All language subtitles for The Good Doctor - 01x18 - More.KILLERS.English.C.orig.Addic7ed.com(1)

I want to be your friend again.

W-Why, Shaun? What happened?

People need friends.

Well...

Yeah, they do.

But you said

you wanted me
to stop interfering, remember?

You wanted space.

You wanted to make your own mistakes.

I need a friend more than I need space.

You were a good mentor and a good friend.

Well, thank you, Shaun.

You don't know how much it means to me

to hear you say that.

But I-I think...

...I think you may need a new mentor.

I'm dying.

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

12 to 18 months.

I'd appreciate it
if you didn't tell anyone, okay?

I-I will in my own time.

Okay.

Have you had a full work-up?

Yes, of course.

It could be a secondary tumor

metastasized to your brain
from somewhere else.

It's the only tumor found.

It could be an inflammatory
or infectious process.

It was a tumor, Shaun.

You should get a second opinion.

Shaun, I've been a neurosurgeon
for 30 years.

I think that qualifies
as a second opinion.

You should get a second opinion.

You have to know whether...

All right, all right,
all right, all right, Shaun.

I'll get a second opinion.

Okay?

Okay.

Can I go to work now?

Okay, Doctor, what's your diagnosis?

I'm drunk.

Not you. Other doctor.

Uh, well, given
the degree of the rotation

and the fact that
the break is almost compound,

I'd say we're dealing with a Bimalleolar

or Trimalleolar fracture.

Very good. What else?

Um...

Color?

Blood flow is restricted.

His foot's dying.

- Oh, no.
- Mm.

I'm gonna have to reset it now.
Hold his leg.

- No.
- No, it's Ok.

It just going to take a second
I need you to count to three.

One...

- One,
- two...

Aah!

Is Caden's leg gonna be okay?

How long has his leg been like this

and how exactly did it happen?

Well, he's been like that
since I found him.

He probably tripped over
a curb or something

because that's where he was.

Any reason you felt the need
to tell me twice

that you found him like this?

Dr. Park, boy's going to surgery.
You're going with.

Don't go anywhere.

Shouldn't I be asleep for this?

Your blood alcohol level
complicates anesthesia

and we think you have a concussion,

so we're gonna keep you responsive.

We did give you a regional nerve block,

so you shouldn't feel anything.

Huh. Cool.

Bend the ICP plate over
two degrees on the proximal end.

Contouring pliers.

BP is dropping, heart rate's rising.

- Let's tube him.
- IV fluids and phenylephrine, stat.

We need to abort until we can get a
handle on what else is going on.

Give me a full body CT,
full blood panels, and an echo.

I think Jared and I may be able
to dig up an answer quicker.

Great. Get on it.

Come up with anything?

Neither did I.

I had a friend,
a neurosurgeon, at SF Muni.

She looked at the scans.

She came to the same diagnosis, Shaun.

I have an inoperable glioma.

Okay?

I think you should go back to work, yes?

I need to go to work.

Be reasonable.

Beg your pardon?

Be reasonable.

I have no idea what you're talking about.

Oh, it'll be clear.

What the hell happened to Caden?

- I... I don't know.
- He twisted his ankle. I...

You lied to me before.

You're lying to me now,
you spoiled little coward.

Hey, hey. Be reasonable.

His friend's hurt.

He's scared, and you're freaking him out.

He's angry, but he's not wrong.

Caden's in bad shape,
and we don't know why.

We need to know what happened.

No, no, don't... don't worry about him.

Talk to me.

You tell me the truth.

You won't get in trouble.
You'll just... help a friend.

All right.

We were pledging.

And there's... there's this,
uh, wheel of torture thing

you got to do for initiation.

Torture?

- But it's mos...
- it's mostly stupid stuff, dude.

It's, like, like,
drink a cup of olive oil

or eat a tablespoon of cinnamon.

And what did Caden land on?

Laundry.

He had to do laundry?

No, like, like, he had to,
uh, eat th-those laundry things,

as many as he could in 30 seconds.

Detergent? Eat detergent?

And how many did he have?

- I don't know.
- Like six, maybe seven, seven.

He ate detergent.

Could've burned a hole
through his esophagus

or his stomach and intestines.

Catch that bleeder, please.

Let's hope he doesn't breed.

What? He isn't an idiot?

We have healthy bowel
attached to healthy bowel.

Let's close him up.

Dr. Melendez?

The trauma S.O.D. is asking
for you in O.R. number 2.

We got an emergency thoracotomy.

Who can give me
the remaining steps for closing?

Cut anchoring sutures, clear
laps, and reposition the bowel.

Remove clamps from
the duodenal resection site,

keeping clear of the underlying aorta,

close the fascia
using a looped O monofilament,

close the dermal layer,
then re-approximate the skin.

Also, you need to ensure
no omentum is caught

in the fascial suture line.

Close him up.

Murphy, you're lead.

Clearing laps.

I will hold the repaired segment in place

while you run the bowel for me.

Bowel is clear
and ready to be repositioned.

Shaun?

Shaun, is everything all right?

I lost something.

In the cavity?

No.

But I know where it is now.

Shaun.

I left my scalpel here earlier today.

You should get Diffusion Tensor Imaging.

A DTI?

Masses are difficult
to diagnose accurately.

You should get more imaging.

People make mistakes.

That's not gonna happen, Shaun.

My scalpel isn't here.

What happened this time?

He's got a bleed somewhere.

I want a capsule endoscopy to check

the entire length of the bowel
for bleeding and leaks.

And get me a complete coagulation

- and metabolic profile.
- On it.

Dr. Glassman is dying.

What?

What do you mean? He seemed fine.

They say he has a glioma.

That's a brain tumor.

And he won't do a DTI scan
to confirm the diagnosis.

Did he get a second opinion?

He has, but delayed or missed
or incorrect diagnosis

has an occurrence rate of 10% to 20%.

Doctors make mistakes.

Shaun, I don't know
what you want me to do.

I-I want you to sit down.

That's what people say

when they want to tell you
something important.

The part about him dying,

that wasn't the important part?

He won't listen to me.

He is stubborn.

- That he is.
- Stubborn.

He will listen to you.

Okay, you have known him longer,

you're his friend, he trusts you.

Shaun, I can't make him
do anything, either.

You... Y-You're an attorney.

I'm not skilled at lying or manipulation.

So you want me to what?

You want me to manipulate him?

You want me to use our relationship

and our history
to trick him into doing this?

Yes, please.

I knew you wouldn't let him die.

Our patient has Disseminated
Intravascular Coagulation.

Can anyone tell me why that is very bad?

Blood clots form
throughout the blood vessels

and rapidly deplete
the body's clotting factors,

thereby causing a systematic bleed.

It's also a catch-22.

If we treat the clotting,

he might end up with a terminal bleed.

And if we treat the bleeding,
he'll have a terminal clot.

So how do we treat it?

We figure out the cause. Treat the cause.

More damage from the detergent?

Margins were clear. It's not that.

He could have a crush injury
from his ankle.

Or a bacterial infection he picked
up before or during surgery.

It might have been set off by drug use.

Or we did this to him.

And by "we," I mean Shaun.

He spaced out in the O.R.
when he was closing,

kind of like he is now.

- I'm listening.
- Comforting.

He wasn't focused.

He could've nicked a vessel,
which could've caused...

Okay, we're talking about Shaun.

Yeah, he's quiet, but he was focused.

He's always focused.

His stitches look like

they came out of a sewing machine.

All right. Complications happen.

The kid was in pretty bad shape
when we got him.

Physician error is way down
on the list of likely causes.

Crush trauma being top.

Get him started on fresh frozen
plasma and crystalloid fluids.

Yeah?

You got a second?

Well, that's an open question.

What can I do for you?

I got a patient with DIC.

One of the possible causes
is surgeon error.

Your patient, your error?

Shaun's.

He got distracted
during surgery, spaced out.

It's not like him.

One place he never misses a beat
is the O.R.

Is there anything going on
that I should know about?

He got some bad news.

About what?

It's a personal matter.

Shaun was distracted by a personal issue?

What, did Lea come back?

She have a new boyfriend?

His cable get cut off?

I have an inoperable glioma.

18 months.

Aaron, I am so sorry.

Me, too.

Is there anything I can do?

I wish.

You should've told me.

Or at least you shouldn't have told him.

His coagulation factors are still off.

Crush trauma isn't the issue.

And his tox screen came back clean.

- It's not drugs, either.
- We don't know that.

He's had so many transfusions,

the blood in his veins isn't
the same blood he came in with.

The drugs could still be
in his organs causing...

I get that you don't want to think

that this could be caused by your friend,

but we have to... The kid came
directly from a frat hazing, hammered.

What are the odds he wasn't on drugs?

We should start IV midazolam

and sodium bicarbonate to counteract...

- That's the treatment for amphetamines.
- If you're wrong,

that could cause a fatal arrhythmia.

I'll find out what drugs he's on.

You're going to find out by asking?

Blake was honest with me before.

It's a lot easier to be honest

when you're not confessing to a crime.

We don't have a lot of choice
in the matter.

That's not true.

Thanks for doing this.

Yeah, no worries.

Noticed it was cut when I first saw you.

Figured it should get cleaned up.

Is it all right if I draw some blood?

Just want to make sure

you don't have any toxins or infections.

Sure.

So, uh, the nurse said
that Caden has DIC.

Do you know what that is?

Mnh-mnh.

Well, in short, his body is clotting

and hemorrhaging at the same time.

If we can't figure out what's causing it,

he'll die.

Just hold that there for me.

All done.

Blake, buddy, you're on something.

Your pupils are dilated,

and you're sweating in a 68-degree room.

Now, I can hand this over to the cops

or you can tell the truth
about what Caden's on.

Molly.

I would've told you the truth
if you'd asked.

I'm sorry.

You have time to talk?

Shaun told you.

He did. Yeah.

I wish I would've heard it from you.

Yeah, I'm sorry.

- We're friends.
- I get it.

- I want to be there for you.
- What, are you mad at me?

Yes.

I'm supposed to be there for you.

To do what? To do what exactly?
Hold my hand?

Yes, if that's what's needed.

Okay, well, what I need
is to be left alone, okay?

Well, you told Shaun,

so that was a brilliant strategy.

Okay, okay, I get it.

Stupid, stupid, stupid, stupid, okay?

Sometimes when people
are told they are dying,

they do stupid things!

Sometimes people around them
do stupid things!

Shaun told you to come here

to try to convince me
to get more imaging, right?!

Aaron, you can't stop fighting.

- Maddie wouldn't have wanted you to stop
- ...Don't, don't, don't, don't you dare.

Don't you dare.

What are you gonna say, huh?

That Maddie was a fighter?

Huh?

That she never quit?

I'm sorry.

Thank you.

And you should get the DTI.

Not for you.

You've accepted your diagnosis.

Shaun hasn't.

He needs to.

Hey, Neil.

I heard there was a complication
in one of your cases.

Caden Hauley?

Heard or have you been monitoring

all of Murphy's cases?

I monitor all my department's cases.

18-year-old with DIC.

Any idea what set it off?

Complications happen.

The kid was in pretty bad shape
when he got to us.

I'm also wondering why you were
in two surgeries at once.

You left three first-years unattended?

You know we do this all the time.

We couldn't function efficiently
if we didn't.

I hope Caden pulls through.

You got a very quick appointment.

I have connections, Shaun.

Why did you listen to Jessica but not me?

Well, Jessica's pretty smart, too.

Yes, but what did she tell you?

I don't think this is a good time.

When is a good time?

I have a lot to learn from you,

and if you're dying,
less than two years to learn.

Sorry to keep you waiting.

There were some surprises on your images.

The previous diagnosis was incorrect.

You have a Glioblastoma Multiforme

located in your pons.

I'm sure I don't need to tell you this,

but it's the most aggressive
form of brain cancer.

We estimate three, maybe four months.

I can have my assistant
get in touch with you

to refer you to a therapist
when you're ready.

He still has low blood pressure
and thin blood,

which means the treatment
for the MDMA didn't work.

So the Molly wasn't the problem?

It certainly didn't help him,
but now we think he...

Our best guess is
Caden has a bacterial infection.

Thanks.

DIC?

What happened there?

Uh, we're not sure yet.

He was pretty sick when he came in.

I guess sometimes
complications just happen.

Interesting choice of words.

Eerily similar
to what Dr. Melendez said to me.

Yeah, he said it during a differential.

I guess the phrasing just stuck with me.

It's not like Melendez
to be that laissez-faire.

He usually likes to know
exactly why things happen.

One of the traits I admire about him.

Yeah, well,
we're trying to figure it out.

But so far, the cultures are negative.

Shaun's closing was textbook.

Drug use doesn't seem to be a problem.

I didn't realize Murphy did the closing.

Good for him.

Oh, my God.

Shaun.

Yes, yes, there are
many different explanations.

You asked me to get a second opinion.
I got a second opinion.

You asked me to get more imaging.
I got more imaging.

Shaun, you have to accept...

No, I don't accept.

I don't accept. I was right.

No, you were not right. I'm dying, Shaun.

- I said - doctors make mistakes...
- Yeah, they made a mistake.

- I have less time than we even thought!
- ...and they made a mistake.

Shaun was right. Shaun was right.

Imaging is unreliable.

The imaging that you asked me to get.

Imaging is subject to interpretation.

Yes, studies have shown that experts rely

on... on... on subjective measures

based on experience rather than object...

No more.

Rather than objective... No more, no.

- No.
- No, no. No more. No more.

- No more.
- Many theories consistent with...

You can't do a biopsy to confirm

because many tumors look alike.

Some are treatable.

- Some are curable.
- Stop, will ya?!

Some are curable. They're curable.

Stop, please, will ya?!
Stop, stop, stop talking!

- Stop!
- Okay.

Stop!

I am not hurting you.

Oh, my God, stop.

I'm helping you.

No, you're not. You're not helping.

I don't need theories.

I don't need white boards.

I don't need doctors!

I don't want to think about the tumor!

I don't want to think about dying!

You know what I want?

You know what I actually want?
I want to... I want to...

I want to go on a long drive somewhere.

I want to... I want to eat pancakes.

I want to watch football.

- It's not football season.
- Oh, my God.

I know it's not football season.

Do you mean you want to have fun?

Yeah.

I want to have fun.

So you can keep fighting.

Keep fighting if you want.

It's futile and it's stupid.

Or you can come with me.

How long has he been hypoxic?

It came on suddenly five minutes ago.

He's on 100% high-flow oxygen,
and his numbers aren't budging.

He's ventilating fine.

He must have thrombosed
his pulmonary artery.

We need to dissolve this clot
before his heart stops.

- Jared, prep for jugular access.
- On it.

50 milligrams T.P.A. infusion now.

Let's go, let's go, let's go!

Is this fun?

The Saturday after Valentine's Day,

her favorite day of the year,

even more than her birthday.

The Chamber of Commerce
would decorate this place

and put out a crappy buffet meal,

hire a deejay, and I'd put on a tux,

and she'd put on a yellow Belle dress,

and she'd...

pin my bow tie on me,

and I'd pin a little
yellow corsage on her.

And we'd come and we'd eat
and we'd... and we'd dance.

♪ Whenever I see your smiling face ♪

♪ I have to smile myself

♪ Because I love you

♪ Yes, I do

I love you, sweetie.

I love you more.

Oh, you think so, huh?

Well, I'll tell you what.

You can take how much you love me,

which I know is quite a lot,

and then you can double it,
and then you can add 10,

and that's how much I love you.

♪ Tell me how much longer,
if it grows stronger every day ♪

I love you more.

♪ Oh, how much longer?

♪ I thought I was in love
a couple of times before ♪

♪ With the girl next door

And I remember thinking,
"This is the moment...

that I know will be in my mind

when I... when I...
when I close my eyes to die."

Only I thought
that she'd be sitting there,

right next to me,

and I'd hear her say it one more time.

I lost my toy scalpel.

The one that Steve gave me.

Yeah, I figured that was the one.

I have been looking for a whole day.

I think it may be gone forever.

Maybe I'll come here when you're dead.

Okay.

Are your memories
of your daughter enough for you?

Not even close.

Do you need me to listen to you anymore?

No, Shaun, you should go.

Okay.

Not all the cultures are back.

But since he's not responding
to any antibiotics,

we can rule out bacterial.

It was never a great fit.

It's a better fit than surgical error.

What if it is bacterial
but resistant to all...

Then he's dead.

What about Paroxysmal Nocturnal
Hemoglobinuria?

PNH?

The incidence
is literally one in a million.

What's the odds of Murphy screwing up?

- I'd put them about that.
- No, it's not PNH.

Caden had normal flow cytometry.

Exotic snake venom can trigger
consumptive coagulopathies.

So can pre-eclampsia,

but he's not pregnant
and he wasn't charming snakes.

Murphy, any thoughts here?

It is kind of your ass on the line.

I know why Caden has DIC.

I squeezed the artery between two clamps.

I must have ruptured the aortic wall,

causing a pseudo-aneurysm.

It was my mistake.

And also...

I have to make a bowel movement.

He's lying.

He's gonna puke.

He's going to Glassman.

I told Dr. Melendez
I had to make a bowel movement.

I think he believed me.

Color me proud.

I have the answer.

Shaun, I hope you're referring
to your patient,

but due to the fact that you're here,

pretending to be in the bathroom,

- I kind of doubt that.
- Yes, it's your answer.

We already...

We already have my answer, Shaun.

We can't do a biopsy on you

because of the arteries in the way,

like the arteries in Caden's abdomen,

but we can't move the arteries
in your brain because...

Why did we go to the carousel?

Because you were sad.

What didn't I want to do?

Do you not know the answers
to these questions?

I do know the answers, Shaun.

I don't think you know
the answers to these questions.

You're not hearing me. I'm dying.

There's still hope.

Shaun, look at me.

Look at me, please.

There is no hope for me.

I mean, hope?

What... What... What... What is hope?

You hope the 49ers find a defense.

You hope the number 4 bus comes on time.

Doesn't mean they magically
learn how to tackle.

Doesn't mean the bus driver
suddenly drives faster.

Hope is irrelevant for me.

Hope is painful.

I don't want to spend
what's left of my life

chasing my tail around in a circle.

You understand?

Okay.

Okay.

Your tumor is located
at the base of your skull.

An open cranial biopsy
would tell us what's wrong.

But there are blood vessels in the way.

The biopsy would cause
an aneurysm or a bleed.

But if we go through
your nasal cribriform plate,

we can cross the tentorium
on the contralateral side

and avoid all those blood vessels.

We can do a biopsy through your nose.

You can't die, too.

I have to throw up.

So how do we do this?
Do we file a report?

Talk to Andrews personally?

You want to report Shaun?

I don't want to. I think we have to.

No, you want to.

And we'd certainly have to
if our sole agenda

would be to take down Shaun

and to give you one less person
to compete against.

And certainly, we'd absolutely "have to"

cover up and bury
a possible fatal medical error

if our sole agenda
was to protect a friend?

Protocol would seem to favor
the bitch over the friend.

Thanks?

I threw up.

We have a duty to report errors

so they won't happen again.

The process saves lives.

And exactly what errors are
we trying to avoid a repeat of?

You worried about the next time
an autistic surgeon operates

on a drugged-up frat kid

after finding out his mentor
is dying of brain cancer?

Dr. Melendez told us, Shaun.

We're really sorry.

It's okay.

It's okay.

I think he's going to be okay.

The protocol exists

so that we don't ask questions like that.

That seems like a bad idea.

You trust your judgment.

Do you trust Morgan's judgment?

Do you trust the judgment of all
the doctors in this building?

If you can make judgment calls,
so can they.

That's why we need these rules.

No, the protocol is fine
for everyone in this building,

except for Shaun.

They'd reprimand any one of us,
but they will fire him.

Okay.

We report it.

We get the investigation, make sure
nothing like this ever happens again.

But we tell them I did it.

They'd fire you, too.

It's not a terrible idea.

Jared's out the door either way.

Can we get back to the medicine?

Caden is still alive.

If we can keep it that way,

there won't be an M&M review.

Which means no one
will be asking questions,

and no one will have to give answers.

It all goes away.

If Caden dies, we tell the truth

and we face the consequences together.

No.

No.

I thought I'd found my toy scalpel.

We need you to come back
to the group, Murphy.

Get me imaging on that pseudo-aneurysm.

Hey. What's up?

Do you still feel
the same way about Dr. Murphy

as when he got here?

Dr. Glassman gave us
certain... assurances.

"If Shaun proves
anything less than excellent,

if Shaun doesn't live up
to everything I know he can do,

he will be immediately released,

and I will resign my position

as president of the hospital."

And you wrote it down.

I made sure it was in the minutes.

Shaun has exceeded my expectations.

Mine, as well, and?

And my feelings about
Dr. Glassman have not changed.

Thank you.

We need to cut him open.

We cut him open and he dies.

He'll bleed out before we
can even get the artery exposed.

If we don't cut him open, he dies.

Don't cut him open.

Murphy, if we don't...

We should insert an endovascular graft

through his leg instead.

Fix it from the inside out.

I've done that for
large abdominal aorta dilations,

but this is a lengthy
dissecting pseudo-aneurysm.

It's safer.

The aortic wall is already compromised.

Could rupture completely.

Caden could die
as soon as deflate the balloon

- inside the graft.
- But doing nothing will kill him.

Not definitely.

There's still a chance Caden
will simply come out of this

without any surgical intervention.

5%, 10% maybe.

Not nothing.

And we're doubling down on Shaun

after we know he caused this problem.

How's that gonna look at an M&M?

I trust Shaun's idea.

He makes mistakes no one else would make,

but he also makes saves none of
us would have ever thought of.

Thank you.

You're welcome.

I still don't think
you should be working here.

I don't think the trade-off is worth it.

Well, let's prep him for surgery.

Pull the guide wire, Reznick.

I'm passing in the graft.

You're right over the pseudoaneurysm now.

Inflating the balloon
to deploy the graft.

Deflating.

Can I do it?

It's delicate.

No, it's not.

And it will either work or it won't work.

If my idea is wrong,

he'll die as soon
as we complete this next step.

You shouldn't have to live with that.

Everything that happens in
this room is my responsibility.

We'll do it together.

Deflating.

Nobody's going home.

I am proud of this team
and what we accomplished today.

Drinks are on me at Harry Hopes.

We're celebrating?

Today was a disaster, and we got lucky.

You're right.

But when you get lucky, you celebrate.

Let's go.

At some point in your career,

you're going to kill someone.

And I hope for your sake
there's a doctor out there

who still believes in you when you do.

It was there all along.

I have to go drinking,
but I wanted you to know...

Uh...

Is that from an IV?

You did the biopsy.

I did.

I have a low-grade glioma.

Not a GBM?

I told you...

Cancer, Shaun. It's still cancer.

I have to undergo brain surgery,

which is really scary

because I'm not the one performing it.

Five days a week
for six weeks of radiation,

10 more weeks of chemotherapy.

And then?

And then...

with a little luck...

you and I can go
to the Super Bowl next season.

You're going to live.

There's hope.

Now go.

Go have some fun with your friends.

Yes. First I have to tell Dr.
Andrews about the mistake I made.

Shaun, y-you can't.

Protocol is clear,
and reporting saves lives.

And I hear Caden
is on the road to recovery,

so your mistake
couldn't have been too bad.

No, I made a mistake.

Shaun, I understand that.

But Dr. Andrews will use this.

And do you remember the commitment

that Dr. Glassman made
when you were hired?

I promised you'd be excellent,
right, Shaun?

And you have been excellent.

You can't give Dr. Andrews this excuse.

I was not excellent.

This time, I was bad.

And surgeons have to be
excellent every time.

Right, Shaun?

You agree with him?

I'm not gonna ask him to lie
to save my job.

Don't do this.

It's up to Shaun.

I trust your judgment.

I'm not doing this to hurt you.

I know.

We are friends.

Yes, we are.

I love you.

I know. I love you, too.

I love you more.

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