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  • 2 days ago
The Good Doctor S02E07
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Transcript
00:00Previously on The Good Doctor.
00:02Coming back to California and moving in with you, it's been harder than I anticipated.
00:08Her stream had everything to me, Sean.
00:10I took the biggest chance of my life going back there, and then it just went away.
00:15Deep brain stimulation was used to treat anorexia.
00:17You want to use brain surgery for a psychiatric disorder.
00:20EBS is an FDA approved for anorexia treatment.
00:23It's not a real option.
00:24My wife's decided against the valve repair surgery, at least until she's tried the deep brain stimulation.
00:28He won't be a part of the surgery, or any of my surgeries.
00:32He went around me, directly to the patient.
00:35You're booting me off your service.
00:53He's very affectionate.
00:58Cats are smart and independent.
01:10I don't think my first pet should be something I'm allergic to.
01:13Did you know constrictors don't crush their prey?
01:24They induce arterial circulatory collapse.
01:27The pH should be maintained within a range of 7.1 to 7.3.
01:45And we're supposed to add three drops of chloro to neutralize the tap water.
01:50Don't worry, Hubert.
01:55Daddy just shows his love in a different way.
02:05Mm-mm.
02:06No.
02:06You don't come by for a month, then you think the store-bought pie is going to make it all right?
02:10It's from the farmer's market.
02:12Uh-huh.
02:13Mm-hmm.
02:13Fine.
02:14Hit it over.
02:15Bring it in.
02:17Thanks for coming.
02:18How is she?
02:23Why didn't you tell me things were getting so bad?
02:26I would have come.
02:27You're busy.
02:28I will always make time for you, Kate.
02:31Good.
02:31Because you're not leaving until the three of us finish a bottle of Merlot.
02:35Did you call that oncologist doing the new ovarian cancer profile trial?
02:39The intake doctor said I don't have the right tumor markers.
02:42Then you need to go back to your hospital.
02:43My team put me on hospice last week.
02:50Do you want a dose of morphine?
02:52No.
02:53I got it.
02:54Just give it a minute to pass.
02:57Her doctors keep upping the dosage, but it's not helping anymore.
03:01Nothing is.
03:01No.
03:06No.
03:06Hey, uh, my college roommate was diagnosed with stage four ovarian cancer a year ago.
03:32She's had six cycles of carbotaxel without cytoreductive surgery due to widespread disease.
03:39They stopped chemo when she stopped responding.
03:42She has a month at most.
03:44Wow.
03:45I'm so sorry to hear that, Claire.
03:47As am I.
03:48And I assume you're not here just seeking sympathy.
03:50I've reviewed her scans and she can't be cured, but this metastatic lesion extending
03:54through her diaphragm is causing most of her pain.
03:58Our surgeon has ruled out removing it due to vascular complexity, but I think laparoscopic
04:04debulking is possible.
04:06Difficult, but possible.
04:08I know you're upset with me, but she's my friend and she's in pain.
04:17Look, I need your help.
04:20I'll take a look at her today.
04:23We need a surgeon over here, fell down the stairs of the construction site while holding
04:28a nail gun.
04:29Portable head x-ray stabbed.
04:30Any other injuries?
04:31No, I just yank it off and slap the band-aid.
04:33Any weakness?
04:34No.
04:35Okay.
04:36On my count, one, two, three.
05:05He's supposed to get you that band-aid.
05:10He could have done that for free at home with a pair of vice grips.
05:14You don't pay for our equipment.
05:16You pay for me to tell you that he got lucky.
05:18It's superficial.
05:19His pressure's dropping.
05:20Can you feel the pain?
05:21A little banged up.
05:23All right, something else is going on.
05:26Let's log roll him.
05:27What's wrong with my brother?
05:32See a puncture wound in his flank?
05:34There's a nail on his abdomen, too.
05:36Let's get him up to the OR.
05:46How bad is the pain?
05:47Maybe a six.
05:49She's lying.
05:51She hides it well, but she's in terrible pain all the time.
05:54Well, Claire said you're not out of options until Dr. Melendez says you are.
06:00So am I.
06:02I think we can make things a little easier for you.
06:06How soon?
06:08Dr. Park and I will do it today.
06:12What about Claire?
06:13I came here because of her.
06:14Dr. Park is excellent.
06:16You're in very capable hands.
06:19When my doctors gave up on me, Claire found a way.
06:23I trust her.
06:24I won't do the surgery without her.
06:27Dr. Park and Dr. Brown will prep you for surgery.
06:39I'll try that again.
07:01I'll try that again.
07:02Show me.
07:03Straight.
07:04Straight.
07:05Straight.
07:06Yeah.
07:07Oh, almost.
07:08Pull back.
07:09Excuse me.
07:11The nail completely ruptured the kidney.
07:21Renal hilum's blown too.
07:234-0 on her driver.
07:26This isn't working.
07:31Clamp the renal vessels.
07:32He's gonna have to live without it.
07:37Expose the other kidney, make sure it's got that new car smell.
07:43The adrenal gland is low-lying.
07:47You won't find the left kidney there.
07:49You expect her to find it on the right?
07:51No.
07:52The most likely reason for the gland to be lower is unilateral renal agenesis.
08:04He was born with one kidney.
08:19Is that the vena cava?
08:21There's so much tumor in there, it's hard to tell what anything is.
08:24I need to free this segment without nicking that vein or...
08:30Park.
08:31Pull on that fragment very carefully.
08:33Got it.
08:34Got it.
08:35All right, Claire.
08:36Need you to tilt...
08:37Exactly.
08:38The tumors invaded the vessel wall.
08:40I think you've got it.
08:54I think you've got it.
09:01Why isn't there tumor tissue penetrating her diaphragm?
09:07Hmm.
09:08The CT scan chose...
09:09The segment we removed was displacing the diaphragm upward, giving the appearance of chest infiltration.
09:15If the cancer's just in her abdomen, she could be a candidate for high-pec treatment.
09:21Treatment?
09:22Not pain relief?
09:23Not pain relief?
09:24We may be able to give her a little more time.
09:29It's called high-pec surgery.
09:30I'd remove as much tumor as possible, and then we'd infuse your abdomen with a chemotherapy solution for 90 minutes.
09:42It could give you another six months.
09:45It comes with a big risk.
09:48This is a major operation, and your body's frail.
09:52You could die on the table.
09:55I want more time.
10:00But her pain is finally manageable.
10:03I'm afraid to press her luck anymore.
10:06The thought of gambling away your last few weeks terrifies me, too, but this wasn't luck.
10:16Dr. Melendez has proof that despite all the challenges of your cancer, he can safely navigate inside your abdomen.
10:24I think it's worth putting your trust in him again.
10:36Okay.
10:40We'll start with a complete PET CT scan, so we can plan our approach.
10:44He has extensive vein thrombosis.
10:56There's a clear segment we can use for an AV dialysis graft.
10:59It's short, but we can attach it to the brachial artery.
11:08Hello, Leah. I'm sorry, but I can't talk right.
11:11There's a problem with Hubert.
11:17Yeah, the pH is exactly 7.2, temp 73. Everything is perfect.
11:22Perfect.
11:23Perfect.
11:24He looks bored.
11:27He can't be bored.
11:29He's a fish.
11:31He's just floating there with nothing to do.
11:33I thought you were working today.
11:35I was.
11:36From home.
11:37Now I'm procrastinating with Hubert.
11:39You should work.
11:41Can you pick up one of those little castles?
11:43Okay.
11:47I'm not sure who's being domesticated.
11:49You were the fish.
11:51Uh, yes, I'm still here.
11:56Call us if anything changes.
11:58Due to his tissue type, Yunus doesn't expect to locate a match in time.
12:02We'll need to find a living donor.
12:07You did a great job today.
12:09Okay.
12:12Oh.
12:13You want some pirate booty and a juice box with that?
12:16Uh-huh, uh-huh.
12:17You keep me waiting for hours on end.
12:19Now at least they have something to do.
12:21Cancer's keeping you waiting.
12:22Yeah.
12:23We're ready for you.
12:25Here you go.
12:26Well, you can keep that.
12:27Oh.
12:28Well, thank you.
12:30Bye.
12:33That story's not gonna end well, is it?
12:35You know, the yo-yo has been around for 1400 years since ancient China.
12:40Watch this.
12:44You're not my only patient.
12:47Remembering and executing these tricks will help with my sequential memory
12:52and protect my brain against your radiation.
12:55With this new targeted therapy, I can better focus on just knocking the things out of your head that I want to.
12:59Of course, I'm also making a little wish list about other things I might want to get rid of.
13:12I'm worried whether it's tomorrow or a few months from now, Dash is gonna lose me.
13:18And he'll be devastated. He's an amazing, loving husband.
13:27I want you to go out with him.
13:30What?
13:32You two get along. You even have chemistry.
13:35We're friends.
13:37If Dash is gonna move on with his life, he needs something to live for.
13:41I think that could be you.
13:42We need to begin now?
13:45We need to begin now?
13:59Don't say a word.
14:01It's none of my business.
14:06Dash seems like a nice guy.
14:07Shut up.
14:08You're a perfect match.
14:12Great.
14:13We just need you to sign the consent forms.
14:17Donation carries several risks, including blood clots, infection, hemorrhage, lung collapse, and possibly death.
14:26There are also lifelong risks such as high blood pressure, which can cause a heart attack,
14:31and protein losing nephropathy, which can impair your remaining kidney, leading to the need for a transplant yourself.
14:36It's a big ask.
14:40It's a big ask.
14:41Yes, it is.
14:47I'm happy to sign the forms, on one condition.
14:52I'm not selling the business.
14:55I told you ten times, we're not taking that offer.
14:59Either sell or buy me out at the same price.
15:01You know I can't afford that.
15:02You know I can't afford that.
15:03I can't afford anything.
15:05Look, Dad left you in charge, but all of my money is tied up in it.
15:08I got investment opportunities.
15:10I got things that I'm excited about.
15:12Dad left me in charge, because when things got tough, you took off to college while we rebuilt.
15:17And now you want to cash in?
15:19We'll both cash in.
15:21The deal I negotiated is way over market.
15:22I don't care how good the deal is.
15:24I like what I do.
15:25And I like my kidney.
15:27Seems we both need to make a sacrifice.
15:29I'm not selling.
15:32Kayla's back in her room.
15:33We finished her staging and everything supports our operative plan.
15:36Do you have any questions about her upcoming surgery?
15:38Did Kay bring up anything about us?
15:39Yeah.
15:40I don't care.
15:42It's all right.
15:43And I like my kidney.
15:44I do not care.
15:45I don't care.
15:46I don't care.
15:47I don't care.
15:48I don't care.
15:49I don't care.
15:50I don't care.
15:51I don't care.
15:52But I don't care.
15:53I don't care.
15:54Uh, did Kate bring up anything about, uh, us?
16:06Oh, my God, I'm so sorry.
16:10I told her not to do that.
16:12I mean, it's, uh, it's nuts, you know?
16:15Oh, it's a little insulting.
16:19I'm kidding.
16:22It's insane.
16:22Uh, just, you know, we'll just forget she mentioned it, okay?
16:29Will she?
16:31I mean, we both said no. What's she gonna do?
16:34You've been married to her eight years. You still ask that question?
16:39Well, we, uh, do have one other choice.
16:44You guys have a chapel here, right?
16:47He's exploiting the situation.
16:49Yes, he's entitled to.
16:51Um, you don't think an organ donation should be an altruistic act?
16:56Can it be?
16:58A majority of donors do it to make their own lives more worthwhile,
17:02and almost a quarter do it to relieve guilt over a past mistake?
17:06Redemption meaning, sure, not money.
17:09So you never take an opportunity to get ahead at someone else's expense?
17:13I'm competing, not trafficking organs.
17:16I need Armando's kidney, and I need it without getting dragged into their family drama,
17:20which is why I have residence.
17:22So you two find a way to make it happen.
17:23The central line will allow us to monitor your heart during tomorrow's surgery.
17:31Have you considered my proposal?
17:35I have been more focused on your surgery than seducing your husband.
17:41Typical.
17:42You got me.
17:44I'm not dating my cancer-riddle friend's husband because I have commitment issues.
17:48You've been sprinting away from men as long as I've known you.
17:52Yeah.
17:52I will find the time when I have the time.
17:55It will never be the right time.
17:57You're afraid to get hurt.
17:59I know how short life is.
18:04I don't want you to miss out on the best part of it.
18:07All done.
18:08What do I owe you for the therapy session?
18:10Date my husband.
18:12Do you know how stupid that sounds?
18:14I want someone to take care of the man that I love.
18:16Does that sound stupid?
18:17Yes, very.
18:18Would you...
18:20Please.
18:22Please, would you just drop this?
18:25I will drop this.
18:27If one date.
18:29One dinner, that's all.
18:31But a real one, not a latte in the cafe.
18:34I want a real date.
18:35Appetizers, main course, wine.
18:38I'm on call.
18:39No wine, but candles.
18:40I want candles.
18:42One date, I will never mention any of this again.
18:48Is a federal crime to barter a human organ for anything of value?
18:52I'm not selling Santiago anything.
18:53You're receiving money from a third party in exchange for your kidney.
18:56He's receiving money from a third party for his business.
19:00So is his brother.
19:02He should love him enough to not...
19:03I love him enough to give him a kidney.
19:05He should love me enough to accept an offer that would improve my life, too.
19:08I mean, it's a much lower ask than a vital organ.
19:10You're not allowed to ask for anything.
19:12Are you saying that if he agrees, you're not going to perform the surgery?
19:14He doesn't agree.
19:15Well, everything in life is transactional.
19:17In this case, I've got all the leverage.
19:20Leverage?
19:21It's what you have that they need.
19:23It's how you shift a deal in your favor.
19:25You guys have no leverage and no cards to play.
19:29Yes, we do.
19:30I don't believe you're willing to let your brother die.
19:33A good negotiator doesn't bluff.
19:36If you cave on a threat, you'll lose all credibility.
19:38And Santiago knows I'm a good negotiator, so he won't die.
19:41Precisely because I'm willing to let him.
19:48I'll talk to your brother.
19:50Okay.
19:51Okay.
20:11How long do we have to stay?
20:17She's had dinner, so I assume until we're done eating.
20:20Okay.
20:23Dessert?
20:24Do you want any?
20:25Not really.
20:26I think we're good.
20:27Okay.
20:27Okay.
20:28Okay.
20:28Look at that old clock.
20:46It's the same as the one that they had at Moline's on campus.
20:50Oh, yeah.
20:50Hey, remember that time he went there on that double date?
20:58You sent me up with your English TA.
21:00Yeah.
21:00Kay said it was a bad idea.
21:02I just remember him droning on about Dryden's influence on 18th century literature.
21:08If you hadn't stepped in, I think I'm going to stack a little bit solid for you.
21:11Yeah.
21:12Kay always knew better.
21:13Yeah.
21:14She fixed me up three times.
21:16And she gave up.
21:17Until now.
21:18Okay.
21:20You should sell the business.
21:37Excuse me?
21:39You would live.
21:42And you could take the proceeds and start a new business without your brother as a partner.
21:48It's a good deal.
21:52Benita's builders is my father's legacy.
21:55He built it from nothing.
21:57He was committed, hardworking, honorable.
22:00He expected the same thing from both of us.
22:04My dad was difficult to please.
22:08I work hard to be someone that my father could be proud of.
22:13And I'm the one he trusted with the controlling share.
22:16I'd rather die than let him down.
22:25Is that bothering you?
22:27Yeah, a little bit.
22:28The graft is failing.
22:45What's happening?
22:46Confusing heparin.
22:51He's hypercoagulable.
22:52The tunnel catheter is going to clot off just like the graft.
22:55That gives him even less leverage.
22:58It should convince Santiago to accept his brother's offer.
23:02Santiago?
23:03Why him?
23:05I'm negotiating.
23:06With the wrong brother.
23:07The catheter is already obstructing.
23:12Whatever we're doing, it needs to happen in the next couple of days.
23:18We'll do a live donor drive.
23:21Okay.
23:22One in a hundred thousand chance of success, but better than planning his funeral.
23:26I think the odds are better than that.
23:28We don't need to find a match.
23:30We just need the parade of selfless family members to embarrass Armando into doing the right thing.
23:34Evening, roomie.
23:41Evening, roomie.
23:52Hubert is dead.
23:53Yeah.
23:58That's odd.
23:59I'm not sure if I overfed him or if it was when I changed the water to clean his pebbles.
24:04But, yeah, definitely dead.
24:10We can get another fish.
24:13We don't need to.
24:15There are many fish in the sea.
24:19I said no.
24:21You wanted a pet.
24:23I got one.
24:24Very briefly.
24:26I'll go tomorrow and...
24:27No!
24:27No!
24:27No!
24:34Are you crying?
24:50Are you sad?
24:53I'm sad.
24:58And I'm angry and frustrated and upset.
25:05We should get another fish.
25:08The fish isn't the problem.
25:10I am.
25:13I'm pathetic.
25:15I went home to Hershey because I wasn't fulfilled with my life.
25:20I thought I could help my bull-headed brother save the shop.
25:26Get part of something I was really passionate about.
25:29Instead, we ended up tanking it together.
25:33Along with our relationship.
25:34Came back here to get my life back on track.
25:37How am I supposed to do that if I can't even keep a damn fish alive?
25:40All right.
25:47All right.
25:51Let's see.
26:01All right.
26:04Let's see.
26:04All right.
26:05All right.
26:06I'll make it through this.
26:36It is okay to be afraid.
26:40How was your dinner with Tash?
26:45Forget about that.
26:47How are you?
26:49If I don't make it, you have to give this thing with Tash a real shot.
26:52Kayla, please stop.
26:54Promise me you have to.
26:57No.
26:58You can't put that on me.
27:01That's right.
27:02Claire never turns her back on a friend.
27:05As long as it doesn't put her heart at risk.
27:09That is not fair.
27:10What you're asking.
27:11I'm asking you to trust my judgment about the two of you.
27:14No, you're trying to pressure me into something that I don't want.
27:17Like you always do.
27:18You need pushing because you've never known what's best for you.
27:25So is that why you dragged me out the Pledge Week to be rejected by every sorority on campus?
27:32Or went behind my back and invited my mother to graduation?
27:36At least you tried.
27:38You put something at risk.
27:39No.
27:40I can't break.
27:41This was never about me.
27:43None of it.
27:44You always have to have it your way.
27:47You are a neurotic control freak who thinks she has the right to dictate how everyone else should live their lives.
27:52It's time.
27:53I'm ready.
27:54Kayla.
27:55I'm ready.
27:56Kayla.
27:57It's time.
27:58I'm ready.
27:59Kayla.
28:00I'm ready.
28:01Kayla.
28:02Kayla.
28:03I'm sure you recognize Raphael, your second cousin from Oxnard.
28:30He drove up as soon as he heard.
28:34Either we get lucky here and you look like an ass or we don't and you look like an ass with a dead brother.
28:44He won't give his life for a contracting company.
28:49He's not dying for the company.
28:52He's dying for your father.
28:57What makes you think that?
29:00He would rather die than let your father down.
29:06He think that that's what dad would want.
29:11Santi did everything the old man asked of him.
29:14Worked twice as hard.
29:15Did everything twice as well as dad ever could but nothing was ever good enough for our father.
29:20And no matter what we did he was always right there to point out where we had gone wrong.
29:26You know what he told me on his deathbed?
29:29Said that he wasn't proud of Santi for following in his footsteps.
29:33But he was disappointed that he settled.
29:40You should tell your brother that.
29:43It's a good card to play.
29:46He was wrong.
29:57You are the most loyal, hardworking and principled guy I've ever known.
30:03And you deserve dad's respect.
30:07You greedy, lying snake.
30:14You will say anything to get what you want.
30:17Even trying to ruin the memories I have of dad.
30:19Your memories of dad?
30:20He was horrible, but you know that.
30:22Get the hell out.
30:24Santi, I'm not trying-
30:25Get out!
30:37Give me the consent forms.
30:52Give me the consent forms.
30:58My father told me he wished I hadn't been born.
31:15I wasn't worth the trouble.
31:20But I knew I was worth the trouble.
31:26Because my brother always looked out for me.
31:34Even when it made his life harder.
31:50Let's see what he did.
31:51Who'd you think?
31:52Is he Wangie's job?
31:53Who'd you like to play?
31:54Who else would you like to play?
31:55Can you play on the other side?
31:56Don't be political!
31:57But I started to get on cars.
31:58Morales, like-
32:02You should've beenml L designs for him.
32:11I didn't Crying at all.
32:15I will probably position the kidney in the pelvis
32:29Dr. Murphy, your stat culture skin bag positive for ethiophtherius multifilius
32:38thank you it's not for this patient do you need to deal with it it's too late
33:08Dr. Murphy, your but health care condition is a risk factor
33:16Dr. Murphy, your presence of a huge deal
33:24Dr. Murphy, your Holidays are a strong, strong and high-rence
33:26and significantlyкой strong, tones are a strong and low-reel
33:31Dr. Murphy and you can see the 1991-1980 on the nextgado
33:36you have a security problem i will get my badge and my gun somebody stole my wallet out of the
33:48locker are you sure you left it there yes i'm sure you were worried about it getting stolen so you
34:04gave this to me before your session today mine sorry stupid don't read anything into this
34:17uh how is she we removed a lot of the tumor she's having the chemotherapy back now
34:33so far she's doing well oh okay okay would want you to eat yeah yeah of course she would she'd forget to eat
34:41herself yeah i really hate the wild all this waiting just sit breathe
34:50you know kail's dealt with so much prodding nausea fatigue so much pain
35:09i just wish you would let me do something for her to make things easier
35:13i want to protect my wife
35:21so i'm just sitting here waiting waiting for her to die
35:25oh
35:41dash i'm sorry they need me back in the water
35:43yeah there's another 60 of lasix
35:57that was 26. she's a cardiopulmonary collapse
35:59second chest tube in sats are still dropping on a hundred percent
36:09that has to be heart failure we need to crush her on ecmo her cardiac index was fine it must be toxic
36:14inflammatory reaction to the chemo she's intolerant stop the chemo
36:18what if the fluid buildup isn't a reaction to the chemo bath what if it is the chemo bath
36:31her mediastinum is widening if her diaphragm perforated fluid could be leaking into her chest
36:36compressing her heart the tumor we removed yesterday was clinging to her diaphragm if we close the hole
36:40she can finish her treatment let's reopen her incision
37:02i just wanted to see how you were doing
37:07his kidney numbers are starting to improve
37:10his kidney
37:13take me back to my room dot
37:16mandy
37:21thanks for the kidney
37:23you're welcome just don't come looking for another one without a big check in your hand
37:29jerk
37:40hey you're just in time for some uh celebratory ice chips
37:53okay i'm sorry
37:57don't be you weren't entirely wrong i i can be a little manipulative
38:05no
38:07no no i was wrong
38:12you don't try to control everything because you think you know better than everyone else
38:16do it because you do it because you're a caring friend
38:22you focus all your energy trying to protect us from pain and suffering and
38:28and that lets you not think about your own
38:34and that lets you not think about your own
38:39but you have to
38:40you are dying kayla
38:50i know
38:53you're dying
38:56you're dying and it is not fair
39:01and it is painful and scary and it feels like you're all alone with it
39:09please stop
39:10but you're not
39:15dash is here
39:16so am i
39:30so am i
39:34thank you for everything you did of course
39:54i am i meant what i said to kayla
40:00you really are the most gifted surgeon i have ever worked with
40:03you did well today
40:11thanks
40:13i'll report back to dr limb in the morning if that's what you want
40:21yeah it's probably for the best
40:33sean i don't need another fish
40:35i don't want another fish
40:37i do
40:37our goldfish died you need to provide a replacement
40:42store policy once a fish leaves the store all responsibility for its well-being
40:46hubert had
40:48ichthyotherius multifilius
40:51a common goldfish parasite picked up in pet stores
40:59you have no leverage and no cards to play
41:03pick a fish
41:15you didn't kill hubert
41:27he was defective
41:31we'll try again
41:35thank you
41:36sean
41:40caring for a fish won't sort out my problems
41:46so i don't
41:47thank you
41:48you
41:51platys
41:51are very hardy fish
42:00you
42:00you
42:01you
42:01you
42:01you
42:01you
42:01you
42:02you
42:06you
42:07you
42:08you
42:08you
42:10You
42:10you
42:11you
42:12you