This is an image of the main character, Dr. Sean Murphy, wearing a white doctor's coat. He is talking to another person wearing a white doctor's coat, but that person's back is turned, making him more difficult to identify.

The Good Doctor: Season One, Episode Four

I have a confession to make: Oftentimes media criticism with a dash of social justice feels like a race to see who can say the most cutting, critical things about poor representation first. Sometimes, like with Atypical, the ire is well deserved. Other times, I feel pressure to declare something irredeemably Problematic before really giving it a chance.

Another related confession: I actually really liked this episode of The Good Doctor. I feel like Dr. Shaun Murphy got to be an actual, flawed person. There are several instances where I sort of wanted to slap him, but not because I thought he was being written badly — Only that he was making some of the same mistakes I or autistic friends have made in the past while trying to figure out how to be an independent adult. Note: I would not actually slap anyone unless they explicitly asked me to for some reason.

The remarkable thing about The Good Doctor, the thing that made me feel hopeful about it to begin with is that it is the story of Dr. Shaun Murphy. It is not the story of Dr. Shaun Murphy’s autism family. As such, the quality and success of the show hinges on making Dr. Murphy interesting. Flawless superhumans aren’t interesting — Even inspiration porn gets tiring to most people after a while. Autism symptom lists aren’t interesting. You can get that information way faster by Googling it. People, though, are interesting. I think this is true not just for autistic viewers, but for all, if not most, viewers. Dr. Shaun Murphy needs to be a person for this show to succeed, and this episode, the writers succeeded.

I left this episode with several thoughts about story lines I hope the writers pursue in the future. I’m sure from a medical perspective, this episode hardly made sense. There were definitely flaws. There’s always room for improvement. But overall, if every episode of the show for the rest of the season were like this one, I would probably declare The Good Doctor to be one of the best representations of an autistic person that I’ve ever seen on television.

‘Why is all your furniture in the middle of the room?’

The episode opens with Dr. Murphy lying in bed in his pajamas. It is night, and the kitchen faucet is dripping in the background. Dr. Murphy sits up and begins tearing his room apart. He throws cloths out of drawers and hangars from his closet. The music is tense. Then, Dr. Glassman arrives to help him look. “Maybe you threw it out with newspapers you used to pack.” “I packed with bubble-wrap, it’s safer and you can see through it,” Shaun retorts. Shaun is panicking. “I know I packed it. I made a list. Look, it’s checked. It’s checked,” Shaun insists with all the urgency he’s expressed in previous episodes about performing lifesaving, emergency surgery.

I have done exactly the same thing Dr. Murphy does in the first scene of this episode. I did it last week when I couldn’t find my keys. Suddenly, something in the natural order of my home was Wrong, and I began to panic. My boyfriend helped calm me down while I looked in places that probably didn’t make any sense over and over and over and over again — In the refrigerator, under couch cushions. You probably don’t care, but they were on the floor next to the stairs. They’d fallen out of my pocket.

In retrospect, I am aware that it is a ridiculous way to react to something not being where I expect it to be. There are so many things I could have done to rectify the problem without needing to find my keys. I could get new keys at the hardware store fairly easily. We have extra keys we give to guests. It is one thing to know these things, and another entirely to think of them when you are so singularly focused on a particular problem.

This would have been such an easy scene to make Shaun the butt of a joke. If this was The Big Bang Theory, the scene would have been accompanied by a laugh track. A screwdriver is obviously not important and entirely replaceable. But the whole thing is dealt with in a sensitive and emotionally honest way, from Dr. Murphy’s perspective.

Dr. Glassman finds the screwdriver in Shaun’s refrigerator, and tells Dr. Murphy that in the future, he should call his building super, “any time” to fix what’s broken in the apartment. He points out that Dr. Murphy has been working long hours and is under a lot of stress. He tells Dr. Murphy to go to bed and leaves.

‘If we were interested in our safest course we wouldn’t be on our third second opinion.’

In the patient’s room, it appears that the tumor has grown to half the size of the fetus. Dr. Melendez regretfully informs the would-be parents that the safest course of action is to terminate the pregnancy. The patient responds that if she was interested in the safest course, this wouldn’t be her third second opinion. Dr. Melendez has apparently removed a similar kind of tumor before with good results. Dr. Melendez points out that due to her condition, a long surgery is very dangerous for her. She could die. She responds, “I’ve had three miscarriages. If I have to go through that again, I might as well be dead.” The sentiment is alarming. The fact that this woman’s sense of self is so inextricably bound up with pregnancy and natural birth is alarming, almost suicidal. He husband attempts to reassure her and that they can try again.

Dr. Murphy suddenly interjects with a possible way to reduce the risk of the surgery. Dr. Melendez pulls the surgical residents into the hallway. “Never contradict me in front of a patient again,” he tells Dr. Murphy. “We’re not in front of the patient now,” Dr. Murphy retorts. That’s some sass. I am often unsure if Dr. Murphy is intended to be this sassy or if every rude thing he says is supposed to be some kind of innocent accident. If it turns out to be the first thing, I’m very impressed. If it turns out to be the second, I’m going to be very disappointed.

Dr. Murphy points out that he didn’t contradict Dr. Melendez. He agrees with Dr. Melendez’s assessment and was just pointing out a way that the surgery might be made less risky. Dr. Browne adds another idea. Dr. Melendez decides to do the surgery, but decides Dr. Balu will assist him, because Dr. Melendez is a fountain of petty cruelty when it comes to Dr. Murphy. He then assigns Dr. Murphy and Dr. Browne to see an emergency room patient. I’m not sure why that’s “scut work,” but OK. Dr. Melendez asserts that he isn’t punishing Dr. Browne. He’s punishing Dr. Murphy and doesn’t trust Dr. Murphy to be alone with a patient. He says this in front of the entire team. Dr. Murphy really, really needs to make an EEOC complaint.

‘It’s not flesh eating bacteria.’

In the emergency room, Dr. Murphy and Dr. Browne see the patient. She is an 18 year old girl. It’s really obvious Dr. Browne has low expectations for how Dr. Murphy is going to interact with the patient. The patient says that she has pain, “down there,” and unsurprisingly Dr. Murphy needs to have exactly what that means spelled out to him. He seems unphased. “Does it hurt?” he asks. “It feels like I’m using a bowling ball as a tampon,” she tells him. That sounds very painful. He guesses that perhaps her extreme pain is caused by necrotizing, flesh-eating bacteria. Obviously, this is alarming to the patient. It’s a cheap laugh, and somewhat disappointing given the quality of the rest of the episode.

Dr. Browne struggles to insert a speculum into the patient in a way that is not too painful. She cries out in pain during multiple attempts. Shaun asks to do it and does it both successfully and quickly. Dr. Browne is surprised. “It’s definitely not flesh-eating bacteria. I was wrong,” Dr. Murphy states. “Thank God,” the patient replies.

Dr. Browne reassures the patient that her pain is probably caused by an untreated chlamydia infection and asks if the patient would like to contact anyone. The patient would rather deal with this alone. “Even adults need someone to drive them home after surgery,” Dr. Browne tells the patient. “I’ll take a taxi,” the patient replies. The patient goes on to say that she is surprised she might have an advanced chlamydia infection because she gets tested ever 30 days, for work. “I do porn,” she explains.

 

‘He’s a guy. All guys watch porn.’

In the hospital hall, Dr. Melendez explains to Dr. Andrews how he could reduce risk for the surgery. Dr. Andrews is skeptical that the patient might actually want the surgery, since it is so high risk. He points out that high risk surgeries mean more deaths, which means the surgery department’s success rate goes down. This seems like a really good example of why measuring hospitals by “success rate” isn’t necessarily a useful metric. All it does is prevent doctors from taking medically complicated cases. Then medically complicated get shunted somewhere else.

In surgery, Dr. Melendez talks to his team about special precautions they will need to take during the surgery, in order to ensure a safe, continued pregnancy for their patient. He is called out into the hall by his wife and fellow board member, Jessica. She takes him to see the patient’s husband. He doesn’t want her to have the surgery. Dr. Melendez rightfully points out that husbands don’t have veto power over their wife’s medical decisions. Jessica asserts that perhaps they could make it an issue of paternity. This seems completely counter to legal precedent.

In the hall, Dr. Balu asks Dr. Browne what kind of porn their patient does. Dr. Browne points out that she was a little busy providing quality medical care to ask. Dr. Balu muses if it’s the kind of porn that has a story or not. Dr. Browne isn’t sure if they even still make porn with stories. “Sometimes,” Dr. Murphy interjects. Both seem a little scandalized, but Dr. Browne recovers quickly. “Why not? He’s a guy. All guys watch porn.” Yes. Autistic adults are adults. Dr. Browne and Dr. Murphy are going to assist Dr. Andrews in surgery to drain their patient’s abscess, since the case is more complicated than originally thought.

Dr. Melendez arrives and tells his team to go home and get some sleep. The fetal surgery has been put on hold.

In an office, the board argues if they can proceed with the fetal surgery or not, based on the father’s consent. Legally, I am pretty sure this is not a conversation that has happened in the United States in the past few decades, for good reason. He does not own the patient’s body. If she doesn’t want to terminate the pregnancy, that is her decision. This means that she can also choose to refuse all treatment and die. Eventually, thankfully, the board comes to the conclusion that they should follow their patient’s wishes. They approve the surgery.

The patient is relieved. Her husband is not. “I’m trying to protect you because I love you,” he argues.” I don’t need your protection,” she retorts. “I need your support.”

‘Do you think she’s of sound mind?’

Dr. Balu and Dr. Browne are in bed together. Dr. Browne muses that her patient doesn’t seem like sex workers she’s met in the past, volunteering in high school. “She doesn’t have the same armor.” Dr. Balu is delighted that Dr. Browne confided in him. His constant push on Dr. Browne’s clear boundaries are creepy. She does not want to have a romantic relationship with him, and says as much. “How about you stop worrying about what I won’t do, and just think about what I will,” she tells Dr. Balu, changing the conversation to sex. They begin to kiss.

Elsewhere, Dr. Melendez and Jessica are in bed together. “Do you think she’s of sound mind?” his wife asks. “She’s basically threatening to commit suicide.” They then have a discussion about the difference between having a biological child and adopting. Jessica thinks that they’re the same thing. Dr. Melendez doesn’t. “Carrying a fetus in your body for nine months, you don’t think that creates a unique relationship?” he asks. “I think every relationship is unique,” she retorts. She thinks the patient is being selfish.

Dr. Murphy is on the bus. He thinks of his childhood, the first time he saw pornography. His brother shared a magazine with him. While reminiscing, he misses his stop. The bus driver suggests that Dr. Murphy get off immediately, since his next stop will be even further away. Speaking from experience, getting off at the wrong bus stop or missing a stop can feel somewhat like getting stung in the feelings by a hoard of angry bees. Shaun waits anxiously for another bus to come and take him back in the reverse direction.

Luckily, Dr. Murphy’s neighbor, Lea, drives by where he is standing. She offers to give him a ride home, and he accepts. She’s come from the gym. “You stink,” he announces. For some reason, she doesn’t find that insulting. She shares that she doesn’t like to shower at the gym because she’s too worried about foot fungus. “You suck at being a neighbor,” she points out. He seems unphased. “I stink. You’re anxious. You always say exactly what’s on your mind,” Lea tells him, approvingly. “It’s the total opposite of most guys. It’s nice.”

Dr. Murphy goes to his super to ask for some repairs. It is 12:40 AM. “Dr. Glassman tells me I can call you any time to get anything fixed,” he announces. The super is not impressed. “I don’t care if you’re St. Bonaventure himself. Unless it’s a fire or a flood, I only work 9-5,” he tells Dr. Murphy angrily. He takes the repair list anyway.

‘Actually, you know what, Shaun? It’s not my fault.’

The next day at breakfast, Dr. Murphy explains what happened with the super. Initially, Dr. Glassman apologizes, but then walks it back. He asserts that because Dr. Murphy is smart, he should be able to figure out what people mean when they say things. It is very much a, “have you tried not being autistic?” talk. It is frustrating to listen to, but I also appreciate Dr. Glassman establishing his boundaries with how he can and can’t help Dr. Murphy in his everyday life.

Dr. Glassman suggests Dr. Murphy get a personal support worker, and Dr. Murphy becomes visibly upset at the suggestion. “No thank you. I can take care of myself. I don’t need an aide. I don’t need an aide,” he asserts repeatedly. Dr. Glassman drops the subject. I hope that this storyline is explored further, as the season goes on. It would be good to see Shaun accept that he needs help doing some things, and that it isn’t fair to ask his friends to do that work for him.

Elsewhere, Dr. Andrews is performing surgery on the patient from the emergency room. Dr. Browne and Dr. Murphy assist. Dr. Andrews is surprisingly respectful to Dr. Murphy, given previous episodes. He congratulates Dr. Murphy on diagnosing something that others may have missed. He then proceeds to ask some  invasive questions about Dr. Murphy’s relationship and sex life. This is depicted as a totally normal thing to do. Dr. Murphy admits that he has never dated anyone, although he did kiss a girl once. “Are you trying to mock me or encourage me?” Dr. Murphy asks Dr. Andrews. “I’m trying to get to know you so I know when I should mock and when I should encourage,” Dr. Andrews replies. “When is the right time to mock you?” Dr. Murphy retorts. I love that sass.

The surgery takes an unexpected turn — It seems that there is a growth under the abscess, engulfing a nerve. When the patient wakes up, Dr. Browne and Dr. Murphy explain that they will need to remove the nerve, which means the patient will lose sensation in her genitals. “I knew it. God’s punishing me.” Dr. Browne begins to tell her otherwise, but instead, Dr. Murphy asks the patient about her faith. It is a surprisingly sensitive move on Dr. Murphy’s part. Dr. Browne’s comments could easily be seen as invalidating their patient’s feelings.

In surgery, Dr. Melendez’s pregnant patient takes a turn for the worst. She has a heart attack very early in surgery. They stop surgery immediately. When she wakes up, they inform her she had a complication and were unable to complete the surgery. Suddenly, the patient’s husband is on board. The board argues about their next steps. Dr. Balu enters and suggests a bypass machine, to prevent heart attacks. I’m not a doctor, but that seems to be pretty far fetched.

At home, Dr. Murphy notices that his sink has been fixed. Once again, he wakes the super up to complain about the super fixing the faucet. Dr. Murphy wanted it to drip at the same rate as his sink when he was living in Wyoming. “If you knock on this door again after 5 PM, I’m going to knock your teeth out,” the super responds. Which seems like a completely reasonable response given the circumstances. Shaun returns to his apartment to “fix” his sink.

The next day, Dr. Melendez’s surgery on the pregnant patient is successful. She is going to have her baby. At the same time, Dr. Murphy suggests an alternative to his patient losing sensation in her genitals — They could do something else that would cause her to lose sensation in her thigh instead. She seems delighted at the idea. That surgery is successful too. After she wakes up, she decides to call her parents.

Dr. Andrews is surprisingly encouraging to Dr. Murphy. “I’m guessing Dr. Melendez doesn’t let you know this enough, but you’re both doing a great job and if either of you needs anything, my door’s always open,” he offers. I can’t help but wonder if there’s an ulterior motive given his previous behavior. I’m interested to see where this goes in future episodes.

Dr. Balu and Dr. Browne tell Dr. Murphy to go to a bar with them, to celebrate their successes. I’m pleased they’re including him and treating him like an equal, but also frustrated that they’re pressuring him to do things he clearly doesn’t enjoy. He doesn’t drink the beer they order him. Dr. Murphy flashes back to his childhood when he almost kissed a girl, Colleen. She tries to convince him to pull down his pants. He doesn’t. Instead, he asks for a kiss. Then all of the other kids come out and laugh at him. “I can’t believe you were going to pull down your pants!” she mocks, even though he wasn’t. It was a trick. Bullies are cruel. In the present, the doctors toast to their successes.

What didn’t

  • More Dr. Murphy sass, please. All the Dr. Murphy sass.
  • “When we’re in meetings together, don’t ever call my ideas ridiculous.” I appreciate that Jessica is always willing to point out when Dr. Melendez is acting like a disrespectful ass. At the hospital, she outranks him.
  • Dr Murphy’s reaction to the suggestion that he gets a home health aide was really important. Autistic people without intellectual disability need support. Needing support doesn’t mean he’s less of a person. I really want to see Dr. Murphy learn how to accept help. Related, I want to see Dr. Murphy meet other autistic people. It seems like he has a lot of internalized self-hate about his disability.
  • The depiction of Dr. Murphy’s sexuality threaded a fine needle. I was concerned he was going to be portrayed as a creep or as completely asexual. Both are unfortunate stereotypes about autistic men. The show portrayed neither, and I am relieved.

What didn’t

  • The abortion and porn plot lines this episode were convoluted and heavy-handed.
  • I’m pretty sure using a bypass machine to avoid blood clots causing heart attacks during surgery is not how anything works.
  • Dr. Balu’s pursuit of Dr. Browne isn’t romantic. It’s creepy. She’s laid out clear boundaries and all he seems to want to do is waltz right past them.
  • Lea, Dr. Murphy’s neighbor, doesn’t seem like a real person yet. She needs a lot more character development. I hope the show takes her farther than just being Dr. Murphy’s love interest.

Neurotypical Bullshit (NTBS)-O-Meter

  • Dr. Glassman’s speech to Dr. Murphy at breakfast essentially boils down to, “have you tried not being autistic?” Being smart and accomplished doesn’t mean an autistic person doesn’t have deficits, and Dr. Glassman should know better.
  • Dr. Andrews asking Dr. Murphy about how he felt on handshakes, hugs, and dating was totally inappropriate. Dr. Andrews should mind his own damn business.
  • Yes, Dr. Browne and Dr. Balu. Autistic people also look at porn. Autistic adults are adults.
  • The stereotype that autistic people don’t date kind of sucks, although to be fair, it seems that Dr. Murphy’s hesitance is a result of childhood bullying, not autism, per se.

So what did you think? Good, bad, or just indifferent? Weigh in on the comments below.

3 thoughts on “The Good Doctor: Season One, Episode Four”

  1. I missed the first 15 minutes of the episode and then I had trouble following the rest because prosopagnosia. Right now I can only reliably recognize Drs. Murphy and Glassman by their voices, which puts something of a barrier in terms of following the plot. This is a chronic problem I have with television. So I am mostly responding to your review, rather than the episode.

    So about the ER and scutwork. Part of surgical culture is to devalue anything that takes place outside an operating room. This includes seeing patients post-operatively in clinic, seeing patients in the ER, examining patients before rounds, going on rounds, talking to families, checking labs, talking to other doctors about patients and lots of other similar activities. There are individual surgeons, of course, who do value these activities and are exceptionally good at talking with patients and families and explaining things to them. I remember one when I was in medical school who made it a point to personally see her patients briefly before they were anesthetized. These were elective surgeries and most doctors in her position would meet them in clinic, but then have a resident do the pre-op necessities on the day of surgery. And I worked with a pediatric neurosurgeon who once spent 2 hours discussing a prenatal diagnosis with a family. As a pediatric resident, I would go to clinic with him when I could, for the teaching. His own residents were seldom there, seeing clinic as a waste of time compared to actually operating.

    So while I’ve never seen the ER specifically handed out as a punishment (it would typically be someone’s turn to cover) it would definitely be considered an undesirable assignment by many surgeons and residents. I did a lot of those chores as a medical student, which was very symbiotic. The residents appreciated getting out of the 60 minute inpatient consultation they didn’t want to do, and weren’t as grouchy about having a medical student who wasn’t physically able to suture or hold some of the OR equipment.

    The residents had better not have all been on for a 36 hour shift because this has been illegal for several years at least. I am still yelling at Grey’s Anatomy for naming their pilot “48 hours” and then putting the team all on for 48 hours together. Also the team doesn’t all take call together. The whole point of being “on call” is that someone has a turn while the rest of the team goes home.

    Using a bypass machine to prevent a heart attack is so medically wrong I don’t know where to start. I mean, it’s not my field. I’m a pediatric development specialist. So I can’t be more specific. But it’s wrong.

    I keep wondering where Shaun Murphy lived for college and medical school. Did he never have to ask someone to make repairs before? Did he never learn about when to make urgent versus routine requests of that someone? Did the apartment not come with written information saying “contact at this number during these hours and at this number for emergencies only after these hours?” Because everywhere I have lived provided that information in writing, and anyone who can memorize an anatomical encyclopedia should be able to memorize the building super’s schedule.

    As an AAA (that’s Aromantic Asexual Autistic) I am cautiously optimistic about the way they brought up Shaun’s sexuality. Sometimes I think being AAA makes it easier for me to discuss sexuality with my patients because I can be more objective and less giggly. At least, that’s what I tell myself to counter the professors who erased asexuals and asexuality during my training and implied that sexuality is something we can all relate to in our patients.

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