All language subtitles for The Good Doctor 2x09 - Empathy

Shaun...

You need to give me
your driver's license.

No, I don't.

Do you remember

- the memory test I gave you?
- Vividly.

Yes. It demonstrated you have a deficit.

A deficit; you shouldn't be driving.

Dr. Blaize agreed.

Shaun, that test was supposed
to be between us;

that's why I didn't want
to do it at the hospital.

Yes, your doctor needs to be informed

of the results of all your medical tests.

Even tests that are done at home.

Shaun, I've been driving
for like half a century.

I'm an excellent driver, okay?

I don't need to give you
my driver's license.

Okay. Then I'll have to notify the DMV.

Dr. Glassman?

You're not gonna notify the DMV, Shaun.

Yes, I will notify the DMV.

Shaun, you will not notify the DMV.

Dr. Glassman,

if you don't give me
your driver's license,

I will notify the DMV.

Dr. Glassman?

George Reynolds, 28,

sudden onset of arm and leg weakness,

right facial droop, and trouble speaking.

CT confirmed a middle cerebral
artery embolism.

I booked us
into interventional radiology.

When did you first notice
your symptoms, George?

About, uh, four and a half hours ago.

Wait, what's wrong with me?

You may be having a stroke.

You're on monthly injections of Lupron?

For three months.

That may have caused this.

Do you have prostate cancer?

No. I-I was diagnosed
with atypical hyperplasia.

That shouldn't have any effect
on what we're gonna do now.

We're gonna take care of you, George.

Don't worry.

This is local anesthetic;

you'll feel a pinch.

Are you a real doctor?

I'm Dr. Shaun Murphy.

People ever call you Murph?

No.

I'm going to make a small incision

so we can insert the tube
and re-inflate your lung.

What do they call you, Billy?

CraterHead, Volcano, ThreeEyes...

those are just the creative ones.

Hold tight. Here comes the tube...

You guys really know what you're doing.

Yes, we do.

We'll order an MRI for your lungs.

Then we will fix
your fractured eye orbit;

that will require surgery.

What do you say
we fix your forehead, too?

You could do that?

- I think so...
- I don't think so.

It's a pre-existing condition,

and it's not medically necessary.

It shouldn't be approved.

...Captions by VITAC...

Synced & corrected by -robtor-
www.addic7ed.com

The MCA clot is obstructing
all distal flow.

Anti-androgens aren't
indicated for hyperplasia...

He said atypical.

You think he's lying?

Maybe he's gender transitioning.

Aside from cancer, there aren't
many other indications.

Let's focus on what we do know.

Feeding the catheter.

Suctioning the thrombus,

and he's recanalizing. Slowly retract.

Whatever his reasons are
for taking anti-androgens,

hopefully there are options.

He either drops them or
he's gonna keep having strokes.

The forehead repair would be
expensive and cosmetic...

It's not about prettying him up;

it could give him a new life, friends,

maybe a few less beatings.

Stopping the beatings is the guards' job.

You really don't have
any empathy for Billy?

Empathy is a bad reason
to fight for someone.

If empathy makes me
only want to help patients

who are from Wyoming or have ASD,

then that's very unfair

to all my neuro-typical patients
from Idaho.

I need to take those drugs.

They caused your stroke.

We don't think you have hyperplasia.

If you tell us the real reason,

I'm sure there are
other safer treatments...

No, there aren't!

If you're transitioning,
there are alternatives...

I told you why I was taking the meds.

George, we are your doctors;

we need to know the truth.

We're not gonna tell anyone.

I'm not transitioning.

And I don't have hyperplasia.

I have problems...

with my sex drive.

I know it sounds stupid,

like why can't I just control myself

but...

It's all I think about.

It's all I can think about.

I can't work,

I can't socialize,

I can't have a life.

And those meds are the only thing

that makes it even remotely tolerable.

They'll kill you.

The residents have a betting pool

on who you're going to appoint.

As your replacement as Chief of Surgery,

the decision needs to be made
with decorum and expediency.

I haven't quite gotten around
to analyzing...

You've had little face time
with your attendings

since you became president.

You need to correct that.

I've scheduled your announcement.

You've got two days.

- Where is he?
- He's gone;

signed out AMA.

- I tried...
- How long ago?

Five minutes...

Why are we in a hurry?

I was researching
alternative meds for him.

Realized Lupron didn't make any sense.

Prescribing anti-androgens
for sexual urges

is like hitting a mosquito with a mallet.

Unless they're deviant urges.

We might've just released
a child molester.

Should we call the police?

We can't.

We have no evidence of a crime.

Lim's at 3 to 2,

Melendez is just behind at 2 to 1,

Cooperberg's 7 to 1,

and if Dartling,
or anybody else comes in,

you can retire.

Andrews might bail on Melendez

when he finds out our patient bolted.

Which is why Melendez is now 4 to 1.

Pari-mutuel betting is very exciting.

Do you need empathy to be a good doctor?

No. I think it can interfere

with effective decision-making.

She's just saying that
to avoid hurting your feelings,

thus making her fake point for real...

her empathy made her lie to you.

I think you just agreed with me

and insulted me at the same time.

I think empathy's very important...

Telling the cold hard truth
even when it hurts,

sometimes is the
most empathetic thing we can do.

Which is what I'm doing
for Shaun right now.

You're welcome.

I have autism

which means I have a deficiency
of mirror neurons,

which inhibits me
from emotionally trading places

with people, which makes empathy
very difficult.

Does that mean I can't be a good doctor?

No, it doesn't.

We all have our strengths
and weaknesses, Shaun.

One of Claire's is making sure
everyone feels validated.

The creep is back.

Is George having another stroke?

No.

Severe lacerations to the scrotum.

Did you give him anything for pain?

Morphine. Four milligrams.
And I notified the cops;

I think it was a hate crime.

Yeah, I don't think so.

All right.

On my count.

One, two, three.

We'll take it from here.

I'll pack him and prep him.

You did this to yourself, didn't you?

I think I know what kind
of urges you've been having.

I'm not a monster.

I never touched anyone...

any... child.

My sister and I were always
best friends...

but then she had children.

If I can't keep taking the drugs...

...I had to do this.

Home surgery tends to not have

the results you're hoping for.

You did a lot of damage

but your testicles are unscathed.

Please... finish the job.

I say we do it; he's a pedophile.

No, he's not.

He just told us he was.

He has never acted on his urges,

and he's asking us to do something

to ensure he never does.

He is a decent person trying...

I'm confused.

What do you want to do with him?

Treat him like a patient
with a diagnosis.

Put him on antidepressants,

refer him to a urologist,
give him a psych eval.

Let the experts determine
if he should have a castration.

Psych eval? Antidepressants?

When we refer people for counseling,

how often do they get cured?

I am looking to help him
manage this dis...

And if they don't get cured,
what happens?

They get more depressed,
can't cope, quit jobs,

maybe kill themselves?

All bad, but not... rape-a-child bad.

So what are you going to do?

We can't ethically remove healthy organs

for crime prevention.

We don't amputate a kleptomaniac's hands

to prevent them from stealing.

Hands have many purposes;

the balls of a pedophile have but one.

Set up his referrals and patch him up.

How long you been in Foothills?

Nine months...

Time flies in Juvie.

Any visitors?

I don't have a granny
bringing me cookies,

if that's what you mean.

This is why empathy is bad.

You're talking to our patient
because you like him,

which is causing him to move,

which is affecting our imagery.

He's scared.

I'm talking to him to calm him down

which is improving our imagery.

The fact that I like him
is beside the point.

You grow up in San Jose?

East Paly... but I got out
of there as soon as I could...

I was 15.

Your parents still there?

Mom's gone...

dear old Dad is... terrible.

Siblings?

Little brother...

He's gone too...

Crappy dad. Lost his brother...

I mean, you really don't ha...

He's not scared.

He's short of breath

because his diaphragm is lacerated.

His stomach has passed through that tear

and is now in his chest.

Billy needs emergency surgery
on his diaphragm.

The defect reaches all the way

from the center
to the anterior costal margin.

So what do we need to do?

Divide the inferior pulmonary ligament

to bring the lung upwards.

Uh-huh. Mesh.

Whoever kicked him was
wearing some serious footwear.

And they'll be waiting for him
when he goes back.

Unless we help him.

Dr. Park wants to fix his forehead.

The Constitution guarantees prisoners

get the same care as everyone else.

Most non-prisoners can't afford
cosmetic surgery.

He would be getting better care
than everyone else.

Kid is smart and personable
and puts up a great front.

But he's scared to death.

And he got 36 months for selling weed;

a crime that doesn't even exist anymore.

You think his life
would be anything like this

if he didn't grow up
with a massive dent in his head?

Sorry, I'm not convinced.

Is that because you don't have
any empathy for Billy?

No. It's because I agree with you:

it's expensive, risky and unnecessary.

But empathy can be
an invaluable motivator,

Dr. Murphy, that truly connects
the physician

with their patient.

Is he still up there?

Yes he is.

We can't do the castration, George.

Not without the proper
psychiatric clearance.

That'll take forever.

Just a few months.

A few months is forever.

Binge watch your favorite shows,

catch up on your reading.

You attracted to men, Dr. Reznick?

Yes. Adult men.

And if that were... reprehensible,

do you think you could stop?

You have no idea what it's like

to live with these thoughts.

I hate them,

and I hate myself for having them.

But I can't stop them...

and I'm afraid of what I could do.

We will start the process immediately.

In the meantime, we'll transfuse you,

get you on antibiotics...

No. I'm refusing treatment.

No transfusion. No antibiotics.
No repair.

Let 'em rot.

We have something in common.

Neither of us has a driver's license.

How do you feel about
not having a driver's license?

I'm pissed, Shaun.

You feel pissed.

Yes, I feel pissed. I feel very pissed

because something important
was taken away from me.

And by a friend.

You feel very pissed

because something important
was taken away from you...

and by a friend.

And parroting everything I say
isn't helping.

I'm finding commonality, Dr. Glassman,

and inquiring about your emotional state,

and actively listening
by restating your responses.

"External corroboration enhances
our sense of self-worth."

Okay.

The day after I got my driver's license,

you want to know what I did?

I went out and bought
a 1963 Galaxie, Midnight Blue.

1,255 bucks;

every penny I earned
for the past three years

working in a gas station.

How do you think that made me feel?

You liked it?

No, Shaun. I loved it.

You want to know why?

Because a car to a sixteen-year-old kid

means independence,

which means he can go wherever he wants

whenever he wants.

And that doesn't change with age, Shaun;

in fact, it means even more.

When you took my license,
that's what you took from me.

I don't expect you to understand.

So you don't have to pretend.

Hey. Is Andrews stalking you?

- Yeah.
- It's annoying.

We need to stand together
and tell him to back off.

I'm not telling the president
he's annoying.

He's infringing on our autonomy

and inhibiting the free flow of ideas,

both of which affect our ability

to deliver the best patient care.

That sounds slightly better.

Okay. I'm in.

- Are you?
- No. Of course not.

The last thing I'm gonna do
right now is confront him;

I'm the front-runner.

Not according to Vegas;

I'm three to two.

Guess they don't know that you
have double my mortality rate.

I'm a trauma surgeon;

you're comparing apples to asshats.

I resent being called an apple.

The diaphragm repair went very well.

And we've scheduled
your orbital fracture repair.

We'll get you some stronger
pain meds for the recovery.

When are you gonna fix my forehead,

make me all John Legend?

I tried, Billy.

I'm sorry.

I wasn't really getting
my hopes up anyway.

My dad taught me that.

He'd say, "You know what, Billy?"

And he'd just punch me in the face.

At least, I think that was the lesson

he was trying to impart.

That's what happened to your forehead?

He was a big A's fan.

Watched every game with a bat
in his hand.

August 14th, 2008,

they lost in the 12th inning...

Infection's setting in but his testicles

still show good flow on the Doppler.

Pain meds? He won't take them.

Thinks they'll knock him out

and we'll step in and repair them.

I hate this.

Me too.

I'm going to be a good driver.

I got every answer correct
on the written test.

Except one

but that was because
it was improperly worded.

I told the DMV
they need to rewrite it and...

they said they'd take it
under advisement.

Great.

Let's go.

Okay... let's close our eyes...

And take some nice, deep breaths...

And how about a little guided imagery,

to evoke positive visualizations?

Okay.

Let's picture the parking lot...

the cars around us...

the yellow steel thingy at
the entrance of the parking lot

that could really do a lot of damage...

A bollard.

The speed bump that is 15 feet
from the corner

with the stop sign that
someone put a "Hate" sticker on

so it says "Stop Hate,"

which is right in front
of the Jiff-E Mart,

which says it's open "8 til Late, 24/7,"

which can't be true beca...

That's great, Shaun.

Super amount of visualization.

And now that we're feeling comfortable

about our surroundings,

we can put the car into drive,

ease our foot off the brake...

Very nice...

We can open our eyes now, Shaun.

What we're doing is cruel.

I'm open to all options, Dr. Browne.

I'm gonna have to ask you
to give us some privacy.

Really?

You want to throw
the president of the hospital

out of a medical discussion?

You're infringing on my autonomy

and inhibiting the free flow of ideas,

both of which affect my ability

to deliver the best patient care.

Dr. Melendez.

There are many drivers

not following the rules of the road.

They fail to signal,
check their blind spots...

display a red flag when the load extends

more than four feet past the tail lamp.

You're right, Shaun, it's a mad world.

But there's nothing
you can do about them;

you just got to focus on you.

Yes, let's focus on me.

Yes.

Let's take the next right.

You can drive in the bike lane

when you're this close
to the turn, Shaun.

No, I can't.

It's a broken line.

That was the improperly
worded question...

whether it's broken or solid,

you can't enter the bike lane

this distance from the intersection.

I told them that it...

Okay, Shaun.
You don't have to go so slow.

She's in the lane;

she's not supposed to be in the lane.

It's a violation carrying a fine...

Okay, Shaun, don't worry
about what she's doing...

No.

Shaun, you have to pull
into the bike lane...

Don't worry about what she's doing...

You can't just stop.

Shaun, you can't just stop...

Shaun!

George is screaming in agony

and we are doing nothing.

Except hiding behind ethical red tape.

Ethical red tape is there
to protect people like him

from making permanent
regrettable mistakes.

I'm glad we're not using it
to cover our asses

the day before the new
Chief of Surgery is announced.

Let me sign off on the documentation.

I'll note his scrotum
is already beyond repair

and surgical castration
is our only option.

- I vote yes.
- No.

I'm not gonna let anyone
falsify medical records.

Not for pain. Not for a pedophile.

Once his testes
are actually beyond repair,

we will castrate him.

So we're just gonna
leave him there screaming;

keeping his entire unit awake?

Move him.

I'd like a clean dissection
through the periosteal planes

so I can slip the MEDPOR mesh
over the fracture.

Why do I prefer MEDPOR mesh?

It allows fibrovascular ingrowth

and integration of the patient's tissue.

Prisoner surgeries are approved

for psychological reasons all the time.

Tattoo removal,

gender reassignments
include breast implants;

hell if he had a crappy smile

we could justify dental work as needed

for proper mastication...

You sent a few kids to Juvie?

More than a few.

You feel guilty.

Think that's maybe clouding
your judgment?

Maybe.

You're afraid
of ruffling Andrews' feathers

this close to decision day.

Think that's maybe clouding yours?

We could give Billy a breast implant.

We could insert it

over his split thickness
frontal bone defect;

it would only require
a tiny incision at his eyebrow.

Now you're in favor of this?

I was against it
because it was too expensive

and unnecessary and risky

but if we do it now,

it won't require any additional surgery.

And it'd be very economical.

He did give us verbal consent
when he was first admitted.

Keep him under.

Get what we need, Dr. Murphy.

Ready or not...

Tell Melendez to meet us in the O.R.

Showing signs of ischemia;

we have a strong medical case
for removing.

Dr. Lim. You a castration fan?

Right now, I am.

- Andrews told me he's backing off.
- Great.

Because you presented him
with a very good argument.

My argument.
Which you regurgitated to him

right after you said
you wouldn't back me up.

Call that leadership?

Yes I do.

You presented me
with a very good argument

but you didn't have the guts to
take it to Andrews on your own.

One more reason I don't want
to work under you.

You don't want this promotion so
that you can improve the hospital,

you want it for the pretty title.

You're an adrenaline junky;

you won't last 2 weeks
liaising with board members.

There's a long and dusty trail

littered with people
who have underestimated me.

We're ready to go.

Curved tissue scissors, please.

His systolic is 68. And look at this.

He's septic.

He's going into D.I.C.

Rerun his labs,

have platelets, plasma and cryo ready.

If he starts bleeding, he'll die.

I reduced the volume from 80 cc's to 35.

Have the odds changed
in the last 24 hours?

- Little.
- Where am I at?

Six to one.

I'll put 100 on me.

He's becoming severely bradycardic.

The pressure on his orbit caused
a retrobulbar hematoma.

If we don't relieve it now, he'll arrest.

Forceps and scissors.

Just lost his pulse; pushing atropine.

Set up a temporary
transcutaneous pacemaker.

If we inject the orbital muscle
with local anesthetic

we might be able to fatigue the reflex.

Do it.

Starting CPR.

I hope that's a look of resolve.

Melendez stood up to me
in front of his residents.

I did the same thing
to O'Connell when I was his age.

What about Lim?

She has the kind of focus
that took me years to develop.

And Cooperberg, he reminds me
of me when I was...

Marcus. You were good.

But no one's gonna be as good
as you think you were.

One of your weaknesses
was decision-making.

I trust you've gotten past that
since I made you president.

Continuing compressions until
I have capture on the pacemaker.

Pacing pads are in position.

Stopping CPR.

Injecting lidocaine.

I have set the rate to 80.

Increase the ventricular
by two milliamps.

Increase by two more.

Blood pressure is responding, 102/68.

Keep those pacer settings

and let's get back to the main event.

Both his PT and PTT are coming back down,

his systolic is stable at 110,
and no ectopy on the monitor.

His D.I.C. score is back under four.

He's stabilized.

Ball's in your court.

Dr. Melendez?

Effects of low testosterone
on cardiovascular function

and sepsis?

Possible acute vascular response,

circulatory collapse...

And what about on D.I.C.?

Increased risk of clots and stroke.

George's body can't tolerate

any loss of testosterone right now.

We want to save his life,
we have to save his testicles.

Sutures.

I know how to get you to drive.

I can't drive.

Driving is just like surgery.

Say you're driving down the street

and suddenly,
somebody steps off the sidewalk,

right in front of you.

Things like that must happen

when you're deep inside someone's belly.

That doesn't make any sense.

It's an analogy, Shaun.

I need you to work with me
just a little bit.

Give me.

Okay.

It would be something unexpected,

out of our control,

from an aberrant source, and very bad.

It would be analogous
to an arterial bleed.

How about if a truck stalls out,
crippling traffic?

A thrombus impeding blood flow,
so we divert.

A thrombus, exactly.

What if you're just cruising along

and a car comes out of nowhere
and goes racing by?

A tachyarrhythmia.

- Yes! Shaun, you got this.
- Yes.

So let's get you driving that hooptie.

I've got this, Albert.

We did the surgery;

your circulatory and clotting systems

were shutting down.

But removing your testicles
would have put you

at greater risk by reducing your...

You would have died.

I've set you up with
a psychiatrist and a urologist.

They'll screen you, get you cleared,

and then we can do this the right way.

George, we can get this done.

You just cannot try this again.

I get it.

I do it your way,
or it just doesn't happen.

It's just another intersection, Shaun,

just like the last one
and just like the next one...

The last intersection isn't
where everyone honked at me

and made me freeze...

That was a different day,
with different drivers

and a different Shaun behind the wheel,

because today, this Shaun has a plan

for this intersection, which is...

...I am going to dissect it.

Damn right you are.

And today, you're gonna turn right

which you will do by...

Determining laterality.

And waiting until I can
legally enter the bike lane.

Somebody just made a turn...

Shaun!

Everybody okay?

You were wrong.

You were wrong, Lea.

I can't drive.

Shaun, I thought I had it figured out.

I can't drive.

I...

Surgery is mechanical.

Mechanics are predictable.

Driving is subject to human foibles

which means there are
limitless possibilities.

You're right. My metaphor sucked.

It sucked very much.

Because...

becoming a surgeon is about
way more than operating.

You had to learn about interacting

with teachers,
co-workers, patients, bosses.

Cooperating with them,
communicating with them...

I am very bad at communicating.

Shaun, you became a surgeon;

one of the hardest things
that anyone can do.

And you proved that
just because something is hard,

doesn't mean you can't do it.

And look what you just did.

I just hit a trash can.

Exactly; a trash can
instead of an oncoming car

or a pedestrian.

You did great, Shaun.

That soccer ball was
a dropped Metzenbaum.

I know, right?

When I accidentally drop
an instrument in the O.R.,

I react quickly to minimize damage.

- Yes.
- Yes.

I dropped a Metzenbaum.

I can drive this hooptie.

Window's about to close.

$10 will get you $20 on Melendez;

$10 will get you $1,000
if you want to bet on me.

Hey, everybody.

I can't be prouder of all of you.

We have grown into a preeminent
surgical department,

which has been recognized
with the official designation

of Surgical Center of Excellence.

It's now more important than ever

that we maintain our high standards.

And so, while there are
many worthy candidates,

I've decided...

to retain the title myself.

Thank you.

Thank you!

Yes!

Y...

You...

You did it. You...

You really did it.

It was his idea.

Murph? You...

We inserted a small breast implant

to fill in the depression

and create a more
aesthetically pleasing contour.

Breast implant?

Yes.

You saved my life.

It was a mistake.

It caused an oculocardiac reflex

and you almost died.

It was a mistake.

George?

George?

Why didn't his monitor alarm go off?

He was stable; I disconnected it
so he could use the restroom.

- I didn't...
- Morgan! He's gone!

George!

I was never gonna confront Andrews.

I was playing you.

But damn if you didn't
actually make it work.

It didn't work for anybody.

He played us both.
He set us against each other.

I think you were right.

Even if you were just bluffing,

we need to stand together.

Where was that wisdom two days ago?

Still in the bottle.

Hey. How'd you come up with that idea?

You mentioned breast implants
and I thought...

Of his forehead.

We were operating on his eye,

his forehead was covered.

Why were you thinking of it?

You care about him;

you were worried about his problem.

You empathized with him.

My idea almost killed him.

No it didn't.

I found these in Billy's drawer.

Three days of pain meds.

He was cheeking them to build up a stash.

He wasn't exaggerating.

You saved his life, Shaun.

This isn't the way
this should have ended...

But I'm not so sure the world
is a worse place

than it was a couple hours ago.

You almost look comfortable
behind the wheel.

This seat has excellent lumbar support.

But I am still very nervous.

I can drive a car.

I can see that.

Lea taught me using a very bad analogy.

Nothing works like a bad analogy.

He's getting pretty good;

won't be long
before he gets his operator's.

Your next radiation appointment
is in 45 minutes.

Ow.

Thank you.