The.Good.Doctor.S01E03
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00:00Previously on The Good Doctor
00:02How hard can it be to just act like a normal human being?
00:06No!
00:08Will you stop petting that stupid rabbit?
00:10We're never going home again.
00:12We have each other and that's all we need.
00:18Your fiancé sure can't handle a knife.
00:20He's got a serious deficit.
00:22So are you proud or disappointed?
00:24Marcus, stop making everything so personal.
00:26You've wanted his job since day one.
00:28Everyone in this room knows that.
00:29How did you...
00:30It's my department. It's my job to know everything.
00:32Since I worked for you, doesn't that make all this actually your fault?
00:35Well, I'm sorry. I stopped listening after I worked for you.
00:37A surgeon needs to communicate.
00:39Can Dr. Murphy do that? Can he do that under stress?
00:41Can he do that knowing that a human life literally hangs in the balance?
00:59A's?
01:00Can I do that?
01:01Can I do that?
01:02I can't do that.
01:03Oh, my God.
01:33So, I'm in the middle of Uncharted, and I'm dead.
01:45Can I borrow some triple A's?
01:47I'm your neighbor.
01:50Hello.
01:5134.
01:53I moved in last week, 33.
01:56Yeah, I know.
01:57I work at a hospital.
01:59That's cool.
02:01Yes.
02:01Triple A's poor for four.
02:06Batteries?
02:07Right.
02:08Do you have any?
02:21Triple A batteries.
02:24Piece of advice, don't be the cat.
02:27What cat?
02:28Beat it once, and I'll never leave you alone.
02:30Thank you for the batteries, neighbor.
02:36You're welcome.
02:37You're welcome.
02:37Surgical.
02:50Well, you're in luck, because I'm not a nurse, I'm a surgical resident.
02:55How can I help you?
02:56We got a liver for Chuck.
03:09Where?
03:10SF Municipal Hospital.
03:11In how long do we have body-to-body on a liver transplant?
03:13Hey, ours.
03:14You don't know the longevity of a liver?
03:16This is a teaching hospital, and I'm the teacher.
03:19You and Murphy, you're on organ pickup.
03:20Check the health and bring the liver back from SFM.
03:22I was at Chuck's intake.
03:24I'd really like to be-
03:25Now you're going to be at the intake for his new liver.
03:27Jared, get Chuck down here and get him prepped.
03:29We got eight hours on this thing, and the clock starts ticking now.
03:32I'm not interrupting your pregame, am I?
03:57You think this is my 400th breast reconstruction?
04:00The board should give me a plaque.
04:03What's up?
04:04You're 4 p.m.
04:06The VIP, Wanamaker.
04:07Yes, the free flap.
04:08He's checked into the penthouse suite, resting comfortably, I'm sure.
04:11I've been working on him for a while now, and he's close.
04:14He's real close to making the foundation his tax relief.
04:17That's good to hear.
04:18I want aces on this.
04:20Everything perfect.
04:23That's good to know.
04:23I was going to phone it in.
04:27Is this the chairman's version of a pep talk?
04:33I'm looking for a fail-safe outcome on the procedure,
04:36and I want you to use Dr. Melendez as your second.
04:40That's your fail-safe, Melendez?
04:43I'm your chief of surgery.
04:44It's just a precaution to guarantee a perfect outcome.
04:48Are you doubting my abilities?
04:49Wanamaker is important.
04:52Everything has to be perfect.
04:53You said that already.
04:54I'm your fail-safe.
04:57The VIP will be fine.
05:04How are you doing?
05:06I know these sounds and everything might be a lot for you.
05:09It's hard for anyone.
05:11I like helicopters.
05:13I didn't know you've been on a helicopter.
05:1515 minutes to San Francisco Municipal Hospital.
05:39You do know what this is, right?
06:04Well, I'll tell you what it is.
06:07It's scut work.
06:09Jared gets the golden ticket, and we get pizza delivery.
06:14The runners just go round and round, Sean.
06:25They don't change.
06:26How do I talk to you?
06:47So, Chuck, any chest pain in your shorts of breath?
06:49No.
06:50Any alcohol in the last six months?
06:52No.
06:53Just a quick pinch.
06:53Are you swelling in your limbs?
06:55It's like Walmart.
06:56I'm Black Friday in here.
06:57Things feed way up when you're having a transplant.
07:00I like it.
07:01It's good energy.
07:02So that's a no on a swelling?
07:04No.
07:05No.
07:06I feel lousy all the time, pretty much.
07:09But I've got a second chance.
07:12You know, with this liver.
07:14Sure.
07:14Oh, excuse me.
07:16It's my daughter.
07:17I already spoke tomorrow.
07:20And Uncle Tommy, too.
07:22Yeah, I need to see your face.
07:25All right.
07:26I love you.
07:27All right.
07:29She just graduated from law school at Cal.
07:31I told you that.
07:33No.
07:33Congratulations.
07:35Must have told Dr. Brown, then.
07:37Where's Dr. Brown?
07:38Here's your liver.
07:47I'm going to need you to sign for it.
07:49Standard operating procedure is to leave the liver in the safety of the body cavity.
07:52I'm aware of the procedure.
07:53We had a John Doe at the top of the registry, but that John Doe died before we could plant.
07:58How long ago did you take it out?
07:59Three hours.
08:00We just lost three hours.
08:02Technically, three hours and five minutes.
08:04True clock's on the cooler.
08:05It can't go below 39 degrees or above 47 degrees.
08:09I'm going to sign for it.
08:17Tissue looks healthy.
08:21What are you doing?
08:23What are you looking for?
08:25What's he doing?
08:26I'm not sure.
08:34John.
08:35What are you looking for?
08:36Masses?
08:36Cists?
08:37They're clean.
08:38Think we'd miss a tumor?
08:40There's nothing there.
08:43I know.
08:46There's nothing there.
08:48Okay, the liver needs to go back into cold storage, and we gotta go.
08:50Then I'll release the vascular clamp and let your blood perfuse a new donor liver.
09:00That's it?
09:01Connect the bile ducts, sew you up, and then we wait.
09:04Does the new one always take?
09:06Over 70% of the time.
09:07Well, I can live with those odds.
09:10You get some rest.
09:12See you later.
09:12He looks at something I don't know what he's looking at.
09:16Is he, you know, is he curious?
09:18Is he concerned?
09:19He won't answer me.
09:20You're having trouble communicating with him.
09:22It's a weekday.
09:23It's Sean.
09:24Hmm.
09:24Let's see.
09:25That seems about right.
09:25He seemed different at the hospital.
09:28You know, I could kind of talk to him.
09:29Yeah, well, he knows what to expect in the hospital.
09:32Outside, everything's different.
09:33Everything's new.
09:33New stimuli.
09:34So what do I do?
09:35I don't know what he's thinking.
09:37Claire, you're not gonna figure out what he's thinking, so don't even try.
09:40In fact, if he's thinking about something in his own mind, just let him be.
09:43I'd appreciate it if people gave me the same courtesy.
09:46I thought with your history...
09:47Claire, if you want to connect with him, you're gonna have to figure out your own way in.
09:53How's Chuck?
09:53Chuck?
09:54Chuck's fine.
09:54He's waiting for a liver, so come home, please.
10:02Doctor.
10:04What's up?
10:05I just wanted to thank you.
10:07I haven't done anything yet.
10:09You have.
10:10You've given my dad home.
10:17You know Chuck was my first patient?
10:20Six months ago.
10:21First day at St. Bonaventure.
10:22I get a liver failure.
10:24You're the nicest guy in the world.
10:26I wanted to be the one to give him the good news.
10:29We're not leaving.
10:32You said you like helicopters.
10:34We're not leaving.
10:35We made it here safe.
10:36We made it here safe.
10:37Yes.
10:38We're not leaving.
10:39We're not leaving.
10:41Fog's rolling in too quick.
10:43Does that mean it rolls out quick?
10:47Could be an hour.
10:48Could be three.
10:49Don't know.
10:50We're out.
10:51Okay.
10:52We're going to need a new ride.
10:58Excuse me.
10:59I need an ambulance to St. Bonaventure.
11:01Sorry, I just don't have the EMS.
11:02I've got to pile up on I-80 and four other vehicles out on call.
11:05Not one ambulance.
11:06let me be clear this is emergent it's time sensitive honey this ain't hurts
11:15what about a police escort
11:20that can be arranged
11:23don't want to ruin the festivities if i could just get a few minutes with my patient alone
11:36mr want to make your go
11:41dr andrews
11:45how are we doing today incomplete let's see what we can do about that look here
11:54well looking not too bad considering we cut out a tumor less than two weeks ago
12:01yeah i've been walking around with a hole in my mouth
12:03ever drink scotch with a hole in your mouth
12:06waste a good scotch
12:09we needed to give it time to heal
12:11yeah yeah you told me
12:13have you continued to smoke
12:16constricts the vessel slows the healing
12:20not a quitter
12:21we are going to grasp some skin
12:27from your leg
12:29and fix that cheek up better than new
12:33i'm a real estate guy
12:35there's an old saying
12:37you can have it fast you can have it good you can have it cheap
12:39pick two
12:40it's not gonna be cheap
12:43yeah i like doctors like you
12:47you're good
12:48you know it
12:50yes it was harvested before we got there
12:55we're waiting for transportation
12:56the itinerary and leg clock have changed
12:59um four hours and fourteen minutes
13:02are you talking to the hospital
13:04have someone tell dr glassman that i might be late for our lunch please
13:08yeah okay
13:11so how do you know about the weather
13:19is it some kind of gift
13:22come on i gotta know
13:26i watch sean murphy as zeus
13:28i watch the weather channel
13:31are you my doctors
13:39sean
13:42sean we gotta go
13:44you're home
14:04dad and mom have had a tough night with your brother and all
14:08come on let's go
14:11i think we'll get there much quicker if we drive sean
14:32could you turn off the flashers please
14:41what's the patient's name
14:53i told you it's charlie
14:55no
14:55no
14:57no the the donor
14:58what's his name
14:59what the liver
15:01oliver
15:05oliver
15:08hey you got a second
15:19what's up
15:20just waiting on a liver
15:23transplant
15:24everyone wants it
15:25they trade their liver to do the liver
15:28hey look you want some help on this free flap
15:32what's his name
15:33wannamaker
15:34right
15:34you got the transplant that should keep any attending busy
15:37i can make time
15:39hey okay come to you about this
15:41look i get it you're the chief
15:43that's right
15:43look this this isn't a coup
15:45what is it
15:46it's about making sure this hospital is first on wannamaker's donation list
15:50i'm aware of the stakes
15:52thanks for coming by
15:54you know it doesn't make you any less of a surgeon having me in there as your second
16:00i'm the chief you're my attending
16:01i can't argue with that
16:03and we both know what your presence in my own will say
16:05it's not my intention
16:07it's the impact attention doesn't matter
16:09thanks
16:10but i'm good
16:12these can't be right
16:27whatever it is it's right
16:30chuck slaps
16:31it's gonna be a false flag or a bad reading
16:33for what
16:34medications foods
16:36i don't know
16:36look if this is right we lose our transplant
16:42sorry that doesn't change the results
16:45there's alcohol in your system
16:48if you drink
16:50the blood doesn't lie
16:52run to lab again
16:57eta to st monumenture
17:0270 minutes
17:03what are you looking for
17:11what do you see
17:13i have a girl neighbor
17:16okay
17:18is she nice
17:21what does she do
17:24does she have a boyfriend
17:25do you know her name
17:29what the hell are you looking for
17:37on the scans
17:38what
17:41the temperature's going up
17:43officer we need to find a place with ice
17:46like now
17:47i tested it chuck
17:52and retested it
17:53talk to me
17:56you know the six month rule
17:57was it a craving
18:00three days ago
18:01my daughter's graduation
18:04nobody in my family
18:11had ever gone to college
18:12there she was
18:17my little girl
18:19wearing the robes
18:23for just that day
18:26i wanted to be normal
18:29so why
18:33i had a glass of champagne
18:36you're out of ice
18:45it's broken
18:46supermarkets about three miles down
18:47we don't have time
18:48the temperature's already at 47 degrees
19:01we can't let it go any higher
19:03you're gonna help me
19:10sweet
19:13you'll like it
19:14what should i do with him
19:28child services
19:30down in cheyenne
19:31it's 150 miles
19:33and help us turn the area
19:34and send me back to the parents
19:35that's normal
19:37no no no
19:40he doesn't seem to want the parents
19:42that's for sure
19:42dating the hospital
19:45social worker there
19:46that won't work
19:53how do you know
19:56sean
19:57you're right
20:01it's not working
20:01why
20:02sean
20:04are you even listening to me
20:07just one drink
20:08that's what he said
20:09should i inform the registry
20:12how long would you chuck out of the drink
20:15three days ago
20:16give me your marker
20:17what type of alcohol
20:35champagne
20:37what percentage of alcohol is that
20:39i don't know what's the difference
20:40they got your phone and look it up
20:41i don't know why it's not working
20:45it needs to be submerged to cool
20:47hey
20:48every five seconds is an excel
20:51why did you answer me last time
21:08but not before
21:09was it because i was angry
21:12was it random
21:15why can't you answer my questions
21:18this better work
21:24it will work
21:26you answer when i don't ask
21:30you don't like questions
21:36i don't
21:37i didn't do well in calculus
21:46this is algebra
21:47with his severe cirrhosis
21:49his alcohol clearance rate
21:51is one milligram per deciliter per hour
21:53one drink say eight ounces
21:58it's champagne six ounces tops
21:59play conservative
22:00eight ounces
22:01results in a blood alcohol level
22:03of 39 milligrams per deciliter
22:06one standard drink
22:07now the purpose of abstinence
22:12at least according to the transplant registry
22:14is
22:15patients who kill their liver
22:16due to excessive drinking
22:17prove they can be sober
22:17let me see that report
22:210.02
22:23check was telling the truth
22:27he did just have the one drink
22:28he didn't fill up the wagon
22:30corporate loves its data
22:32i'm not sure it'll actually make a difference
22:34but
22:35it does give us an argument
22:36you're a genius
22:39you don't like the cafeteria food
22:54you only make one thing well
22:56what does it say
22:57when the staff sees the president of the hospital
22:59not eating their cafeteria food
23:00well it says the president of the hospital
23:03isn't allowed in the kitchen
23:04you sat down
23:06what can i do for you
23:07i'd like your advice
23:09really
23:10where's Aoki
23:12did she die
23:12this was a mistake
23:15that's insulting
23:16sit down
23:16at least hear what i have to say
23:18and then decide it's bad advice
23:20sit
23:21Aoki is pushing Melendez on me
23:25for the vip
23:26ah
23:27you didn't get the email blast
23:28rich people aren't allowed to die
23:30in this hospital
23:30you're not the young star anymore
23:32Melendez is
23:33i know that
23:34and you're upset about the why
23:36why does Aoki think that
23:38you should be asking who
23:40who
23:40i know who
23:41Melendez
23:42who are you
23:43are you a chief who wants to be top surgeon
23:46or are you a chief who wants to be president
23:48because if it's the latter
23:49take your ego
23:50shove it in the cupboard somewhere
23:52and start acting presidential
23:53dr melendez
24:05dr melendez is going to argue to the board that you get this liver
24:07i think it's a pretty good argument
24:08do i deserve it
24:11i'm not sure that's relevant
24:14you know
24:18when you're dying
24:20and i've been dying for a long time
24:24you start to think about your life
24:28i haven't led a great one
24:32i could have been a better dad
24:35a better man
24:38he was flash
24:42drank too much
24:44you know i also have a son
24:47yeah
24:49first marriage
24:50i haven't seen him in three years
24:54getting a liver is not a second chance
24:58and it's not a reward for being perfect
25:00it's just what we can do
25:02maybe
25:04but on the registry
25:07all of us wait in line together
25:10and i see these
25:13these people here
25:17waiting
25:18i know their faces
25:21even their names
25:24they all have stories
25:27we're in it together
25:30and i
25:32i broke the
25:35chuck
25:39chuck
25:41cold blue
25:41chuck can you hear me
25:43it's got blood in his oesophagus
25:59it's got very sore bleed
26:01all right
26:02stay lean wide open
26:03i've been crossed four units
26:04i'm gonna ban the main
26:08pressure's coming up
26:21chuck had a very sore bleed
26:30what was in there
26:44portal hypertension decompression
26:45is it finished
26:45you've got three months to live
26:48maybe
26:49you have to be six months alcohol free before you register eligible
26:54and you said you weren't good at math
26:56he gets this one or he dies
27:00you know what this thing looks like at 8 a.m.
27:12i need a police escort to work every morning
27:14280 south
27:15where all roads meet
27:17no they don't
27:22what's wrong with him
27:34he's autistic officer
27:36what's that mean
27:37does he need to be in a hospital
27:39last place he should be is the hospital
27:41what are you doing
28:06sean
28:08what are you thinking
28:09this isn't a question
28:18i just
28:18i don't know what you're looking for sean
28:21yes
28:22i can feel it
28:23it's firmer
28:23and
28:24i don't know what that means
28:27there must be a clot
28:29but there isn't a clot
28:30the scans show no clot
28:31it's because
28:41the scans were taken before they harvested the liver
28:44prior to the liver being flushed with uw solution
28:47it's dying
28:48to preserve the liver
28:49they replaced all its blood with a solution to protect it from the cold storage
28:52but they must have left some blood behind which clotted
28:54how long does st bonaventure
28:55less than 30 minutes
28:56can't wait
28:57we have to immediately remove the clot
28:59and flush the left lobe to protect it from the ice bath
29:01okay we need to stop the car
29:03here
29:03yes yes we need to operate right here right now
29:06flushes from the right
29:22so the left lobe starting at the middle hepatic vein
29:26less intrusive cut would be along the falciform ligament to allow access to segment three
29:31when you locate the blockage i'm gonna have to remove it
29:33i need a straw to cannulate the vein please
29:40i need a straw to cannulate the vein please
30:00i need a straw to cannulate the vein please
30:03there's a straw in my cup
30:04uw solution will stabilize the cell walls
30:15preserve the integrity of the organ
30:18this is better than having a baby in my car
30:36how are you feeling
30:44like i'm writing a blank check
30:46you're gonna be fine
30:48you're the best
30:49this bleed
30:58these varices
30:59this isn't good news
31:00tells us that your liver failure has progressed considerably
31:04how much
31:06you have two to three months
31:08we're getting the liver today
31:11in an hour
31:11i don't get it
31:12you didn't tell them
31:15what
31:16your father had a drink
31:18he had one glass
31:22transplant registry doesn't quantify things like that
31:25so he doesn't get the liver
31:26i'm gonna try and get it for him
31:28why are you a car salesman
31:30what are you gonna try
31:31the final decision is out of my hands
31:33and if you fail
31:39i'm gonna do everything that i can
31:42i'm meeting with the committee in ten minutes
31:45excuse me
31:49i handed my dad the drink
31:57it doesn't matter how it happened
31:59he didn't want it
32:01he just wanted to make me happy
32:02if you let him die
32:04it will have killed my father
32:05It was a glass.
32:35A glass of champagne at his daughter's graduation.
32:37I have the labs to prove it.
32:39Chuck didn't fall off the wagon.
32:40He had one drink.
32:41Never went back.
32:42The transplant registry guidelines don't play in the gray for a reason.
32:45These guidelines are so arbitrary.
32:47Have one drink and you die.
32:48A couple pills of ecstasy, no problem.
32:50Hepatitis B from careless sexual practice.
32:52No, nothing at all about that.
32:54So what do you want us to do?
32:55Throw out the rules?
32:56I want us not to hide behind them.
32:58We do have a responsibility.
33:00Without the rules, we're playing God.
33:02We need the rules.
33:03Does that help you sleep better at night?
33:04Yes, it does.
33:07We have one liver today and 800 people in this state need it.
33:12I don't want to be haunted by the other 799.
33:14Your guy hasn't earned it.
33:15He knew the rules.
33:16And this, it's a technicality.
33:19Well, the drink is a technicality.
33:21Jessica, what's the legal version here?
33:23It's significant.
33:24If we move forward with this transplant, we could lose privileges on the registry.
33:29If it was discovered.
33:30If it were discovered, how narrow can you be about this?
33:33Dr. Glassman, where are you on this?
33:35I can make a good argument either way.
33:37Go ahead, please.
33:39Better to remove the arguments altogether.
33:42What the hell is he talking about?
33:43The hell I'm talking about is that we have a patient in this hospital who needs a liver.
33:48We also just happen to have a liver that needs a patient.
33:51It's not that simple.
33:52It is that simple if you consider the patient.
33:54Rules are secondary.
33:56But is saving this patient worth the risk of not being able to save hundreds of others?
34:03I don't have hundreds of patients right now.
34:05I have one.
34:06His name is Chuck.
34:11Blood pressure steady.
34:12Donor vessel to the facial artery.
34:14And we're ready to close him up 10-o-colipropylene in vascular forceps.
34:18Nice work, Dr. Andrews.
34:23What do we have here?
34:26A hematoma?
34:27I can see that.
34:28Let's find its source.
34:29Sponge, stick, and probe?
34:31Sponge, stick, and probe?
34:36It's not my recipient artery.
34:38Heart rate is dropping.
34:39Whatever it is, it's compressing his carotid.
34:41I can't get deep enough here.
34:42I need better access.
34:46We move to zone three from the outside.
34:48Zone three is a minefield.
34:49I'm aware, but we need to do this.
34:51Whatever you're gonna do, do it quick.
34:53It's strangling him from the inside.
34:56Get me Melendez.
35:03We made it.
35:04Yep.
35:05We're here.
35:06Downstairs.
35:07Coming up.
35:08No, no, no, no.
35:09Jared, you're not gonna believe.
35:11What?
35:12Yeah.
35:13Got it.
35:30Um, Chuck's been moved to the bottom of the list.
35:34San Jose, Presbyterian, you're coming to get the liver.
35:36Are you coming to get the liver?
35:44Oxygen sats tanking.
35:45Help him to 100% O2.
35:46You have to go through the mandible from the inside while I probe for the source.
35:49It's the only way.
35:50Loops.
35:51You have to be careful in there or he'll get a stroke.
35:52You just have to be careful then.
35:53Give Dr. Melendez the mandibular channel retractor and number five bone cutter.
36:06It's 29 minutes.
36:18It's a lifetime.
36:20This is amazing.
36:21Gotta go, the whole team is waiting.
36:22Nine minutes.
36:23It's a lifetime.
36:25This is amazing.
36:26Gotta go.
36:26The whole team is waiting.
36:27His name is Oliver.
36:42It was a good day.
36:47We saved a life.
36:50Just not Chuck's.
36:52It's not your fault.
37:19I want to believe that.
37:22It will never be fixed.
37:28So we saved a few things that were spared.
37:33And brought it to the ground.
37:36It will never be fixed.
37:38Because you're always building better.
37:42The second time around.
37:44It will never be fixed.
37:57It will never be fixed.
38:02It will never be fixed.
38:03Hi.
38:14Hello.
38:15Are you a lab guy or something?
38:17I'm a surgeon.
38:18That's insane.
38:19May I have my batteries back?
38:23The ones you borrowed?
38:26Yeah.
38:27You could still see where the water was.
38:33Hello.
38:39What's your name?
38:41I'm Leah.
38:43I'm Dr. Sean Murphy.
38:44Nice to meet you.
38:50So we saved a few things that were spent
38:54And brought it to the ground
38:58Cause you always build it better
39:05The second time around
39:06I drove past the place where we used to live
39:09Where you said you never wanted kids
39:14I drove past the place where we used to live
39:21I drove past the place where we used to live
39:34Where you said you never wanted kids
39:39Sometimes something so broken can never be fixed
39:47Stay with me tonight
40:16And tomorrow we'll figure out the rest
40:21You always build a man
40:25You always build a man
40:41You always build a man
40:46The second time now
40:49You always build a man
40:50The second time now
41:00You always build a man
41:01The second time now
41:03You always build a man