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The Good Doctor Season 3 Episode 20
#TheGoodDoctorSeason3Episode20
#TheGoodDoctorS3E20
#TheGoodDoctorSeason3
#TheGoodDoctor
#Season3Episode20
#ShaunMurphy
#ClaireBrowne
#Melendez
#Park
#Lim
#StBonaventureHospital
#MedicalDrama
#Drama
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Transcript
00:00You could have increasing intracranial pressure from contusions, edema, or hematoma.
00:04I don't.
00:05I'm pretty sure I know my symptoms better than you do.
00:08No headache, no unilateral weakness.
00:10The doctor without the head injury makes the call.
00:20There's the rupture.
00:22Flipping tube's necrotic.
00:24Dibinky forceps?
00:24Dibinky stabilizing at 90 over 65.
00:31I'll take the clamp.
00:31I'm fine. You remove the laps.
00:33It's better if you do it less likely to damage your hands.
00:35We need six hands. We've got four, and you want us to work with two?
00:41Any tool crumb like catgut?
00:45His heart's shifted from the pressure on his chest. Try retracting it to the right.
00:50There's nowhere for it to go.
00:51Close him up. We'll have to go in through his side.
00:58That won't be easier.
01:00It better be, because this way's impossible.
01:09Hello?
01:10Yes, John?
01:12Leah?
01:13Yeah, I see. You okay?
01:14Why is it still you?
01:16I'm fine. I wanted to see and help.
01:17No.
01:18I don't need you, okay? I need a rescue worker.
01:22They're taking in a lot of scaffolding and stuff, hoping to reinforce the walls.
01:25The water should be a priority.
01:27They set up the main.
01:28They don't know why it's still flowing.
01:30We're going to drown in about five minutes.
01:34That's not true.
01:37At the rate the water is filling, we have about an hour.
01:39And I could leave.
01:58I am going to cut the rebar to free you.
02:01I didn't do it before, because it was structuring your posterior tibial artery, but now we need to take this.
02:09Cutting will intermittently cause your leg to move, which will cause a lot of pain.
02:13How did you deal with your heartache?
02:26You just asking to keep me calm?
02:28Yes.
02:29Distracting you from the disastrous situation you're in will help keep your blood pressure down and reduce bleeding.
02:35Honesty was the problem with my ex.
02:45I opened up to him, told him everything.
02:49In return, he didn't.
02:55Were you being honest when you said you were going to move on after this?
02:58One upside of being impaled on rebar underground, a room slowly filling with water, is it focuses on priorities.
03:09Yeah.
03:10Yeah, I'm moving on it.
03:13If you locked him,
03:16maybe you can't.
03:25I told you.
03:26What?
03:27Be quiet, be still.
03:29The machine has already passed the point where you would have seen any damage.
03:32The fact that you haven't said anything means you're either trying to figure out how to tell me I'm going to die,
03:36or trying to figure out how to apologize for wasting my time.
03:39You're right.
03:40I'm glad your brain is fine.
03:42I'm not sorry at all.
03:44I appreciate the excessive concern.
03:46Now I can get out of here.
03:47Take patience, and you can get back to the winery to help.
03:51Brewery?
03:52Oh, come on, I misspoke.
03:54Been a bit of a rough day, you hear?
03:56There was an earthquake.
03:57I've seen you on a lot of rough days, but not once have I seen you confused.
04:01Move your gown.
04:02You're bleeding internally.
04:08I need bass irrigation, and then we can start closing her up.
04:17Dr. Resnick.
04:20Please step back, Dr. Andrews.
04:22We're trying to keep this area as sterile as possible.
04:24Glad you're aware it's not an actual operating room that you seem to be operating in.
04:27There weren't any available, and there weren't any surgeons either.
04:30Suction?
04:31So you violated Dr. Glassman's order to not use your hands.
04:34Ectopic pregnancy.
04:35The fallopian tube ruptured.
04:37Patient would have died.
04:39Omax on sutures.
04:41You could have found another way, but you wanted her to be a hero.
04:47Get your hands out of the patient and take them to your room.
04:49I'll finish.
04:52He has a traumatic dissection all the way to the ascending aorta.
05:13The clamp would tear through the vessel wall, and he'd bleed out.
05:19And if we clamp proximal to it, he'd lose perfusion to his head.
05:24He'll be brain dead.
05:31You should go back to the hospital.
05:34I'll stay with the boy.
05:43Who's in charge?
05:47First Andrews, then Morgan, then Andrews again.
05:49She's back in her patient room.
05:50He's in surgery.
05:50What do you got?
05:51Bay 4.
05:52Otherwise healthy 35-year-old with chest pain.
05:54High sensitivity troponin's back?
05:55First was negative.
05:56Repeat the tropes in an hour.
05:57If there's still no change, discharge him.
05:59Yeah.
05:59Bay 2.
06:0016-year-old dresser fell on her leg.
06:02Normal pulse and sensory exam?
06:03Yes.
06:04It's a non-displaced fracture.
06:05Prepper for a posterior slab and book a follow-up.
06:08Dr. Lim.
06:12Who's this?
06:13Dr. Melendez.
06:23Dr. Part.
06:25So how'd it go?
06:29Not good, Casey.
06:32We couldn't fix things.
06:35When we take this off you, you'll start bleeding and we won't be able to stop it.
06:43You're going to die.
06:49No.
06:50No, no, no, you're wrong.
06:52You got to be wrong.
06:55Where's my dad?
06:56He's on his way.
06:59We're going to keep you comfortable.
07:00I'm not in pain, okay?
07:03You got to be wrong.
07:05I'm sorry, Casey.
07:06Where's my dad?
07:13Where's my dad?
07:23Isn't moving on just a euphemism for giving up for failure?
07:28Do you really believe that?
07:32Do you think you failed?
07:36Accepting loss makes us stronger.
07:40Refusing to accept failure makes us not fail.
07:47If we keep fighting until we succeed, then...
07:49That's not true.
07:50It traps us.
07:53Prevents us from moving on to other victories.
08:04Your hematocrit suggests you're still bleeding.
08:07Appears to be in the retroperidoneum.
08:08Probably from the pancreas.
08:10If we open you up, it means major resections and reconstructions,
08:14and you could end up with ostomy or diabetes.
08:16I'm well aware of the risks of abdominal surgery.
08:19The more conservative approach is an NGO for embolization to stop the bleed.
08:23Less invasive...
08:24Again, aware.
08:26Do the embolization.
08:28In this case, I don't think it's actually safer.
08:32If the bleed isn't from the pancreas,
08:34we'll have to keep poking around until we find it,
08:37and it might be too late.
08:43You want to do the surgery instead?
08:45Not really.
08:47Claire's right.
08:54We've been able to get a satellite hookup to your dad.
08:57Do you want me to talk to him first?
08:58No, I need to talk to him.
09:04Son?
09:08Dad, I'm sorry.
09:12Dad, I'm so sorry.
09:13Dad, it's my fault, okay?
09:22Dad.
09:24Dad.
09:29Get him back.
09:31The plane's caught in a storm.
09:33I don't know if that's...
09:33Get him back.
09:41Divide the gastrocolic ligament and expose the pancreas.
09:46It's a branch of the superior mesenteric artery that's torn,
09:49not his pancreas.
09:50Good call.
09:50I need to resect the devitalized tissue to get a healthy anastomosis.
09:53We need clamps and six ovicules on Kestros?
09:59Dr. Lim?
10:00Above the SMA, the small bowel.
10:07There are three ways to stop a bleeding vessel.
10:20Clamp, cauterize, or repair.
10:24Since this vessel is made of steel, clamping requires a 60-ton press,
10:28and cauterization requires an oxyacinine torch.
10:32I don't need to stop the water.
10:39Just slow it down.
10:41You're good at adapting to challenges.
10:45Yes, I am.
10:47Blindly keeping on sawing wasn't going to work.
10:50No.
10:51But it wasn't a failure.
10:52Because cutting the rebar wasn't your goal.
10:58Saving me was your goal.
11:01And your goal isn't Leah.
11:05It's love.
11:06It's love.
11:22I think this girl will work with the tattoos.
11:51The bleed wasn't from the pancreas.
11:57It was from the SMA.
11:58But we found additional injuries all the way to the celiac trunk.
12:03Ischemic bowel?
12:04Early stages.
12:05We have restored full blood flow and reperfused.
12:09I'm sure the bowel is going to be just fine.
12:11Hell sure.
12:13What's my life date?
12:17Four.
12:17It means there's already been some failure of the bowel wall.
12:25We are going to retest your lactate.
12:27And I'm sure it'll have gone down.
12:29But if it's gone up, it means ischemia is progressing and there'll be more bacterial leakage.
12:33Which, in turn, will mean a septic shot.
12:40Pass the point of treatment.
12:41We're not there yet.
12:57Let him know it's still going to be a while.
13:01How long is the while?
13:02Sorry, I don't know.
13:03He says they're going to drown in 15 minutes.
13:05It's a while more or less than 15 minutes.
13:08That last tremor made things too unstable to send my crew down.
13:11You're supposed to be saving lives.
13:13You're supposed to be the hero.
13:17If you let me, what I'm going to do right now is help my crew get in more braces, scaffolding, and heavy machinery.
13:22What you need to do right now is convince Dr. Murphy to get out of there.
13:25Talk to me, Casey.
13:33I'm tired.
13:35Let's just talk.
13:38Why do you need to apologize to your father?
13:40What do you think you did?
13:44Whatever it is, there's nothing you could have done that he's going to be mad about right now.
13:48I don't know anything.
13:52I know how a father feels.
13:55I know no matter how mad or how ugly things get, we don't stop loving our children.
14:08I killed my mother.
14:16You need to get out.
14:18Soon.
14:19You need to get out now.
14:20It's not stable.
14:22Eric can't leave.
14:25The firefighters told me they're making great headway and they'll be able to stay here as soon, so you need to get out of the way.
14:39Are you lying?
14:40You need to go.
14:51You need to go.
14:58If I leave, you die.
15:03If you stay, we both die.
15:06You can't cut through the rebar, Antony.
15:29You can't cut through the rebar.
15:31But I can cut through your leg.
15:41In the Civil War, there was a doctor who could amputate limbs in under three minutes, which kept blood loss and pain to a minimum, thus reducing the effect of shock.
15:57Our scalpels are sharper, so I can slice through the skin and muscle faster.
16:01And I only saw the rebar with the top half of the saw.
16:05So the bottom half is still pristine to get through the bone.
16:08Do you consent to the procedure?
16:13No.
16:16I have one condition.
16:19You have to promise me that if I don't make it, you'll move on.
16:25You deserve to find love.
16:33You need to.
16:37You're down here risking your life for me, right?
16:40Well, this is me risking my life for you.
16:45Promise me you'll move on, Sean.
16:49Promise.
16:50Promise.
16:50Promise.
16:50Promise.
16:55I promise.
17:06Let's do this.
17:15A year before med school, I took six months off.
17:22Backpacks across Southeast Asia.
17:25Hostiles were three bucks a night.
17:29Pieros, 50 cents.
17:32And I found this little island in Thailand.
17:37Koh Lanta.
17:39Nothing but bamboo huts and palm trees.
17:44Stayed eight days.
17:47Red Moby Dick.
17:48I fell in love.
17:57How high?
18:02High.
18:088.1.
18:098.1.
18:098.1.
18:098.1.
18:118.1.
18:138.1.
18:17The place is probably overrun with tourists now.
18:28She had an accident.
18:31Nothing really.
18:31Mom didn't even report it.
18:33It was big enough to mess with her neck.
18:40A lot of pain.
18:41But she was dealing with it.
18:46I thought.
18:47She became dependent on the pills?
18:51Going through her purse.
18:54Looking to steal a couple bucks for the movies.
18:56I found three half full of prescription bottles.
19:02Same drug.
19:04What did you do?
19:09Nothing.
19:13I didn't say anything to her or my dad.
19:16I didn't know what to say.
19:26Three weeks later, she OD'd in her sleep.
19:31He would have gotten her help.
19:33I need to tell him.
19:48You will.
19:50I promise.
19:51I promise.
19:51When I was a second year resident, I was assigned to a Dr. Wilmot Fortengale.
20:11Full of himself, sarcastic, thin-skinned.
20:14Our first case together, I saw he screwed up.
20:22And I called him on it.
20:23He lit into me.
20:25What kind of ego I must have.
20:28What little regard I must have for my superiors.
20:32How hard it must be for me to trust anyone in my life.
20:36Two days later, the M&M.
20:39Guess who screwed up?
20:42Me.
20:44When you're a resident, you think you know everything.
20:52I'm sorry.
20:54I should have told you about my diagnosis.
20:59It's hard.
21:00Yeah.
21:01And what that showed me is that you don't respect protocol.
21:04You don't respect your superiors, your patients.
21:09The only thing you care about is your own career.
21:14And again, I was wrong.
21:19What you did today for your patient was remarkable.
21:22You made it clear that saving lives is your first priority.
21:33Fortunately,
21:35it may have cost you your career as a surgeon.
21:40You've traumatized your joint capsule incisions.
21:43I'm sorry.
21:46I'm sorry.
21:58I'm not afraid to die.
22:00I was raised a good Catholic.
22:06Altar boy.
22:08First communion.
22:08faithfully wore my silver crucifix that the Abebe gave me for confirmation.
22:18I was a true believer.
22:22And I went to college.
22:23Maybe it's just now that I'm staring into the yawning void.
22:32I'm hedging my bet, but
22:33it's coming back to me.
22:42Like an old friend with a horn lock.
22:44I want you to know that I don't.
23:14You should go.
23:20This place still has a crisis going on.
23:37Goodbye, Claire.
23:40Goodbye.
23:41Goodbye.
23:4496.1.
23:52That's okay.
23:56Feels way colder than 96.
24:01Feels like
24:0356.
24:0846.
24:1136.
24:13Casey.
24:14You have to stay with me just a little longer.
24:19I can't give you any more hippie.
24:22Casey.
24:37It's bad.
24:38It's bad.
24:38Yeah.
24:49I'm right here.
24:56So you had morphine?
24:58I saved it in case I needed to do this.
25:01Good thing you're not telling me.
25:03Yes.
25:03The upside?
25:04The upside?
25:05In three minutes, I'm going to lose 10 pounds.
25:07I'd say only eight, unless you count blood loss.
25:10And...
25:11I just take everything that early.
25:12No.
25:14Leah?
25:15I need you to count off the seconds from one to 180.
25:19I want to know how close I am to three minutes.
25:23How will that help you?
25:24I don't think it will, but it may help distract you from the screaming.
25:31Ready?
25:32No.
25:35Just do it, for God's sake.
25:37I want to go back in.
26:05If we resect more bowel and do a trauma whipple...
26:09A trauma whipple?
26:10It's a big surgery.
26:12Okay?
26:12A huge surgery.
26:14And there's obviously no guarantee and lots of complications, but if we act now, I feel like...
26:19Whoa, whoa, whoa.
26:19Let's just hold on for one second.
26:21First of all, we are talking about Melendez, correct?
26:24Secondly, we do know the numbers.
26:27They're terrible.
26:28And maybe so is this idea, but that's how this works.
26:31You shoot down mine, I shoot down yours until we come up with a viable solution.
26:35Okay, here it goes.
26:40The mesenteric bypass already failed.
26:44His lactates have more than doubled from 4 to 8.1, and his significant revascularization
26:49is already out of the question.
26:50By some miracle, he were to survive the surgery, he'd be tube-fed, a diabetic, with an ostomy bag,
26:59waiting for a liver transplant.
27:00Your turn.
27:09It's time to stop being a doctor, be a friend.
27:13Dad, I knew...
27:25I knew about Mom.
27:31I knew about the drugs.
27:33I should have told you.
27:45I knew, too.
27:49Of course I knew.
27:53When you love someone, you know when something's wrong.
28:03But, Dad, if you knew...
28:05I did what I thought I could.
28:08Sometimes...
28:10Sometimes you can help them.
28:15Sometimes there's just nothing anyone can do.
28:20And we were the adults.
28:23It was our problem, our responsibility.
28:26Never yours, Casey.
28:27It was never your fault.
28:32It was never your fault.
28:45Seven.
28:46Seven.
28:47Seven.
28:48Seven.
28:50I made it to the bone.
28:52What?
28:53Seven, two.
28:54You need to stay conscious.
28:56Zero.
28:56Four.
28:58Five.
29:01Eight.
29:02Eight counting.
29:03Uh, 80.
29:04Eighty-one.
29:08I'm sorry.
29:11I should have been able to do more.
29:13Faster.
29:14Better.
29:16I know you want to find blame.
29:20There's blame.
29:21There's reason.
29:23Sometimes.
29:24It just isn't.
29:29It pisses me off, too.
29:36I could have spent a lifetime drinking whiskey with you.
29:43I was even starting to like it neat.
29:49I was even starting to like it neat.
29:57What did we do?
30:02No blame.
30:03Herrn?
30:03No.
30:04Sure.
30:18No.
30:18I'm sorry.
30:21All right.
30:23My palavras.
30:24You're going to bite them if not.
30:24Yeah.
30:25I'm not easy.
30:25That's right.
30:27No.
30:28voices.
30:28That's three minutes, Sean.
30:58Sean, can you hear me?
31:12Sean!
31:13Dad, it's so cold.
31:17I know.
31:18I'm sorry.
31:20We should go snowboard it.
31:23You teach me one of your tricks.
31:27If you break your leg, your mom would kill me.
31:32Good boy.
31:36I love you, Dad.
31:46I love you, too.
31:56I love you, too.
32:01I love you, too.
32:03I love you, too.
32:05I love you, too.
32:15I love you, too.
32:17I love you, too.
32:19I love you, too.
32:26I love you, too.
32:28I love you, too.
32:38I love you, too.
32:40I love you, too.
32:42His father's in the squad car.
32:46We have him on the line now.
32:50Let's get this bar off him.
32:56Mr. Taylor, I'm Dr. Park.
33:03Leah?
33:04It's time to go.
33:09I can't.
33:11There's nothing left to do.
33:14We should get you checked out.
33:19We've got something.
33:23Hey, you need a helmet!
33:33Hey.
33:34Hey.
33:35I heard the ace picked up another reliever.
33:40Yeah.
33:42I keep thinking what's going to happen to the next Teresa Adams.
33:50Remember her?
33:52Goldbladder.
33:56That's all we thought.
33:58We get in there.
34:00It's completely healthy.
34:01I blame it on lousy imaging.
34:04You call a duodenal ulcer blocking the duct saved her life.
34:12Just so you know,
34:16you're the best I ever worked with.
34:20Otto McAllen says they win the division.
34:3525 or 17?
34:3825.
34:40It's a sucker bet.
34:43Hey, it's my funeral.
34:48I look forward to that scotch.
35:16I got you something.
35:23What the hell are you here?
35:26Hey.
35:27Hey.
35:29Hey.
35:31Hey.
35:32Hey.
35:36Hey.
35:37Hey.
35:39Hey.
35:40Hey.
35:41Hey.
35:42Hey.
35:43Hey.
35:44Hey.
35:45Hey.
35:46Hey.
35:48Hey.
36:00Hey.
36:04Hey.
36:05Hey.
36:06I was just in the right place
36:13At the right time
36:16That was all you
36:20You're gonna be okay, Claire
36:34There is something I need to tell you
36:36Me too
36:40I go first
36:43You
36:48Are
36:50A terrible bowler
36:55Maybe the worst I've ever seen
37:02And I wanted to tell you
37:04That I hate your tattoo
37:05You're way too much antler
37:08I love you
37:16I love you too
37:25Come on
37:28All right
37:37All right
37:38You're come to me
37:42I love you
37:43It's the start of a new day.
38:05Yes, it is.
38:07That was both literally true and a metaphor.
38:13It's the start of a new day.
38:43Hey, I have to be closer to you guys.
38:53I'm going to move back.
38:55Look, he's killing her, and I need to hear his voice.
39:02Hey, son.
39:16Hey, son.
39:46Hey, son, you should get a drink sometime.
40:12I made a promise to Vera.
40:25I don't know what that was.
40:37It could be a practice kiss, or a pity kiss, or a goodbye kiss.
40:42Otherwise, then I'm such a stupid idiot for not seeing it.
40:47But I love you with all my heart kiss, and this is another.
40:54Fear didn't die, so the promise doesn't count.
41:07Fear didn't die, so the promise doesn't count.
41:15You make me lose.
41:18You make me lose.
41:19Send my love to everyone.
41:24Send me love.
41:28Send my love.
41:32Send my love.
41:35To everyone.
41:38Send me love.
41:42Save my life
41:46Save my life
41:49To every world