All language subtitles for The Good Doctor - 04x12 - Teeny Blue Eyes.PHOENiX+Syncopy+MiNX.English.C.orig.Addic7ed.com

I couldn't sleep.

We should start taking
your blood pressure every day.

This is very sweet and responsible.

Yes, I am going to try
to be extra responsible now.

Yeah.

W-We... We have to talk
about what we... want to do.

I love you.

I want a child. So I want this child.

I love you, too.

And I do want kids,
but it's complicated.

Is this the right time in my career?

In our relationship?

Am I too young?

Can we afford this?

Am I willing to make
this commitment right now?

We can start depositing money

into a shared account for expenses,

and I can talk to Dr. Glassman
about hiring you an assistant

to help with your workload...

Shaun, just slow down.

I-I don't need you
to answer these questions now.

I just need to... think.

To figure out what to do.

And you do, too.

Dr. Chambers, I'd like you
to meet a few of our residents.

This is Doctor... I know that I'm old,

but I can still read name tags.

Dr. Chambers, you started
experiencing aches

in your right hand a month ago?

Then tremors, weakness, spasms.

Had to drop out in the middle of
a bowel resection last Friday.

I sent you a video of the surgery.

Given your symptoms, it seems
that carpal tunnel...

Oh, it "seems."

Well, then, problem solved.

I'll be on my way.

Sir, can I just say that the documentary

on your work in Haiti changed my life.

It's the reason why I went into...

If you want to suck up to me,
call me "doctor," not "sir."

And this is a hospital, not Coachella.

If you can't wear something appropriate,

at least try something that fits.

Rule out autoimmune disorders,
hypothyroidism,

diabetes, amyloidosis, MS,
and multiple myeloma.

Then we'll get back to carpal tunnel.

Alright.

If you have any other questions
or concerns,

please don't hesitate...

Twelve.

First, I prefer blankets
not made of sandpaper.

Second, dim these damn lights.

This isn't some
San Fernando Valley porn shoot.

If you made a list,

you don't need to tell us.

He's had the pain for nine months now.

And it's on both sides?

Mm-hmm. Sometimes his forehead,

other times his cheeks, his nose.

And it's persisting through
very high doses of hydrocodone.

Yeah, obviously,
the drugs don't work. It's why I'm here.

Oscar.

It's a fair question.

Look, I'm sorry.

Okay, I've been to six doctors now.

I can't work.

I mean, I-I c...
I can't even kiss my wife.

I can hardly smile.

I'm just gonna lightly brush your cheek.

Okay.

Please... help me.

I've been on the phone for like
an hour with the cable company...

Lea's pregnant.

You want to have...

Yes.

Wow.

I'm glad you're happy.

Um, do you have any concerns?

Yes.

Sleep deprivation.

But I have started looking
into an affordable night nurse.

Well, there's gonna be
some bigger issues.

I mean, this is a...

This is a gigantic moment for anyone,

especially... Especially for you.

You mean...

because of my ASD?

Yeah, because of your
ASD. Because of your family.

Your job.

I mean...

A million things.

I don't want to tell you
what... what to...

I mean, I don't even know what I...

Having a child...

changes everything.

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

Nasal cavity's clear.

There's no abscess,
facial tumor, or sinusitis.

It could be acoustic neuroma.

Without any hearing loss?

Let's do an MRI to check.

We've run eight negative tests already.

We don't need a ninth.

We do the tests
till we know what he has.

It's fibromyalgia.

So, your diagnosis for his pain

is "pain that no one can explain"?

- Well done.
- Some pain's unavoidable.

When I was competing in Tae Kwon Do,

they taught us to adjust
our relationship to it,

learn to tolerate it.

It can make you stronger.

Wow. That statement has
the absolute ideal ratio

of heartlessness,
humble-bragging, and machismo.

Bravo.

Seriously? You're pleased with that?

"Machismo," Spanish, "bravo"'s Italian.

And "humble-bragging"'s 2011.

We can do better, don't you think?

Maybe we're not finding anything
because it's psychological?

Some kind of conversion disorder?

You do the MRI. I'll talk to the wife.

Negative for endocrine issues.

He's got a history
of moderate carotid stenosis.

If enough plaque builds up,

starves the brain of oxygen,

maybe could cause the hand problems.

If it got that bad, we'd have
already seen signs of a stroke.

Anyone else annoyed that we're wasting

all these resources to confirm
what's clearly carpal tunnel?

He may be a jerk,
but he's a great doctor.

If Silas Chambers has a medical opinion,

we better check it out.

I didn't think he was a jerk.

Dr. Andrews and Dr. Lim
also criticize us

and have particular demands.

Yeah. They want us to improve.

How do you know Dr. Chambers doesn't?

He did improve Enrique.

Not kidding.

You look snazzy.

I know what Dr. Chambers has.

We're having trouble finding
a physical basis

for your husband's pain.

And you defended me when I asked him

about painkillers earlier.

A few years ago,
Oscar was on a job site.

Working crazy hours.

He was exhausted.

He shot himself with a...
With a nail gun.

Right through his palm.

We didn't have insurance,

so we went to this clinic, and, um...

Opioids?

Really bad.

Took a year for him to kick.

Now, um... he's taking
more pills than ever.

Whenever I talk to him
about getting help,

he just gets mad.

I, uh...

I had to move out last week.

I'm only here because he asked me to.

I think he's faking.

You threw 113 sutures
in your last day of surgery.

In at least half, I detected
a very subtle tremor.

Congratulations on discovering
a symptom I told you about.

It occurs during the part of your stitch

when the wrist is straight,
not when it's bent.

That is not carpal tunnel.

It is musician's dystonia.

My wrist flexes on every suture.

You're talking about
a difference of milliseconds.

Yes, he is.

Your condition was probably
caused by your repetitive technique.

Even Dr. Andrews throws sutures
in varied ways.

You never do.
This kind of obsessive behavior

is common for those with autism.

So, I can refer...

What did you just say?

I'm not autistic.

Dr. Murphy didn't mean any offense.

He himself is on the spectrum.

Oh, is he?

I thought his robotic voice
and hand clasping

were just charming affectations.

Do you really think
I am anything like him?

- I'm not saying that...
- I am.

You're extremely organized.

You hardly make eye contact.

And given your problems
with food, blankets,

and lighting, plus the fact you
wear headphones even in surgery,

you clearly have sensory issues.

I'm organized.

Would you rather I show up
in the O.R. and just wing it?

I have good taste in food and music.

Now that's a mental disorder?

And as for eye contact...

Okay.

I didn't come here for a psych consult.

It was just an observation
about a possible reason

for the behavior that led
to your hand symptoms,

which is what we should
be talking about.

Physical therapy is the
recommended course for dystonia.

I'm not wasting months
on a treatment that won't work.

I want an MRI-guided ultrasound ablation

of the VO nucleus of the thalamus.

You want to jump to brain surgery?

I would jump right to amputating a toe

if it got me my career back.

What were you thinking?

You just supported me.

Yes, because part of my job
is not yelling at residents

in front of patients.

What you did is equivalent
to looking at a fuzzy MRI

and blurting out a patient has cancer.

Cancer can kill you.

Neither diagnosis is one
a patient is excited to hear.

Prep him for the ablation.

And do not talk to him again
about autism.

He's seen six doctors in the last month,

gotten three opioid prescriptions,

and he had a previous opioid problem.

It's textbook drug-seeking.

It's also textbook "a bunch of dingbats

missing a trigeminal neuralgia
diagnosis."

Mm, his wife agrees with me.
She knows him.

Would explain why yours left you.

Snap. Except my wife didn't leave me,

so neither a good point,
nor even a clever one.

FIESTA imaging would take hours
to set up,

cost the patient serious money,

and still come out negative.

Because... it's textbook drug-seeking.

We have other patients who need us.

I'm sending the discharge order.

Hey.

I hate poop.

Like, what if I suck
at changing diapers?

Maybe we should start
with the bigger issues

and work our way down.

This isn't at the top of my list,

but since you are a doctor...

Shaun's ASD... Is it...?

Inheritable?

Probably.

But it's unclear how much.

So, even that.

W-What am I supposed to do with that?

Think it through.

Let's say you have a little baby Shaun.

Like... tiny, honest,

brilliant guy who adores me...

Mini button-down,

teeny blue eyes...

And me?

A mom?

I mean, I'm not saying
my life would be worse,

but it would just be so different

from what I was planning.

Not that I was really planning,

but I am enjoying just... being.

And so what if you wait?

I just want to make sure
I'm making the right decision.

Mm-hmm.

I guess you'll never really know.

I had to make a lot
of hard choices about my mom.

And I still wake up wondering

which of them went the wrong way.

But... you still gotta choose.

No abnormal signal in the mid pons.

So, are you and Dr. Park
like this at home, too?

When I let him out
of his cage for meals, yes.

Hey, we're almost...

Oh, come on.

Did you not get the text
I didn't send about this?

Don't bother asking for consults
if you're gonna...

Wait.

What's that on the right
superior cerebellar artery?

An abnormal loop causing compression.

He has trigeminal neuralgia.

The pain's real.

We have good
visualization of the target area.

Connect the ultrasound
to the stereotactic frame.

Ablation won't work.

You changed your mind?

You don't think he has dystonia?

He does, but it's a symptom.

His vertebral artery takes
an aberrant course.

It is pressing against his spinal cord.

He needs vascular surgery or he'll die.

It's a disorder of the nerve
that carries sensation

from the face to the brain.

And it's one of the most
painful conditions that exists.

And very hard to diagnose.

Thank God Dr. Park approved
all those tests.

Y-You were in agony.

And I...

I told him I thought you were lying.

You thought I was lying?

You thought I was just being an addict.

And still you came here with me.

Sat at my side.

We'd like to do
a microvascular decompression.

We'd go in through the back
of your skull

and put in a Teflon patch
to cushion the affected nerve.

You're... You're cutting into his brain?

It's relatively safe. And other options

are unlikely to relieve the pain.

Look, I-I'll do it.

Uh, thank you so much.

We want to run a vertebral artery BTO.

If you tolerate it,
then we would sacrifice the...

Sacrifice the vessel
with onyx embolization.

We recognize you might not love
this proposal.

The one in which
my hand weakness remains,

destroying my career?

Did you consider
vertebral-to-vertebral artery bypass

with physical removal
of the aberrant artery?

Mm, that would carry a very high
risk for a stroke or bleed.

It would fix the dystonia
and let me get back to work.

With your history of carotid stenosis,

it would be a coin flip
whether you survive.

I can live with those numbers.

Or, for that matter, die with them.

Corridor to the trigeminal
nerve origin is open.

I freed up the offending vessel.

Teflon sponge.

The sponge is too big. It'll
compress the brain stem.

I have at least 4 millimeters of room.

You have half that.

Yes, you have a better view
50 feet away.

How long have they been like this?

- A while.
- It's getting worse, though.

Sorry, Park, you're right.

Just like you were when you
decided to discharge the sick guy.

Wow, you invented sarcasm.

Really impressive.

Hey, look at me, I'm using it, too.

Park, you missed the diagnosis.

Reznick, you ignored protocol.

How about you both show
some humility and shut up?

Sorry.

Teflon's placed.

What if we used the saphenous
vein for the bypass?

Not enough flow. He'll stroke out.

Carotid to distal vert, then?

Stenosis is too severe.

Dude's loaded.

He's at retirement age.

He could teach, travel,
screw around all day.

Why is he demanding that we do this?

When you dedicate your life to
something that gives you meaning,

it starts to define you.

His decision may be irrational,
but I get it.

I don't think it is irrational.

Dr. Chambers has no friends,
no children,

no family, no outside interests.

If he can't be a surgeon,
he'll have nothing.

I think our best bet is a radial graft.

Highest flow I can think of.

Any other ideas?

Okay. We go with the radial graft.

I'm impressed.

I was actually starting to
wonder if I was losing my touch.

But then I had a dark afternoon
of the soul

and suddenly I knew it...

Those were totally solid burns.

Maybe not A+, but A-, B+ at the worst.

So it hit me... your plan was
to throw me off my game,

make me doubt myself...

I'm attracted to you.

I've been fighting this stupid feeling,

trying to find reasons to not... feel.

Are you kidding me?

Yes.

Your jokes were lame.

And that's how you screw with someone.

No.

You're not that good of a liar.

I-I can't have a roommate
who has feelings for me.

Since when can't you take a joke?

Since my roommate hit on me.

You have to move out.

As soon as possible.

We've decided to use your
radial artery for the graft.

We've scheduled an O.R.
for tomorrow morning.

- Good call.
- I agree.

You should risk your life
for this surgery.

Are you being facetious?

No.

It just boggles the mind.

You can't understand what anyone means.

You can't express yourself
like an adult.

You're a child playing dress-up.

And everyone here just plays along.

Let's go, Shaun.

Y-You're agitated.

I'm fine.

You are rubbing your mug.

People with ASD
often have comfort objects

for when they become agitated.

I can order you Propranolol.

You're gonna give me
the Ruseckas-Freedman

ASD Diagnostic Questionnaire,

and that's gonna shut your damn mouth.

Okay, the "Rafad-Q" is just a tool.

An official diagnosis needs
to come from a psychiatrist.

Well, since I might be dead tomorrow,

this is your next-best option.

I'll get the test.

Why can't you treat people
with just an ounce of respect?

Respect has to be earned,
not doled out like candy.

No, that's just an excuse
people like you use

to justify your garbage behavior.

That's just an excuse people
like you use

to avoid facing reality.

No one was respectful to me
when I was a resident.

They were dismissive and cruel.

But it lit a fire and it made me
the man I am today.

The man that you came
into my room idolizing.

Not anymore.

I'm devastated.

Surgeons deal in human lives,

not childish fantasies.

If you want to succeed,

you're gonna have to be
a lot more like me.

Everything okay?

- Yep.
- Surgery went very smoothly.

No pain right now.

Want to take it for a test drive?

It's worse.

Collateral circulation is not ideal.

How are we gonna harvest the artery?

What's going on?

How much am I gonna have to
change who I am to be a surgeon?

Ah, to be great...
Or even good... at anything,

we have to compromise.

I used to get too emotionally
involved in my work,

with patients, everyone.

And I had to learn to distance myself.

Yeah, you've really grown cold
and heartless.

I have changed.

We all end up changing.

You just got to try
and make it a good change.

I don't want to change.

I want to change what's around me.

Oh, I'll figure it out.

I'm sure you will.

Hey, you're the guy who makes
living in a van look cool.

So, uh, the circulation...

The right side looks like
it has better length.

Yeah. Better collateral, too.

Given the poor outcome,

we can't recommend
further surgery right now.

We suggest six months of pain medication

and referrals to neurology
and pain management specialists.

W-What surgery aren't you recommending?

A DREZ lesioning.

We'd cut the signal
from the trigeminal nerve

to the sensory areas of your brain.

But there's a real possibility
of paralysis

on one side of your body.

I want the surgery.

Baby, I'll help you manage the pain.

I-I'll move back in.

I'll take care of you.

You know how I treated you before.

I'm only gonna get worse.

I would never leave you again.

That's what scares me.

I'd start cutting you down,

being cruel,

and you'd just put up with it.

I won't let that happen.

We'll prep an O.R.

"I frequently point out
other people's mistakes."

Duh.

That's a yes.

"People tell me I overthink things."

Only people who underthink things.

But, fine, another yes.

"I sometimes speak in an abnormal tone."

Who thinks they speak
in an abnormal tone?

Just mark no.

How many more of these?

None.

Your answers are fully congruent
with someone on the spectrum.

No.

You keyed it wrong.

No, look. No, I... Or something.

- Here. Look, I didn't.
- No, give it to me.

- No, I...
- Oh! Don't!

You idiot!

S-Stupid, careless...

I-I stepped back...

Get out of my room.

- Get out!
- Okay.

Make sure we're not impacting

normal spinal cord pathways.

Somatosensories are at baseline.

BP's steady.

Leg and arm SSEPs
at 50% decreased amplitude.

Check the cord above and below
for hematoma

or bony compression.

Cord's fine.

Push IV fluids and start pressors.

So, what is it?

I don't know.

Any issues with motor potentials?

Unilateral amplitude down 70%.

We're about to get
total neurological collapse.

It's a clot from a small branch artery.

We checked the spinal blood vessels...

The outside.

But the electrode could have
injured a sulcal artery.

We need to follow
the DREZ pathway inward

and search for a small clot.

Start at the site of last
ablation with the electrode.

It's gotta be deep.

This'll be easier if she's in here.

Scrub in, Dr. Reznick.

We're setting up the neuromonitoring

for Silas' surgery.

He's angry with me.

Silas?

He's angry with everyone.

Dr. Andrews said to stop
talking to him about ASD.

But I brought it up anyway,
gave him a test,

his mug broke,
and I don't know what to do now.

I don't know what to feel.

And Lea...

Lea told me about the pregnancy.

Okay.

Is this hard for me because I'm dealing

with both things at once?

I think both things are related.

What if my child...

has no friends?

What if they're picked on?

This is not small-town Wyoming.

The world has changed, Shaun.

I haven't changed.

How can I...

...know what they're feeling?

How can I comfort them?

How can I be a good father?

Remember when we first met?

Right over there?

You were mad at me.

Yeah. But you were right
about the patient.

And you were stubborn. And crazy smart.

And you are still all of those things.

But if you were still just that guy

that I met running through those doors,

we would not be sitting here right now.

You have changed.

You've adapted. You've grown.

Do you know how hard that is?

Most people don't even try.

And you are going to grow
into a great father.

Whenever it happens.

Slowly go perpendicular

at the angle of our ablation electrode.

Still not seeing the clot.

Amplitude loss at 80%.

Maybe it's not a clot.

Maybe it's something higher up,
in the brain.

No. You were right the first time.

Maybe it's hiding behind some
ultrasound-impervious segment.

Cut the dentate ligament.

It'll get more lateral access.

Completely section the ligament.

I see it.

Removing the clot.

Amplitude returning to normal baseline.

Let me know if you need me.

We're good.

Thank you.

Hey.

We did good together.

We did.

You still have to move out, though.

Tonight.

On my first day here, Dr. Melendez said

I would never do anything
besides suction.

But later, he let me make
my first surgical incision.

He became my friend.

I miss him.

Are you in the right room?

Did somebody tell you
I needed pointless stories?

I used to think

being a doctor was
all I needed to make me happy.

It did make me happy.

But I realized I wanted more.

And that I could have more.

I changed.

You can change, too.

But not if you're dead
from this surgery.

I've made up my mind.

Please leave.

My brother Steve,

he gave me a plastic scalpel
before he died.

It broke. I was very sad.

I asked you to leave.

When I fixed my scalpel,
it made me feel better.

I was 9 years old when my father died.

I loved drinking hot chocolate
with him in the morning.

He'd bring me a mug
after every business trip.

He understood me.

My mother didn't.

Nobody did.

I tried fitting in, but...

I got frustrated.

So I gave up.

On relationships.

On friends.

On all but the one thing I was good at.

And now, Dr. Murphy, I'm too old.

I've made too many enemies.

Too many mistakes.

People tolerate me because I save lives.

Without that...

why would anyone ever care about me?

I care.

That smells good.

Bland.

Mm, pasta with olive oil.

Kinda puke-proof.

Have you thought any more about...

Yes.

I made a list.

I guess I've learned from you.

What's the first thing yours says?

That I think I would be a good father...

but that I can't know for sure.

You'd make a great dad.

It's on my list.

You were right.

It is very complicated.

But I do know...

...I want you to be happy, Lea.

I have so many reasons to do this.

And so many doubts.

I'm just scared, Shaun.

But if we are both having doubts,

then maybe now isn't the right time.

Okay.

Mm.

I see that my hemoglobin's stable

and my white count is fine.

Yeah. We just wrote
your discharge orders.

This is a referral
for an ASD specialist.

I can look into that on my own.

Thank you, Dr. Murphy.

And thank you, Dr. Guerin.

Welcome back.

Mm.

Did it work?

Let's find out.

Mm.

Your hand's cold.

I'm transferring out.

Last year, I applied to
a program at Johns Hopkins.

They train doctors to travel the world,

help out needy areas.

They'll let me enroll late.

Sounds like a good place for you.

Thanks for always being a great boss.

And a great friend.

Can't have been that great,
sneaking out like this.

Uh, actually, for the first time
I can remember,

it felt hard to say goodbye.

You're always doing so much
for other people.

Please don't forget to do
something for yourself

every now and then.

Were you messing with me or not?

If I was, would you let me stay?

Yes.

I wasn't messing with you.

Then I guess it's good
we're not roommates anymore.

'Cause I couldn't do this.

This is a one-time thing.

Unless I change my mind.

So consider that an incentive.

Lea Dilallo?

She called your name.

I spent all day reminding myself
of all the reasons

why this was a good idea.

But now that it's actually happening,

it... doesn't make me feel any better.

It just makes me feel really sad.

Maybe it's not the right time,
but will it ever be?

I...

...feel the same.

Are we really doing this?

We...

...are having a baby.

Mm.

Yes.

Yeah?

Okay.

Okay.