will she?
I mean, we've both said no. What's she gonna do?
You've been married to her eight years.
You still ask that question?
Well, we, uh, do have one other choice.
You guys have a chapel here, right?
(BOTH LAUGH)
He's exploiting this situation.
Yes. He's entitled to.
You don't think an organ donation
should be an altruistic act?
Can it be?
A majority of donors do it to make their own lives more worthwhile,
and almost a quarter do it
to relieve guilt over a past mistake.
Redemption, meaning, sure, but not money.
So, you never take an opportunity to get ahead at someone else's expense?
I'm competing, not trafficking organs.
I need Armando's kidney.
And I need it without getting dragged into their family drama,
which is why I have residents.
So you two find a way to make it happen.
This central line will allow us to monitor your heart during tomorrow's surgery.
Have you considered my proposal?
I have been more focused on your surgery than seducing your husband.
(LAUGHS) Typical.
Ah. You got me.
I'm not dating my cancer-riddled friend's husband
because I have commitment issues.
You've been sprinting away from men as long as I've known you.
Yeah.
I will find the time when I have the time.
It will never be the right time.
You're afraid to get hurt.
I know how short life is.
I don't want you to miss out on the best part of it.
All done.
What do I owe you for the therapy session?
Date my husband.
Do you know how stupid that sounds?
I want someone to take care of the man that I love.
Does that sound stupid? Yes, very, but...
Please.
Please, would you just drop this?
I will drop this. If... One date.
One dinner. That's all.
But a real one, not a latte in the cafe.
I want a real date. Appetizers, main course, wine.
I'm on call. No wine. But candles.
I want candles. (GROANS)
One date. I will never mention any of this again.
It's a federal crime to barter a human organ for anything of value.
I'm not selling Santiago anything.
You're receiving money from a third party in exchange for your kidney.
He's receiving money from a third party for his business.
So is his brother.
He should love him enough to not...
I love him enough to give him a kidney.
He should love me enough to accept an offer
that would improve my life, too.
I mean, it's a much lower ask than a vital organ.
You're not allowed to ask for anything.
Are you saying that if he agrees
you're not gonna perform the surgery?
He doesn't agree. He will.
Everything in life is transactional,
and in this case, I've got all the leverage.
Leverage? It's what you have that they need.
It's how you shift a deal in your favor.
You guys have no leverage and no cards to play.
Yes, we do.
I don't believe you're willing to let your brother die.
A good negotiator doesn't bluff.
If you cave on a threat, you lose all credibility.
And Santiago knows I'm a good negotiator.
So he won't die
precisely because I'm willing to let him.
I'll talk to your brother.
Okay.
(SOFT PIANO MUSIC PLAYING)
(INDISTINCT CONVERSATIONS)
**
Um... (CLEARS THROAT) How long do we have to stay?
She said dinner, so I assume till we're done eating?
Okay.
Dessert? Do you want any?
Not really. I think we're good.
Okay. Okay.
(MUSIC AND CONVERSATIONS CONTINUE)
**
Look at that old clock.
It's the same as the one that they had at Meline's, off campus.
Oh, yeah.
Hey, remember that time we went there on that double date?
You set me up with your English TA.
Yeah. Kay said it was a bad idea.
I just remember him droning on about...
BOTH: Dryden's influence on 18th-century literature.
If you hadn't stepped in, I think I might have
stabbed him with my salad fork. (LAUGHS)
Ah, Kay always knew better.
Yeah. She fixed me up three times.
Then she gave up.
Until now.
(INHALES SHARPLY)
(CLEARS THROAT)
(MUSIC AND CONVERSATIONS CONTINUE)
You should sell the business.
Excuse me?
You would live.
And you could take the proceeds and start a new business
without your brother as a partner.
It's a good deal.
Benitez Builders is my father's legacy.
He built it from nothing.
He was committed, hardworking, honorable.
He expected the same thing from both of us.
My dad was difficult to please.
I worked hard to be someone that my father could be proud of.
And I'm the one he trusted with the controlling share.
I'd rather die than let him down.
(GRUNTING LIGHTLY)
Is that bothering you?
Yeah. A little bit.
**
The graft is failing.
Oh!
(ALARM BEEPING)
What's happening?
Infusing heparin. He's hypercoagulable.
The tunnel catheter is gonna clot off just like the graft.
That gives him even less leverage.
It should convince Santiago to accept his brother's offer.
Santiago? Why him?
I'm negotiating.
With the wrong brother.
(ALARM BEEPING)
The catheter's already obstructing.
Whatever we're doing, it needs to happen in the next couple of days.
We'll do a live donor drive.
Okay.
One in 100,000 chance of success,
but better than planning his funeral.
I think the odds are better than that.
We don't need to find a match.
We just need the parade of selfless family members
to embarrass Armando into doing the right thing.
Evening, roomie.
Hubert is dead.
Yeah.
Hmm.
That's odd.
I'm not sure if I overfed him
or if it was when I changed the water to clean his pebbles,
but, yeah, definitely dead.
We can get another fish.
We don't need to.
There are many fish in the sea.
I said no.
You wanted a pet.
I got one.
Very briefly.
I'll go tomorrow and... No!
(SCOFFS)
**
(SIGHS) Are you crying?
Are you sad?
I'm sad.
And I'm angry and frustrated and upset.
We should get another fish.
The fish isn't the problem.
I am.
I'm pathetic.
I went home to Hershey because I was unfulfilled with my life.
I thought I could help my bullheaded brother save the shop,
be a part of something I was really passionate about.
Instead, we ended up tanking it together,
along with our relationship.
I came back here to get my life back on track.
How am I supposed to do that if I can't even keep a damn fish alive?
**
I'll make it through this.
**
(BREATHES DEEPLY)
(DOOR OPENS)
It is okay to be afraid.
How was your dinner with Dash?
Forget about that.
How are you?
If I don't make it, you have to give this thing with Dash a real shot.
Kayla, please stop.
Promise me. You have to.
No.
You can't put that on me.
That's right. Claire never turns her back on a friend,
as long as it doesn't put her heart at risk.
That is not fair.
What you're asking...
I'm asking you to trust my judgment about the two of you.
No, you're trying to pressure me into something that I don't want.
Like you always do. You need pushing
because you've never known what's best for you.
So... So, is that why you dragged me out
to pledge week to be rejected by every sorority on campus?
Or... Or went behind my back
and invited my mother to graduation?
At least you tried.
You put something at risk.
No. Give me a break.
This was never about me, none of it.
You always have to have it your way.
You are a neurotic control freak
who thinks she has the right to dictate how everyone else should live their lives.
(DOOR OPENS)
WOMAN: It's time.
I'm ready.
**
Kayla...
(SIGHS)
I'm sure you recognize Rafael, your second cousin from Oxnard.
He drove up as soon as he heard.
Either we get lucky here and you look like an ass,
or we don't and you look like an ass with a dead brother.
Mmm.
He won't give his life for a contracting company.
He's not dying for the company.
He's dying for your father.
What makes you think that?
He would rather die than let your father down.
He thinks that's what Dad would want?
(SCOFFS)
Santi did everything the old man asked of him,
worked twice as hard, did everything twice as well as Dad ever could,
but nothing was ever good enough for our father.
No matter what we did, he was always right there
to point out where we had gone wrong.
You know what he told me on his deathbed?
He said that he wasn't proud of Santi
for following in his footsteps...
That he was disappointed that he settled.
You should tell your brother that.
It's a good card to play.
**
ARMANDO: He was wrong.
(HEART MONITOR BEEPING)
You are the most loyal, hardworking,
and principled guy I've ever known.
And you deserve Dad's respect.
**
You greedy, lying snake.
You will say anything to get what you want,
even trying to ruin the memories I have of Dad.
Your memories of Dad? He was horrible. You know that.
Get the hell out.
Santi, I'm not trying to... Get out!
(COUGHING)
(HEART MONITOR BEEPING)
(INDISTINCT PA ANNOUNCEMENT)
Give me the consent forms.
(FOLDER THUDS, PAGES RUSTLING)
(SNIFFS)
My father told me he wished I hadn't been born.
I wasn't worth the trouble.
But I knew I was worth the trouble
because my brother always looked out for me...
...even when it made his life harder.
(BREATHES DEEPLY)
**
(FOLDER THUDS)
(HEART MONITOR BEEPING)
**
DR. LIM: 5-0 prolene.
Position the kidney in the pelvis.
(DOORS OPEN)
NURSE VILLANUEVA: Dr. Murphy.
Your stat cultures came back positive
for ichthyophthirius multifiliis.
Thank you.
It's not for this patient.
Do you need to deal with it?
It's too late.
**
(KEYS CLACKING)
(ALARM BUZZING)
(RUMBLING)
(SIGHS)
(RUSTLING)
You have a security problem.
I will get my badge and my gun.
Somebody stole my wallet out of the locker.
Are you sure you left it there?
Yes. I'm sure.
You were worried about it getting stolen,
so you gave this to me before your session today.
(INHALES SHARPLY, CLEARS THROAT)
Mine.
Sorry.
Stupid.
Don't read anything into this.
Uh, how is she?
We removed a lot of the tumor
and she's having the chemotherapy bath now.
Mmm-hmm. So far, she's doing well.
Oh. Okay.
Kayla would want you to eat. Yeah.
Of course she would.
She'd forget to eat herself.
(CHUCKLES, SNIFFLES)
(SIGHS)
Man, I... I really hate all... All this waiting.
Okay. Just sit.
Breathe.
Kayla's dealt with so much
prodding and nausea,
fatigue and so much pain.
I just wish she would let me do something for her to make things easier.
(SNIFFLES)
I want to protect my wife.
Instead, I'm just sitting here, waiting...
(VOICE BREAKING) Waiting for her to die.
(GASPS)
(EXHALES SHARPLY)
(CELL PHONE VIBRATING)
(SIGHS)
Dash, I'm sorry.
They need me back in the OR. Oh, yeah, yeah, yeah.
(BREATHING DEEPLY)
(ALARM BLARING)
DR. PARK: Push another 60 of lasix.
MAP is 26.
She's in cardiopulmonary collapse.
DR. PARK: Second chest tube in.
JL: SATS are still dropping on 100%.
It has to be heart failure. We need to crash her onto ECMO.
Her cardiac index was fine.
It must be toxic inflammatory reaction to the chemo.
She's intolerant.
Stop the chemo.
**
What if the fluid buildup isn't a reaction to the chemo bath?
What if it is the chemo bath?
Her... Her mediastinum is widening.
If her diaphragm perforated,
fluid could be leaking into her chest, compressing her heart.
The tumor we removed yesterday was clinging to her diaphragm.
If we close the hole, she can finish her treatment.
Let's re-open her incision.
**
I just wanted to see how you were doing.
His kidney numbers are starting to improve.
Take me back to my room, Doc.
Manny, thanks for the kidney.
You're welcome.
Just don't come looking for another one
without a big check in your hand.
Jerk.
**
(BOTH CHUCKLING)
That's good.
Hey. You're just in time for some, uh, celebratory ice chips.
(CHUCKLES)
Kay, I'm sorry... Don't be.
You weren't entirely wrong.
I... I can be a little manipulative.
No.
No, I was wrong.
You don't try to control everything
because you think you know better than everyone else.
You do it because you're a caring friend.
You focus all your energy
trying to protect us from pain and suffering, and...
And that lets you not think about your own.
But you have to.
You are dying, Kayla.
I know.
You're dying,
and it is not fair.
And it is painful and scary.
And it feels like you're all alone with it.
(CRYING) Please, stop. But you're not.
Dash is here.
(SNIFFLES)
So am I.
(GASPS)
(SNIFFLING)
**
(KEYBOARD CLACKING)
Thank you for everything you did.
Of course.
I, um... I meant what I said to Kayla.
You really are the most gifted surgeon I have ever worked with.
You did well today.
Thanks.
I'll report back to Dr. Lim in the morning if that's what you want.
Yeah, that's probably for the best.
**
Shaun, I don't need another fish.
I don't want another fish. I do.
Our goldfish died.
You need to provide a replacement.
Store policy... Once a fish leaves this store,
all responsibility for its well-being falls up...
Hubert had ichthyophthirius multifiliis,
a common goldfish parasite picked up in pet stores.
You have no leverage and no cards to play.
(THE THE'S THIS IS THE DAY PLAYS)
**
(SIGHS)
Pick a fish.
**
You didn't kill Hubert.
He was defective.
We'll try again.
Thank you, Shaun.
Caring for a fish won't sort out my problems.
* You pull back your curtains
That one's pretty cute.
* You watch a plane flying
Platies are a very hardy fish.
They are difficult to kill.
(LAUGHS)
* This is the day
* Your life will surely change
* This is the day
* When things fall into place *
**