[indie rock song playing]
♪ What do you say? ♪
♪ Is this our lives? ♪
♪ To think my fears will not reprise ♪
♪ Whoo-hoo-hoo ♪
♪ Whoo-hoo-hoo… ♪
Can I give you a hand?
Oh. No, thanks.
♪ Can't be late ♪
♪ What will you decide? ♪
♪ It's a win or lose… ♪
Everything in its place.
♪ On a rolling die ♪
♪ Whoo-hoo-hoo ♪
Ahhh!
Ahhh.
[pencil sharpener whirring]
[Shaun] No. Please stop.
What's wrong?
That noise hurts my ears.
And you don't need pencils. Our orders are electronically entered.
I use pencil when I'm doing research.
[sing-song] Congratulations.
I come bearing gifts for our new attending surgeons.
Bummer you have to share an office,
but I can make sure your first day starts with a smile.
Is it noise-canceling earbuds?
It is not.
You guys are big decision-makers now. Figured you might need some help.
-[clicks] -[kid's voice] Of course!
[giggles]
-[clicks] -Sounds like a brilliant idea!
-Huh? -Is the answer always "yes"?
I don't know. Ask.
-Is the answer always "yes"? -[clicks]
-[man's voice] Tequila stat! -Oh!
Am I awesome or what?
-You are awesome. -Mm.
But tequila can't be the answer to everything.
I would not be so sure.
-[cell phone vibrates] -[Dr. Park sighs]
Uh, Lim is in the parking lot.
Hmm.
You… You okay?
Yes.
Why wouldn't I be?
[elevator bell dings]
[exhales]
[applause]
[whooping]
Welcome back, chief.
Thank you.
I've never been this happy to be at work.
[light laughter]
-We've missed you so much. -Oh.
It's only been a few months.
It's been 14 and a half weeks.
Awkward.
Her and Murphy.
[Asher] It's awkward between Murphy and most people.
He didn't paralyze everyone.
He didn't paralyze her. He saved her life.
If he would've done the surgery Glassman ordered him to do--
There's no way to know what the outcome would have been.
The M&M was clear on that.
The final determination was "inconclusive."
I'd hug you, but I'd have to steal your wheelchair.
Oh. What happened?
Oh, I lifted the front end of a bus, you know, to save a kid. Normal Monday.
-Gotta lift with your legs. -Yeah.
So, I tried to keep your inbox empty, but that was impossible.
Everybody, party's over. She's got work to do.
[light laughter]
[Dr. Lim] Well, no, actually, um, before you go,
I just want to thank you for the flowers, the food, everything.
It was incredibly helpful.
And I'd like to thank Dr. Murphy.
You saved my life.
You're welcome.
Oof! So awkward.
[theme music playing]
[both singing indistinctly]
Doctors Wolke and Allen, meet our new first-years,
Doctors Danica Powell and Daniel Perez.
[gasps] Newbies.
-Don't call them that. -Sorry.
Welcome to St. Bonaventure.
Thanks. Glad to be here.
I look forward to working with you both.
Have a great first day.
Thank you.
Nurse Hawks showed us around, introduced us to the OR staff.
Everyone seems super-helpful.
I'm sure they were.
Hmm.
You want the soldier or the farm boy?
Naval Academy grads are called sailors, not soldiers.
Well, she's been in combat. That makes her a soldier in my book.
They both have excellent USMLE scores.
She has more real-world experience,
but he'll be useful getting extra help from the nurses,
which could come in handy on our first day.
It's not our first day.
We've been here five years and have leadership experience.
Being an attending shouldn't be much different
than being a senior resident.
I'll take Handsome Dan.
Okay.
[indistinct conversation]
Good morning. I'm Dr. Shaun Murphy.
I'm an attending at San Jose St. Bonaventure Hospital.
You and Dr. Wolke will be with me today.
Allen and Perez, you're with me in the ER today.
Actually, I was just about to take Perez.
You may have been about to, but I did.
-Come on. Let's go. -Hold on. Dr. Murphy and I--
Were decorating your new shared office while I was getting this approved.
Oblivious to anyone else's needs but your own, as usual.
Blaming everyone else for your problems, as usual.
They used to be in a relationship. It ended badly.
Let's go.
[hoarsely] It still feels like I'm choking.
The EMTs said they could barely get into your apartment.
Looked like you hadn't cleaned up or take out the trash in months.
Those are my collections.
It's none of their business. [winces]
Large, palpable anterior mass.
When was the last time you saw a doctor?
I don't know. Ten, twenty years.
When was the last time you left your house?
What does that matter?
We just want to make sure you're taking care of yourself.
If you want, we could have a social worker come down to talk to you.
You know, this is exactly why I don't come to hospitals.
All you want to do is meddle in things that are none of your damn business.
It looks like you may need some surgery to remove this mass.
Think you'd be okay with that?
What the hell do you think I'm here for?
The donor heart is on its way,
so we need to start prepping you for surgery.
I see you brought in reinforcements.
Hi. I'm Dr. Danni Powell.
Dr. Powell's one of our new residents.
This is her first day.
-Oh, and she's assisting? -Yes.
I don't want a first-year on her first day in on my husband's heart transplant.
You're a surgeon yourself.
You are aware the only way residents learn difficult surgeries
is by participating in them.
Yes, and I'm also aware that residencies last five years,
so there's no reason she needs to do this day one.
Honey, it's okay.
I'm sure Dr. Murphy knows what he's doing.
Mmm.
It's gonna be fine.
How can I be more worried than you?
You're smarter.
It's part of why I love you.
And hopefully my new heart will too.
[chuckles]
It definitely won't change that.
Can you hear me? I've got you. Code Blue! I need a cart!
-[grunts] -Ahhh!
[Dr. Reznick] I've been looking for you.
I have a patient in the ER who needs a mass removed from his neck.
I need an attending for Allen and Perez.
Okay. Uh, I'm pretty swamped.
Obviously, I wasn't expecting you to do it,
but Murphy's on a transplant, Park's busy decorating his office…
"Obviously"? Why wouldn't I do it?
I just… Andrews said--
Surgeries are still done with our hands, right?
The only thing that should be obvious is that I'm not on call, but Park is,
so get over your stupid breakup drama and go talk to him.
So, I'll reschedule your 11:00?
I can fit it in.
Didn't you wanna make sure you had funding confirmed?
Good point.
I will be doing Mr. Persiko's hernia repair.
Audrey, I'm amazed by your courage and fortitude,
and I will do everything in my power to assist in your return.
But that might not include surgeries.
I have pretty much lived at physical therapy
the last three months.
I have practiced extensively in a custom chair that holds me upright
so that I can see and reach the entire surgical field.
You know practicing in PT is not the same as working in an OR.
And your office is not the same as a courtroom,
so I won't bore you with my rights under the ADA.
I can do all the duties of chief surgeon.
Okay.
But I'm joining you on Persiko.
There is no reason the president and chief surgeon
need to tag-team a hernia repair.
Yes, there is.
[monitor beeping steadily]
[Shaun] Heparinization complete.
Bypass initiated.
[Asher] Cross clamping the aorta.
And tighten the caval snares.
Dr. Powell, prep the donor organ,
check the atrial septum, make sure there's no patent foramen ovale.
Looks good.
The mitral, pulmonic, and aortic valves, also good.
Thank you.
I will transect the superior vena cava
while you divide the aorta and pulmonary arteries.
Are you serious? That's the most difficult part.
Are you confident you can handle it?
Definitely.
Then so am I.
Potts scissors.
[Danica] Wait, hold on.
The donor heart has a floppy tricuspid.
[Shaun] No evidence to suggest severe tricuspid insufficiency
on the donor's echocardiogram.
The valve is damaged.
That must've happened during the organ recovery surgery.
We can't replace one damaged heart with another.
It took three months to get this one. He won't last three more.
Aborting and putting him on ECMO would move him to the top of the list.
We should be able to find a new one in a few days,
a week, at most.
You wanna take that risk?
It's not her decision. It's mine.
Abort the surgery.
We need to find a better heart.
[footsteps approaching]
We had to abort the transplant.
The damage was too severe.
We placed him on ECMO and closed his chest.
He's being transferred to ICU while we wait for a new donor.
You made that decision without even consulting me?
It was surgical judgment.
And I'm a surgeon.
Not at this hospital. Here, you're just the patient's wife.
"Just"?
My husband's life is in your hands. I have every right to ask questions.
Excuse me, Dr. Hall, may I ask you something?
What?
I understand that you're upset and frightened,
and you may disagree with our decision to abort the transplant.
But we are gonna do everything in our power to find a new heart.
Is there any way that we can help you?
Any pre-op echo or operative reports that you'd like to see?
Is there anyone else that you'd like to talk to?
Can I see him?
Absolutely.
As soon as he's stable in the ICU, we'll have a nurse bring you in.
Anything else that we can get for you? Any food or a coffee?
Um, no.
Thank you.
So, what kind of stuff do you like to collect?
I collect Egyptian pottery.
I got obsessed with King Tut in elementary school.
I know. My friends all think it's very odd too.
[chuckles]
Uh, I collect electronics, mostly.
Hi-fi stereo, computers, TVs.
All people care about now is the next shiny thing.
Use it once, toss it in the trash.
You go to flea markets or garage sales?
Mmm-mmm. They try to rip you off there.
I can shop and compare a hundred different places online,
select what I want, have it delivered right to my door.
It's just nice to go out sometimes.
I'm not a hermit or a hoarder.
-No one's calling you that. -Everyone calls me that.
Just do your damn test.
Remove the thing, and I can get out of here.
Okay.
-[grunts] -Let me help you.
No, I can do it.
You never had a problem asking me to scratch your nose during surgery.
Thanks.
[chair whirring]
This thing…
I feel slow and awkward.
You're like Ripley in Aliens.
A total badass.
I'm sorry.
You didn't do anything.
I wish I was as strong as you.
I can't sleep. Still have nightmares.
You're stronger than me.
I'm just a better poker player.
Your bedside manner is impressive.
I spent two years in Afghanistan,
so had plenty of practice de-escalating conflict.
What about a biventricular assist device?
Could extend the function of his current heart.
Well, that's pretty short-term. I was actually thinking--
Okay, he isn't oxygenating sufficiently despite the ECMO,
and he's bleeding from his cannula sites.
Considered a CARMAT?
We looked into artificial hearts weeks ago.
He is not a candidate.
I shouldn't have aborted the transplant.
What about a xenotransplant?
I was just reading a study about the use of pig hearts.
That's not an option.
Why not?
The most recent patient lasted two months,
which is longer than ECMO will keep him alive.
Because it's immoral.
Animals aren't surgical devices.
They are living beings who have a right to self-determination.
Hmm.
So was the guy whose heart we just threw in the trash a few hours ago.
That man made a free choice to have his heart removed after he died.
No one executed him so they could take it.
We execute millions of pigs every day for food,
and saving a human life is more important.
Killing animals for food or for medicine is wrong.
I won't do it.
Okay.
Dr. Powell, you have no choice.
Refusing to comply with an attending's decision
would be grounds for termination.
Everything I've ever done has been my choice.
So, you can fire me if you want to,
but I won't participate in a xenotransplant.
Mmm.
So, what are we doing?
As long as his wife consents, xenotransplant.
Right. I will be here if you need me for another patient.
[Asher clears throat]
Cut.
Can you loosen the top strap so that I can lean forward a bit more?
And someone get her brow.
Thank you.
Okay. That should be good.
3-0 vicryl sutures.
Yeah.
[breathing heavily]
-You need help? You want me to-- -No. I got this.
I got it.
[sighs]
[clears throat]
[Dr. Andrews] It's okay.
This is a damn hernia repair. I should be able to do it in my sleep.
Metz scissors.
[exhales sharply]
[breathing shakily]
[Dr. Andrews] You okay?
No.
Take over.
Metz.
The mass has completely grown into the larynx.
With possible bilateral involvement.
We should be able to excise without doing any damage to his voice.
Yeah, I don't think the patient cares about his voice.
He's not interested in talking to anyone.
Or he just likes solitude.
I used to spend every summer alone in the cab of a combine, and I loved it.
So, Mr. Already-Knows-Every-Nurse-By-Name is a lone wolf?
I don't buy it.
Our lone wolf has refused a psych consult,
so we should focus on what we can actually fix.
-I agree. -Then let me finish.
We need a laryngoscopy to assess the compression
from the mass on his vocal cords.
I disagree.
Better to do a needle aspiration to assess malignancy.
He's my patient.
Laryngoscopy.
But I'm the attending.
Needle aspiration.
We could do both.
Fine.
Sure.
The chief of surgery is responsible for a lot more than just cutting.
I'm not giving up just because I failed on my first try.
That wasn't what I was suggesting.
-[button clicks] -[chair whirs]
I'm just
impatient.
I screwed up, which could've endangered a patient.
You should be pissed off at me, not giving me a damn pep talk.
-Do I have the power to fire residents? -Yes.
I have a heart transplant patient who is rapidly deteriorating--
Stop. You're now an attending.
You need to learn how to make tough decisions on your own.
[straining softly]
-Good job. -[grunting]
-Now breathe. -[exhales]
Two-minute rest, and we'll do one more.
Hey.
What are you doing here?
[sighs] Looking for a heating pad.
-Or is it ice? I never know which one. -[Dr. Lim] Ah, nobody does.
Judging from your walk, you need a lot more than that.
She's right.
And the real problem's not your back. It's your shoulders.
Your posture's all slumped.
I see that a lot in my older clients.
Oh. Well, thank you.
I fell into a trench during World War I.
I'm gonna get you a bolster.
How you doing?
Other than having to tap out of a hernia repair?
Fantastic.
Standing's a lot harder than it looks.
So don't. Do the surgery from your chair.
Well, unlike Murphy,
I have to be over the patient to see inside.
So lower the patient.
That would throw a bunch of things out of sync.
The staff, the table.
You're the chief.
Let them sync up with you, Chief.
-[keyboard clacking] -The doctor's password is irrelevant.
The patients have their own separate login ID.
You say "irrelevant," yet the patients can't log in.
They have to reset their password every time they try.
Damn it.
I need some advice.
And I need an epidural.
And I need a new tech. This guy's coding is a total mess.
I'm doing a xenotransplant,
but my new resident refuses to participate.
She think it's immoral.
Dr. Andrews said I have the power to fire her,
but I am not sure if I should.
Mmm, if she's this defiant on day one, it's only gonna get worse.
You have been defiant to your attendings, right?
Surgery you did on Lim, as an example.
[Shaun] That's different.
My decision in Dr. Lim's surgery was right.
Dr. Powell, clearly wrong.
Your decision left her paralyzed.
He's not here to discuss Lim.
Your newbie is trouble in all caps. Fire her.
I'd like to remind you it's her first day.
It's also your first day.
Take a minute, think about it.
Thank you for your help.
You have much more leadership experience than Lea does.
But I trust her more.
I'm going to fire Dr. Powell.
It's a pig.
It's a life.
Animals feel pain and fear.
They have emotions just like humans.
Every drug we take gets tested on animals first. Are you against that too?
Call me a hypocrite,
but I believe that there is a difference between a rat and a pig.
And as soon as the tech advances, we should stop using rats too.
Didn't you fight in a war?
You're okay with killing for your country,
but won't sacrifice a pig for your patient?
I was never okay with killing.
And only somebody who's never been in the military
or known somebody who has been
would say something so idiotic.
I'm sorry. I didn't mean to…
I need to speak with Dr. Powell.
[cell phone vibrates]
The pig heart's here. We need to go.
We will finish this later.
Pull it back a little. You went past the cords.
Wish there was a way we could reach this guy.
At least get him to go outside
and stop trying to fill his loneliness with electronic junk.
When my grandma died, I saved her sweaters
because they smelled like her pipe tobacco.
That's interesting,
on a number of levels.
Grandma's sweaters are obviously different than a stack of broken TVs and receivers.
And you're handsome enough.
You don't need to go on about how much you love your grandma.
[Dr. Reznick] Already flirting.
He's only been here a few hours.
Have you at least finished the scope first?
Finishing up.
I'll export the images to his chart.
And we were definitely not flirting.
Absolutely not. I usually wait till the second day of the job for that.
[Nurse Villanueva] Needle nose.
Uh…
I always thought the needle nose was the unsung hero of the toolbox.
Got it.
Awesome.
Actually, not awesome.
Even with all the covers off, your knees won't fit under.
[sighs] Damn it.
What if you took the motor out totally?
OR nurses can manually raise and lower the table without the motor.
It's not the motor, it's the frame, which is welded to the table.
Which means I'm screwed.
We can figure this out.
[cell phone vibrates]
I gotta go.
Thanks for your efforts, but this isn't happening.
Where is the cooler?
-Cooler? -We thought you were bringing the heart.
I am.
[pig snorting]
We've found that patient outcomes were much better
if the heart remained in vivo until the last possible moment.
Sign here, please.
For specimen A71923?
We're not supposed to name the specimens,
but we call him Wilbur.
Okay.
[snorting]
Come along, Wilbur.
[snorts]
We need a pre-op ECHO.
How? He's covered in hair.
-How do you think? -[razor buzzing]
Is it okay? They want to see him.
I'm sorry. We have to prep him for surgery.
It is okay.
You can do that while they pet him.
Why does he need an operation?
Oh, he is giving his heart to another one of our patients.
But how will he live if he gives his heart away?
[mouths] No.
He can't.
He is going to die.
Mmm.
[Wilbur grunting]
Dr. Lim.
-This better be fast. -It will be.
I thought I should let you know that I am firing Dr. Powell.
-Okay. -Okay.
Uh, mind if I ask why?
Oh.
She refused to participate in the xenotransplant.
She thinks using animals for medical procedures or research is immoral.
That's an odd opinion for someone who wants a career in medicine.
But it's not your job as an attending to weed out the bad residents.
It's to mentor and mold them into…
[girl gasps excitedly]
It's okay. Wilbur is very friendly.
Good talk. I gotta go.
We finally figured out how to lower the light.
-Still haven't solved the table issue. -I have. Scrap the whole thing.
-And do surgery sitting on the floor? -No.
On a sturdy stainless-steel table
that sits on four legs instead of a bulky pedestal.
Like they have at my butcher shop.
And in our morgue.
Your beliefs are misguided and very wrong.
Dr. Andrews and Dr. Lim confirmed
that your insubordination is just cause for termination.
I'm sorry you feel that way.
But I understand.
I'll clean out my locker.
You don't have to do that.
My job is to mentor and teach you how to be a good doctor.
So I want you to watch the xenotransplant from the OR gallery.
Just because you think it's immoral
doesn't mean you shouldn't learn how it's done.
Are you willing to do that?
Yeah. Yes.
Good.
You can go now.
[Daniel] A lot of blood from the tumor surface. I need gauze.
It's not stopping.
Cut off the tumor blood supply.
[sarcastically] Thank you, Dr. Reznick.
Actually, I think the bleeding might be coming from the superior laryngeal artery.
[Dr. Park] Adding additional clamp and a silk tie.
The bleeding stopped.
-Good catch. -Thanks.
You're more than just a pretty face.
My grandma, who I loved and cherished, would agree.
[Jordan chuckling]
[monitor beeping steadily]
There's a minor tear in the inferior epigastric artery.
No, I've got this.
I need to get more light and a 10 blade.
I'll open over the entry site.
Thank you.
Come on. Where are you?
There it is.
Bipolar forceps.
And we're back on track.
[Dr. Andrews] Nice work.
[monitor beeping steadily]
It's kind of a big deal. Maybe you wanna say something?
[Shaun] Mmm, why?
Never mind.
You're our hero, Wilbur.
10 blade.
Sternal saw.
[saw whirring]
[whirring stops]
Oh.
This is harder than I thought it would be.
-[softly] You want me to do it? -No. I am the attending.
I will do it.
Okay.
[saw whirring]
[Jerome] Stop!
Motorcyclist just declared brain-dead in the ER.
He's a match, and his family consented. Heart's on the way.
-[Shaun sighs] -[cheers and applause]
[Asher] Oh. That felt inappropriate.
It was.
We need to close Wilbur's chest and wake him up.
Your surgery was very successful,
and, thankfully, not innovative at all.
You're gonna be fine.
Thanks to Dr. Murphy.
It was a team effort.
Except for Dr. Powell.
[grunts]
I thought I was supposed to rest.
Movement post-surgery helps the blood flow and recovery.
[snorts]
What's a pig doing in here?
His name's Wilbur.
He was gonna donate his heart, but turns out they didn't need him.
Want to meet him? He's super-nice.
Pigs are one of the smartest animals.
I grew up on a farm.
We once had a pig who could do long division.
-Mmm. -[chuckles]
What's gonna happen to him now?
He'll have to be euthanized.
He's been genetically modified. Can't be around other pigs.
[Jeremiah sighs]
Use you once
and throw you away.
You are brilliant.
-It worked? -Perfectly.
Wilbur's got a new parent,
and Jeremiah's got a reason to step outside twice a day.
Hmm.
I'm impressed. Seriously.
You should be. Because I'm awesome.
[both chuckle]
Jeremiah just needed a little push in the right direction.
I'm glad you didn't just make a snap judgment based on his appearance.
I thought I knew your type.
I'm sorry.
Hmm.
Wanna grab a drink, let me make it up to you?
[chuckles]
We're good.
And I'm beat.
Gonna go home, do some restorative yoga, and, uh, hit the hay.
Yeah, me too.
No, I'm kidding.
I'm gonna drink.
[both chuckle]
But mad respect.
Namaste.
So, he wasn't your type, but now he is?
-I never said that. -[chuckles]
You absolutely said it.
You just used your flirty voice. You were like, "Mad respect. Namaste."
Can we continue this argument over negronis?
I paid last time.
-No, I paid last time. -[laughing] Oh, really?
Yeah, 'cause I had to leave the tip too.
Kick.
Toes up.
Good.
Down.
How was the appy?
Fine.
Fine, but what?
I'll, uh, get you set up with the E-stim.
I feel like a racehorse that's been relegated to the carousel.
[sighs] I used to tell people that it took me two years
to get back to being the surgeon that I was,
you know, before the brain cancer and all that.
I lied.
I never got back to being the surgeon I was.
You're never going to be the doctor you were. That's a fact.
But you have no idea the doctor you're gonna become.
And I am here for you.
Anytime.
Thanks.
[breathes deeply]
I've been told you two have been sniping at each other.
-No, we-- -This is not a conversation.
You two need to sort your stuff out, I don't ever wanna deal with it again.
-Yes. -It won't happen again.
Good.
So, how was your first day?
-[clicks] -[man's voice] Tequila stat!
Are we commiserating or celebrating?
We are definitely celebrating.
[sighs]
Ugh.
Come on!
-Hey. Tough day? -Oh.
[sighs]
-I know you said you don't want-- -No, I can do this. Thank you.
[grunts]
[grunts in frustration]
Come on!
[breathing heavily]
[car door closes]
[breathes deeply]
You okay?
No, I am not okay.
I'm so sick of this chair.
I'm sick of having to drive with my hands.
I'm sick of not being able to get around because there are stairs everywhere.
And I hate that my body won't do what I want.
I hate having to train like an Olympic gymnast
just so I can get off the damn toilet.
And I hate Shaun Murphy.
This is all his fault.
[closing theme music playing] toilet.