This week’s episode of The Good Doctor is titled “Oliver.” “Oliver” is the name of the donor of a very important liver, a liver that will save a life. The episode’s main plot dealt with the ethics of transplantation, which is pretty heavy stuff. Transplant lists literally decide who will live and who will die. Overall, the episode was decent — Much better than last week’s DSM dumpster fire. Sean once again has motivations beyond pathology. God willing he stays that way for the rest of the season and even perhaps grows as a person.
I think ABC really missed an opportunity with this episode to educate, however. While exploring the ethics of transplantation, it would have been wonderful if they had explored the ethics of transplantation as it relates to people who have intellectual and developmental disabilities — People like Dr. Sean Murphy. If Sean needed a transplant, he might be discriminated against because he is autistic. If you were not aware of this problem and believe people like Sean deserve a fair shot at life, the Autistic Self Advocacy Network has a toolkit for that.
‘Feed it once and it will never leave you alone.’
The episode opens to Dr. Murphy’s apartment. Apparently, he has gotten some furniture! Or at least he has gotten some deck furniture. A cat lounges on a deck chair and meows loudly. Suddenly, there is a knock at the door. Dr. Murphy’s neighbor in the next apartment was playing video games but her controller went dead. She asks if she can borrow some batteries. Dr. Murphy gets them for her. I am not sure if she’s flirting with him? Dr. Murphy doesn’t notice anything amiss, and it’s hard for me as an autistic viewer to tell too. On her way out, she warns Dr. Murphy not to feed the cat. “Feed it once and it will never leave you alone.” I think she’s using feeding the cat as a metaphor for giving her batteries? Dr. Murphy seems to be making friends.
At the hospital, Dr. Browne answers the phone at the surgical department. The person on the other end asks to speak to a doctor, not a nurse. “Well then, you’re in luck, because I’m not a nurse, I’m a surgical resident,” she says, handling some unpleasant sexism smoothly. The next minute, she’s running through the halls of the hospital. They have a liver transplant to pick up — It will be viable for eight hours. Dr. Melendez orders Dr. Browne and Dr. Murphy to go pick the liver up and bring it back to the hospital. There is a man named Chuck who needs a new liver, and he seems well liked by the surgeons. Dr. Balu is ordered to prepare Chuck for surgery.
In surgery, important board member Allegra Aoki speaks with other important board member and chief of surgery Dr. Marcus Andrews. She stresses the importance of a surgery going well — She hopes that the man receiving the surgery, Wannamaker, will give a large donation to the hospital. She also asks Dr. Andrews to take Dr. Melendez as his second during the surgery. Dr. Andrews is offended and feels he could do perfectly on his own.
‘The rotors just go round and round, Sean. They don’t change.’
‘I’m not a quitter.’
Dr. Edwards sees Wannamaker. His room is enormous, private, and decked out in flowers. “I’ve got a hole in my mouth. You ever try drinking scotch with a hole in your mouth? Waste of good scotch,” Wannamaker comments. It turns out that despite just having had an oral cancer removed, Wannamaker has continued to smoke. “It restricts the vessels, hurts the healing,” Dr. Edwards explains gently. “I’m not a quitter,” Wannamaker responds.
Dr. Edwards explains the procedure — How they will take skin from his leg and graft it onto his cheek. The Wannamaker responds, “I’m an old real estate guy. There’s an old saying. You can have it fast, you can have it good, you can have it cheap. Pick two.” “Well, it’s not gonna be cheap,” Dr. Edwards answers.
At the hospital, Chuck’s labs test positive for alcohol. The rules for liver transplants state that you can’t have a drink for six months before surgery. Dr. Balu insists there must be some kind of mistake, and is distraught. If Chuck doesn’t get a liver transplant, he will die.
Dr Balu confronts Chuck, and asks if Chuck has fallen off the wagon — Part of why Chuck needs the liver in the first place is that he is a recovered alcoholic. Chuck confesses to having had one drink, three days ago, at his daughter’s college graduation. She’s the first person in his family to graduate from college. He had a glass of champagne. One glass, to celebrate.
Dr. Melendez does some math on the amount of alcohol in Chuck’s blood and checks to see if Chuck is telling the truth. I am sure high school math teachers everywhere will be using a clip of this scene to show how algebra is useful and important in the real world. Dr. Melendez verifies that Chuck is telling the truth. Chuck only had one drink, three days ago. Unfortunately, the registry rules aren’t flexible. Dr. Melendez feels that at least he has an argument, though. He decides to fight for Chuck.
‘You don’t like questions, do you?’
In the police car, Dr. Browne and Dr. Murphy make awkward small talk. Suddenly, the temperature on the liver cooler begins to rise. They need to get to somewhere with ice in order to save it. This being television, that means filling the liver cooler with blue slushie at a gas station because the ice machine is broken. Nope. Not joking. The store clerk informs them that every five seconds of slushie will be charged as a “large.” That’s going to be an interesting receipt for reimbursement from the hospital.
Dr. Browne asks Dr. Murphy a barrage of questions which he does not answer. She realizes that Sean is more likely to respond to her when she makes a direct statement, rather than when she asks a question. There is rising, stirring music, as if this is some great epiphany. From my perspective, it is arbitrary nonsense. To quote Dr. Glassman earlier in the episode, “just let him be.”
At the hospital, Dr. Balu goes to inform Chuck that he might not get the liver transplant, but that he and Dr. Melendez are going to fight for him. Chuck ask he if deserves it. He talks about dying. He talks about how he could have been a better man, a better father. He drank too much. He tells Dr. Balu that he has a son, too, but that son hasn’t spoken to him in over three years. Dr. Balu’s responds, “getting a liver isn’t a second chance. It’s not a reward you get for being perfect. It’s just what we can do.”
Chuck makes peace with his death. He understands that there are other people on the registry who also have names and stories and who want to live. The actor delivers the monologue as well as possible, but it’s a little over the top. Who is really this self-sacrificing and Christ-like? Who goes to their death so willingly? It seems inhuman. Suddenly, Chuck coughs up blood and collapses. Dr. Melendez determines that without this liver transplant, Chuck has three months left to live.
‘This is better than having a baby in my car.’
Back in the police car, Dr. Browne marvels at the lack of traffic. “I should get a police escort to work every morning.” “280 South, where all roads meet,” the police officer jokes. Dr. Murphy laughs, taking him literally. “No they don’t!” I appreciate that the line is Dr. Murphy enjoying the joke in his own way, rather than his misunderstanding being some kind of punchline.
In a flashback, a policeman brings Dr. Glassman to Sean. Sean is sitting silently, reading an anatomy textbook with a large picture of a liver. “What’s wrong with him?” The policeman asks. “He’s autistic, officer” a woman responds. “What’s that mean? Does he need to be in a hospital?” “The last place he should be is in a hospital,” Dr. Glassman tells them.
In the police car, Dr. Murphy finds a blood clot in the liver that needs to be transplanted. This is damaging the liver somehow. This means Dr. Murphy dumps out some of the blue slushy and operates on the liver in the side of the highway. It’s non-sterile conditions and at one point, Dr. Murphy uses a straw from the policeman’s cup for part of the procedure. I have a hard time believing the liver is still usable after this. The policeman is impressed. “This is better than having a baby in my car!” he declares. Honestly, cutting open a liver and sticking a drinking straw in it is pretty boring compared to the miracle of a new life, but OK.
Dr. Melendez goes to make his case for Chuck in front of the transplant committee. He makes good points about the arbitrary nature of many of the transplant rules. “One drink and you die. A couple pills of ecstasy, no problem. Hepatitis B from careless sexual practice, nope. Nothing at all about that.” Dr. Melendez thinks an exception should be made. Dr. Edwards counters, “We need the rules. Without the rules, we’re playing god. He’s right, to some extent — There are a lot of people on the transplant list. “We have one liver today and 800 people in this state need it. I don’t want to be haunted by the other 799… Is it worth it to risk the lives of hundreds of patients?” Dr. Edwards asks. “I don’t have hundreds of patients right now. I have one. And his name is Chuck.” This scene is easily my favorite in the entire show so far.
Dr. Browne learns that Chuck won’t get the liver, and so the liver needs to be taken to a different hospital. She is heartbroken. Sean seems serene. “It was a good day. We saved a life. Just not Chuck’s.”
Dr. Melendez watches Chuck leaves the hospital with his family. He is going to get palliative care at home. He sees Wannamaker fresh out of surgery for his cheek reconstruction. Wannamaker has a cigar in his mouth. He has done nothing to change his behavior, but he gets to live. Chuck had one drink at his daughter’s college graduation, and he is going to die. Life isn’t fair.
Dr. Murphy goes back to his apartment building. He stops to ask his neighbor for the batteries she borrowed. Apparently no one ever explained to him that “borrowed” is contextually ideomatic and that the person who “borrows” a small, disposable item like a tissue or a battery isn’t expected to give it back. She doesn’t seem to mind. In fact, she seems to think he’s flirting with her.
Dr. Melendez lies in bed at night with his eyes open, feeling guilt for what happened at the hospital today. Dr. Murphy feeds the cat on his porch, even though he was advised not to.
We flash back to Dr. Murphy as a child eating pancakes with Dr. Glassman. The episode closes with an adult Dr. Murphy and Dr. Glassman eating pancakes together in the hospital cafeteria. They sit, enjoying each other’s company, and do not speak.
- This episode dealt with the ethics of transplant allocation in a really complex and challenging way.
- The messages about healthcare quality, personal responsibility, and class were pretty heavy-handed, but definitely topical.
- Sean gets to be a person with motivations this week, instead of just a pile of walking autism symptoms. God willing, that will carry into the rest of the season.
- Dr. Melendez had likeable qualities this week. I’m happy he’s becoming more complex, instead of just a bigoted tyrant trying to destroy Dr. Murphy’s career.
- Tim Russ’s monologue as Chuck about life and death had me in tears. It was melodramatic, but extremely well executed.
- Dr. Browne was extremely annoying during this episode. That is in the pro column, though. I look forward to watching her learn to interact with Dr. Murphy on his wavelength, rather than trying to force him onto hers. She needs to learn to see him as human.
- I actually liked Dr. Glassman this week. For the past couple episodes, most of his time on screen involved getting off to his own inspiration porn. Seeing him spend time and connect with Dr. Murphy in a comfortable, natural way, and to encourage others to do the same was really nice. I want to see more of Dr. Murphy’s relationship with Dr. Glassman.
- High school math teachers everywhere are going to be showing that scene where Dr. Melendez uses algebra to their students every year from now on.
- I wish they would stop showing Sean’s pet rabbit getting murdered during the recap at the beginning of every episode.
- Is the 24 style countdown for transplanting an organ actually a thing?
- The whole thing with the blue slushy machine, the roadside liver surgery and the drinking straw was just beyond silly.
- Is it actually possible to tell in a lab test that someone had a drink of alcohol three days beforehand.
- Please, for the love of God, somebody buy Dr. Murphy some hearing protection.
Neurotypical Bullshit (NTBS)-O-Meter
- Basically everything Dr. Browne said to Dr. Murphy this episode. Calm down and leave him alone. Not every moment needs to be filled with constant chatter. Christ.
So what did you think? Good, bad, or just indifferent? Weigh in on the comments below.