The Good Doctor Season 4 Episode 15
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00:002-6-6! 2-6-6!
00:03It's just an hour.
00:05Which really means an hour and a half,
00:07which means by the time we get to Jason's,
00:09the party will be over.
00:10It's not a party.
00:11It's four boys arguing over who's going to play
00:13Call of Duty's Warfare.
00:15Meanwhile, you're going to be learning
00:16how to exercise your First Amendment rights.
00:17By leaving signs at cars,
00:19and it's Call of Duty colon Modern Warfare.
00:23Everyone who sees our signs knows that they're not alone.
00:26And when we have numbers, we have a voice.
00:28We are heard.
00:29At least someone's being heard.
00:31This is democracy, Ethan.
00:33Making a difference.
00:34This is how change happens.
00:36Yeah, well, change sucks.
00:42It's 10.30.
00:43I will have you at Jason's by 11.45, okay?
00:46Ooh, I see a spot.
00:51Really?
00:52Why'd you let her in?
00:53Because the idiot would have smashed our car.
00:56How about we go get milkshakes instead?
00:59Hmm?
01:00I spent three hours making signs.
01:03Oh, there!
01:04There's a spot!
01:05266!
01:06266!
01:07266!
01:08Sweet.
01:11Any hint of trouble?
01:12We are leaving.
01:13Got it?
01:14Inspiring speech, Mom.
01:15Very Vince Lombardi.
01:17I saw his hologram.
01:18Oh!
01:19Here's your very own wristband.
01:23Solidarity!
01:24Yeah!
01:25Yes, they already did the finger prick and gave me the gloop.
01:26It's a 50 gram glucose solution.
01:27It was gloop and it tasted awful.
01:28Gloop wouldn't tell us if you have gestational diabetes, which is associated with hypertension,
01:32preeclampsia, preeclampsia, preterm labor, and for the baby, respiratory issues, and obesity.
01:49Before we buy jumbo baby clothes, let's get the test results, okay?
01:53Okay.
01:54Will you text me when...
01:55Whoa.
01:56What's this?
01:57We know at least two people have been shot, but we have no information on their status.
02:05By all reports, the rally in support of...
02:07That is less than a mile from here.
02:10Despite the presence of some counter-protesters.
02:12But just about 20 minutes ago, what witnesses...
02:15I have to go to the ER.
02:17Stat!
02:18...the passenger opening fire...
02:27Nine-year-old boy with multiple gunshots to chest and abdomen.
02:39He took three rounds of Epi, still PEA.
02:41Trauma base six.
02:42Checking the ABCs to have to take over compressions.
02:44Clear, assess wounds.
02:45You're the mom?
02:46What's his name?
02:47Mason.
02:48Mason, got it.
02:50Entry wound left chest.
02:52Right over his heart.
02:54Emergency thoracotomy.
02:5520 blade.
02:56We'll take good care of Mason, but right now you need to go.
02:59I can't.
03:00Now.
03:01Rib spreader.
03:03We got a pumper.
03:05I can't see a thing.
03:07Suction!
03:11Hole in right ventricle.
03:12I got my finger on it.
03:13That stopped the bleed.
03:15But we gotta get the heart pumping normally again.
03:17Urinary catheter.
03:20Stick it in the hole.
03:22Inflate the balloon inside the ventricle.
03:24That occlude the hole.
03:31And we've got a regular heartbeat.
03:32Red cell splatelit transfusions.
03:33Let's get him to the OR.
03:34Very good, Dr. Brown.
03:35Kid took one gun shot to the head, became unresponsive en route.
03:41Intubated him.
03:42He's bradycardic.
03:43Pupils are blown.
03:44No response to sternal rub.
03:45And the kid's leaking brain.
03:46Glasgow coma scale 3T.
03:47One gram per kilo mannitol.
03:4850 milligrams per kilo Keppra.
03:49Elevating ahead 30 degrees and banging down to CO2.
03:50All right, let's take him.
03:51OR2.
03:52Let's take him.
03:53OR2.
04:02Let's take him.
04:03OR2.
04:04And we can now confirm that the shooting victims were young boys.
04:11witnesses describing them as both under 10 years of age.
04:18According to accounts, one was shot several times in the chest and abdomen.
04:23The other shot at least once in the head.
04:25The fact it was children who were shot is devastating news.
04:28And so we have yet another day in an otherwise peaceful community erupting in violence.
04:33The kind of atrocity that has sadly become all too commonplace.
04:38And that only makes this attack more tragic and senseless.
04:42We are awaiting updates and we'll let you know as soon as we have any.
04:46Fixed the liver laceration.
04:47Let's get the spleen out of there.
04:48Suturing the right ventricle.
04:49Next up is left ventriculotomy.
04:50All that'll leave is the bronchial injury, the diaphragm tear, the VSD, and the holoviscus
04:54bowel injury.
04:55BP's dropping fast.
04:56We're going to need every unit of oneg or compatible blood.
05:24Do you have someone in surgery?
05:46No.
05:47I'm just here for a test.
05:49Mrs. Wilkie?
05:51What is it?
05:52And Mrs. Bardo?
05:53What happened?
05:54Nothing.
05:55I just need you to fill out these forms.
05:57Forms?
05:58Necessary evil.
06:00Do you have copies of your insurance cards?
06:03Uh, no.
06:05I must have left my...
06:07I work here in IT.
06:09I'll help them with the forms.
06:11Oops.
06:12This is not a happy brain.
06:23Let's clean out as much as we can.
06:25Scalp, hair, skull fragments, and let's not forget bullet shrapnel.
06:31Ultrasound?
06:32I'm looking for any deeper bullet fragments.
06:33Brain's herniating.
06:34CO2 is normal.
06:35Is he storming?
06:36Heart rate's way too low.
06:37We need to take off his entire right skull.
06:39Drill with you one bit.
06:40Uh, initial there.
06:41And sign here.
06:47Leah.
06:48Leah.
06:49Leah.
06:50I-I think that's the other mom.
06:51I-I think that's the other mom.
06:52I'm sorry.
06:53Just think about it.
06:54You need to take off his entire right skull.
06:55Drill with you one bit.
06:57Uh, initial there.
07:00And sign here.
07:08Leah.
07:09Leah.
07:10I-I think that's the other mom.
07:19Mom
07:33I'm Karina
07:35Were you at the rally?
07:42I'm Taryn
07:50Mason's nine
07:53Nathan's eight and a half
07:59They'll be fine
08:02I know it
08:04You're one of them
08:22Them?
08:24Get away from me
08:25It's so sad that people can't express their views peacefully
08:29The right is so intolerant of political differences
08:32Any differences
08:33I think there are some intolerances on both sides
08:35Oh, like there are good people on both sides?
08:37What if I told you I belong to the NRA?
08:39I think you were saying that to make a coin
08:41About five years ago my wife and I went to a very trendy restaurant in a very shady part of town and on our way back to the car we were mugged at gunpoint
08:49differences. I think there are some intolerances on both sides. Like there
08:54are good people on both sides? What if I told you I belong to the NRA? I think you
09:00were saying that to make a coin. About five years ago my wife and I went to a
09:04very trendy restaurant in a very shady part of town and on our way back to the
09:08car we were mugged at gunpoint. The next day I bought us both handguns. I'm a card
09:13I remember. I voted for Trump. Too soon. I'm serious. I'd like to stand on Israel but I've never told
09:28anyone because I'd be absolutely vilified. As you should be especially. Pulling up he's hypotensive
09:33lactate's rising. Okay crates down to 17. We could put him into deep hypothermia. Ah the low temp would
09:38only worsen his coagulopathy. He just needs more blood. I've used up most of the oneg and aneg for
09:43blood bank. Start calling other hospitals now.
09:53You actually voted for Trump? Once. And then what? You suddenly discovered he was
10:04exactly who he said he was? I don't feel like you want an answer. I feel like you want an apology.
10:09Ugh. Well this kind of changes how I feel about you. What does that mean? You think you don't
10:17respect me? We can't be friends because of a vote? It is more than a vote. Yeah. It's a fundamental
10:22right that I exercised. This kind of changes how I feel about you. If I can't have a political opinion
10:27about the best way to improve all our lives. Do you think anybody's life got better? That's enough.
10:31Are you okay? Your repairs are almost finished. We could be done with this in two or three hours.
10:43We have just enough blood. That's if we want to.
11:04Mrs. Bardo? What is it? We fixed two holes in your son's ventricles. We've removed his spleen and
11:11repaired his liver but he's still in surgery. Your son has lost a lot of blood. We're giving him
11:18transfusions but the blood loss may have caused damage to his brain.
11:30If his brain is fine, then we should push on. But if his brain isn't fine,
11:35then continuing the surgery could kill him. Unfortunately, we can't accurately assess for
11:46brain function in the OR so we would have to wake him up and do a traditional neuro exam.
11:51You need her to decide that? Why put that on her? You guys are the doctors.
11:57Wake him up. Maybe wake him up. I can be there, right? You can. But he will be confused and stressed.
12:09His belly will still have to be open. My husband died in a car accident two years ago.
12:16I didn't get to say goodbye. This is not goodbye. This decision should not be based on...
12:22It's not goodbye. Please wake him up. Okay. Come with us.
12:37Why haven't I heard anything?
12:45The brain looks more relaxed now. There are a lot of clots.
12:52I'm fine. Two kids shot? We all are.
13:06You're not supposed to be here. I know. I am so sorry.
13:09Is the baby okay? Did you get your test results?
13:12No, but I'm fine. The baby's fine. How's the boy?
13:15You can't be here and we can't tell you.
13:19I'm sitting in a waiting room with a terrified mother. Somebody needs to tell her he's being taken care of.
13:24Ms. Wilkie. I'm Dr. Sean Murphy. Is my son okay?
13:37Okay. We have successfully removed half of your son's skull to reduce brain pressure.
13:44We've removed blood clots, bone chips, and bullet fragments.
13:48But we are still trying to find the less accessible and deeper chunks of the bullet in his brain.
13:57Can I see him?
14:00Of course not. He's in surgery.
14:01We just needed to let you know his status.
14:17I'm sorry.
14:18Mason. I need you to follow my finger, okay?
14:42Can you wiggle your toes for me? Your little piggies?
14:48You're acing this test, Mason.
14:54Now, can you squeeze my fingers?
14:58Just, you're trying to make a fist. It doesn't have to be hard. Just a little squeeze.
15:08Okay. No, that's okay. Hey, Mason. Look at me.
15:10You're gonna be okay, Pumpkin. Everything's gonna be okay.
15:23Hey.
15:23There's an indentation on a right M3 segment branch artery.
15:40That suggests the presence of a deeper fragment.
15:46Nice catch.
15:46Yes, but I'm not sure how we get it out.
16:03When was Ethan's birthday?
16:09Um, October.
16:11It was just the three of us, and we have a golden doodle named Derber.
16:21Ethan wanted to invite a couple of friends over, but I said no. It wasn't safe.
16:28He wanted two friends. He has like a hundred of them, and I said no to two.
16:33It feels like all Ethan and I ever do now is fight.
16:43Children don't need their parents to be buddies. They need limits, structure.
16:50You don't have kids, do you?
16:51You'll die hating me.
17:00Taryn, you cannot think like that.
17:09We found the last bullet fragment.
17:12It's deep but stable, so it is very unlikely to cause further brain damage,
17:16bleeds or seizures. We should leave it where it is.
17:21You want to leave a bullet in my son's brain?
17:26Removing it comes with a high risk of lacerating key brain vessels.
17:37You can trust them. They're the best doctors I've ever known.
17:46You can trust them.
17:47Okay.
17:48Leave it in.
18:08Did you get to see Mason?
18:12They had to have more tests.
18:16But I know he'll be fine.
18:21He will.
18:26Does Mason play any sports?
18:31Basketball.
18:34Team captain.
18:37Likes to be in charge.
18:40So mature for his age.
18:42When my husband died, it was Mason who kept me going.
18:51Brought me coffee every morning.
18:54Opened my curtains.
18:57Helped me get out of bed.
18:58I'm a single mom, too.
19:08A hell of a day to be one, isn't it?
19:15When did you lose your husband?
19:16We divorced two years ago.
19:21Not amicably.
19:24Divorced.
19:27I know it's not the same, but...
19:29I buried my husband.
19:30You lost him in the worst possible way, yes.
19:36But I doubt you also lost half of your friends, your self-respect and the love of your son.
19:44I doubt you ever had to tell your son that daddy was never coming home again.
19:50Look, I didn't mean to...
19:51You figured you know me.
19:53You've experienced pain, so you understand all the pain everybody else has ever felt.
19:59I understand pain...
20:00Shut up.
20:01Right.
20:02Right.
20:02Someone disagrees with you, and you shut them up.
20:05You couldn't let us wave our little signs in peace.
20:07You had to come shout us down, and when that didn't work, you had to shoot us!
20:29Yes, yes.
20:40You can go first.
20:41Why?
20:44I'm being polite.
20:45It won't make any difference who hears their news first.
20:49We don't think there is any brain damage.
20:52We're going to take them back to the OR to finish their repairs.
20:56Wonderful.
20:57Thank you so much.
20:59We have to leave Ethan's skull off until his brain swelling has gone down,
21:08which could be a couple of days from now, or months.
21:14We've moved him to intensive care.
21:16You can see him now.
21:29When he was a baby, I used to love watching him sleep.
21:41It was the only time he wasn't bouncing off the walls.
21:43The only time I could just look at him was when he was older.
21:50And if he caught me watching him, he would say that I was weird, and I just told him how beautiful he was.
21:57That only made me weirder.
22:00But he is so beautiful.
22:10His eyes moved. They moved. He's looking at me. That's good, right?
22:13Yes.
22:18No, he's not looking at you. His eyes are deviating to the right.
22:22What is that? He's squeezing my hand. Ethan, honey, mommy's here.
22:28How hard is it getting firmer?
22:29Ativan, increased propofol and we need a CT and an EEG.
22:35He is having a focal seizure, which is originating in the left side of the brain,
22:39which wasn't the damaged side, which is very strange.
22:44The bullet fragment must have migrated. It was a mistake to leave it in.
22:59He's seizing. This is exactly what he said wouldn't happen if we left the bullet in.
23:07Exactly. I'm sure he'll figure out what to do and...
23:13Who do you have news for?
23:16Ms. DiLello?
23:26Good news?
23:26Oh, it's nothing.
23:31It's okay for someone to be happy.
23:35I'm expecting. And all is good.
23:42I gave birth on Christmas Eve.
23:46All the nurses were singing carols.
23:49Kenny joked that the only thing missing were the three wise men.
23:53It was hokey and ridiculous.
24:00But it was magical.
24:06Ethan was three weeks premature.
24:10We were having just one last fun weekend, the two of us, and I guess Ethan didn't like that idea.
24:15So I gave birth in a motel room 300 miles from my OB.
24:22Left a really good tip for housekeeping.
24:24It's very strange.
24:37It's very strange. I was wrong.
24:40It's very, very strange.
24:43No, you weren't.
24:46The fragment's still stable in location.
24:49No severe compression on MCA, no new bleeds.
24:52That just means we missed something else.
24:54There. Deep into the thalamus.
25:04I wasn't wrong.
25:06I wasn't wrong.
25:07You were.
25:09You missed it.
25:09No. No, I wasn't wrong.
25:12I would have noticed another fragment.
25:16There.
25:17There was nothing there eight hours ago.
25:22Okay, so it's just new to this location, which means it's moving.
25:30And based on its trajectory, it's going to cause a lot more damage.
25:33It's much deeper than the other.
25:40So we can't get to it.
25:52We can't go through the water drainage system at the boy's brain,
25:55because that would mean having to puncture the ventricular wall at the thalamus.
25:57And we can't follow the injury pathways, the MRI guidance,
25:59because the metal and the bullet rules out the MRI.
26:01And we can't.
26:02Sean, Sean.
26:03You are a neurosurgeon, okay?
26:06You will know what I have missed.
26:12You don't think you missed anything?
26:15No.
26:17Then you didn't.
26:23Okay, then...
26:27Ethan is probably going to die.
26:32This one's different, huh?
26:52Because he is a child?
26:53Yeah, yeah, because he's a child.
26:55No.
26:58I've lost children before.
27:03Sean, every parent has one job.
27:06And that's to keep their kid alive.
27:09To keep him from all the horrors in the world.
27:11And maybe because you can't protect Ethan, you think?
27:21That's not rational.
27:23No, that's not rational.
27:28The price of parenthood.
27:29But you know what?
27:31It's worth it.
27:32If it makes me upset and irrational, it doesn't sound like it's worth it.
27:38You don't mean that?
27:39I came here to ask for your surgical advice about Ethan,
27:52and all you've given me is emotional advice about me.
27:56Yeah, because that's all I got.
27:59You know, Callan started playing soccer when he was seven.
28:27And he loved that jersey so much.
28:32Wore it to bed every night.
28:33Wouldn't let us wash it.
28:39And he spilled grape juice on it.
28:43A big purple stain.
28:45And I got angry at him.
28:53I always get a little like this with kids.
28:59I think maybe Sean and Lim can handle it fine without me.
29:03If it was Callan in that ICU, how would you feel if his doctor appealed on him
29:10because his kid has filled grape juice ten years earlier?
29:15Yeah, it's brutal on you.
29:17About a hundredth as brutal as it is on them.
29:28So you agree with Biden on every single issue?
29:42No, of course not.
29:44But I agree with him on more than one.
29:46How many?
29:48Where's the line?
29:50Every vote is a compromise.
29:52We support the things we think are important and rationalize the things that aren't.
29:58Unfortunately, compromise has become a dirty word, which is ironic,
30:02since that's the essence of democracy.
30:04And the lack of compromise is why I left home.
30:07His left foot is cold.
30:13It's pulseless.
30:14I've got a pulse here.
30:20Something's happening between here and you.
30:23Good?
30:24Nothing.
30:25Good?
30:29Nothing.
30:30Nothing.
30:32It's his popless heel artery.
30:33He must have thrown a clot.
30:34We have to fix this now or he loses the leg at best.
30:44Ethan's seizures were caused by a different fragment that migrated to the left side of his brain.
31:07We weren't wrong about leaving the other fragment in.
31:09So you weren't incompetent about that, just about completely missing this other fragment?
31:17Yes.
31:20But the new fragment isn't stable.
31:24And will almost definitely continue to cause damage.
31:29So you'll remove it as soon as possible?
31:34It's too deep to remove.
31:36Which means you'll do what?
31:43We'll keep him on anti-seizure meds.
31:46And we'll monitor him.
31:49Hope for the best.
31:53Monitor?
31:55An eight-year-old boy is dying and you're gonna monitor him?
31:59If this was your child, you could live with that?
32:01They're in there doing nothing.
32:02They're doing nothing!
32:03Leah.
32:04It's okay.
32:04It's okay, Sean.
32:09You're a couple?
32:15I made a decision about my son's life based on your opinion of your boyfriend?
32:21Taryn, I'm so sorry.
32:23Isolating popliteal artery.
32:34Next.
32:34In size vessel transversely.
32:37Use Fogarty catheter to complete the embolectomy.
32:40Confirm flow with angiogram.
32:42How's our blood?
32:44Maxing out on procoaculants, anti-hemophiliacs, and recycling every last drop of cell saver suction.
32:50And we're still down to our last 100 cc's.
32:52What about in other hospitals?
32:54There was a multi-vehicle crash on the 280.
32:56Nobody has anything to spare.
32:58I'll just have to work a little faster.
33:00Removing catheter.
33:02BP's falling.
33:04Dammit.
33:05Catheter toward the artery.
33:07Clamp and suction.
33:08There's not enough blood.
33:10His hematocrit is on the floor.
33:11He's dying.
33:20You got your test results hours ago.
33:23You need to go home.
33:26I can't.
33:26Mason is hanging on, but we have used up all the oneg and aneg blood.
33:39We're having some medevac from LA.
33:41How long will that take?
33:44Another couple of hours.
33:53You don't think it'll last that long?
33:56You don't think it'll last that long?
34:02We're hoping.
34:26You don't think it'll last that long?
34:33I'm in a grave.
34:56Sometimes we can't.
35:07Every parent has an overwhelming need to protect their child from horrors.
35:12It's the price of parenthood.
35:17Taryn donated twice the typical amount of blood, and Mason needed every drop of it.
35:23It's gonna be a long night.
35:25Where are you going?
35:32Yeah, you should come with.
35:34Where?
35:34You ever read Hansel and Gretel?
35:36That's what you were reading?
35:37I thought you were doing research.
35:47The scans show no sign that the fragment tore major brain tissue, and there were no significant
35:51bleeds or clots as it migrated, which means it didn't cut a new route. It took a trail that was
35:56already there.
35:57Okay, that wasn't helpful.
35:59It weaved through CSF spaces or sulsai in between the brain parenchyma. If so,
36:04it left us some breadcrumbs.
36:05Heme, products, staining.
36:07Along the way, and we can use a rigid three millimeter endoscope, find the trail and take that trail
36:11all the way to the bullet without damaging the brain.
36:35It's okay, it's decaf.
36:36You shouldn't feel guilty about being happy.
36:46I didn't feel happy. Not right then. I felt scared.
36:55For us?
36:57And for me. Me too. You're so different and so angry.
37:06But you are so strong, and I'm...
37:13You don't think you're strong?
37:16No. Not strong enough for this.
37:21This doesn't usually happen. This isn't supposed to happen.
37:27And the way we've been coping with it has nothing to do with whether we're good parents.
37:31Strength doesn't matter. It's compassion.
37:37And the way you've treated us, you're going to be a great mother.
37:43Mason made it.
38:00Thanks to Taryn.
38:01Ethan made it.
38:08Thanks to Park.
38:09They're in the ICU.
38:27They want to see their moms.
38:28I don't know.
38:43They want to see them.
38:47It doesn't matter as بد.
38:50They're in the ICU because they've got one of their families.
38:54Take my hand, breathe a small leaf.
39:20The shore is the sting of these.
39:30Now push the folds of life to dust.
39:38Put your heads to sleep tonight.
39:46So dream.
39:47I'll buy you a cheeseburger.
39:52It's 6 a.m.
39:55I figure we should talk.
40:01I'd like that.
40:17You saved Ethan's life.
40:19Nice job.
40:20I was ready to walk.
40:22And most people would have felt for me, supported that decision.
40:27You saved his life.
40:30Thank you for that nice Albie had completely inaccurate thought.
40:35You just needed some encouragement.
40:38You want to come back to my place for a little more?
40:48It's been a long day and night.
40:53I think we should stop seeing each other.
40:56You're good for me, but just sleeping with you isn't.
41:10I want to give Heather a chance.
41:12Good for you.
41:13She's such a wimp.
41:14She'll make you very happy.
41:17She's such a wimp.
41:18She's such a wimp.
41:19Yeah, she's such a wimp.
41:20She's such a wimp.
41:21She's such a wimp.
41:22Okay.
41:23Do you know how I feel right now?
41:38No, I don't know how I feel right now.
41:44Lucky.
41:47I think I feel tired.
41:52And lucky.
41:58Ibrah!
42:07Leah?
42:09Leah?
42:10Shine.
42:11Leah?
42:12Okay.
42:13No.
42:14Okay.
42:15Help!
42:17Help!
42:18I need help!
42:20Please help!
42:22Help!
42:23Okay.
42:24Help!
42:25Help!
42:26Okay.
42:28No.
42:31You can find me.
42:32Let's cast out the
42:34PDF on the PDF gera.
42:36Choose a PDF!
42:37Anyway…
42:38Go!
42:39All!!!
42:40Go!
42:41Go!
42:42You're finished.
42:43Give me hook!
42:44You're done!
42:46There're something in the world.