Season 4 Rewatch: 4×04 Not The Same

The Good Doctor Argentina on Twitter (@TheGoodDoctorAr) is currently running a ’20 Days Countdown to The Good Doctor Season 5’, and on Day 4 we’ll be recapping episode 4×04 Not The Same.

Patient Stories

Patient #1 is Billy, who comes into the clinic for an ingrown hair on his upper arm. It’s Morgan who first sees this patient, and then she calls Claire to drain the abscess that has developped. Asher and Enrique are also assigned to this case. Looks pretty routine, right?

Turns out it’s not routine. It’s skin cancer. And Billy isn’t all that distraught. He’s kinda Mister Optimistic, nothing seems to throw him.

During surgery, Billy has an anaphylactic reaction to the dye they use, and they realise he has additional vascular issues and may need further surgery. And as if that isn’t enough, they also detect malignant metastases in his liver. Finding a treatment option that will help Billy suddenly has become near impossible.

Billy’s personal story is actually really touching. He was ready to commit suicide after the death of his wife, but then he saw some kids with a flat tyre by the side of the road, and instead of killing himself, decided to help them. He just wants to help people, it makes life worthwhile. I can so much underline this notion. It is such a wholesome thing if you can make someone happy just by donig a little thing to help them. I wish there was more of that out there, and less egocentricity and profiteering.

Patient #2 is a young pregnant woman (with twins), Kenzie, who comes in with abdominal pain, also first seen by Morgan. Shaun gets interested in the case as avoidance strategy not to have to teach his first year residents.

While Morgan and Shaun bicker over whether or not the First Years are useful, the patient’s blood pressure skyrockets and Shaun diagnoses preeclampsia. Over the course of the episode, Kenzie develops a number of complications, and it turns out that she doesn’t actually have preeclampsia. One of her twins is Rh+ and one is Rh- (Rhesus factor — a type of human blood group system), which sends Kenzie into an immune reaction that causes her body to reject one of her twins.

The sick twin takes a turn for the worse, while the amniotic sack of the healthy twin ruptures. It suddenly becomes really complicated because they can only save one of the babies. But which one? It’s an impossible choice. Shaun has an idea how to save both babies, but that makes it a 70% chance that both babies could die if they try his suggested delayed interval delivery. How does one make such an impossible decision, and who is most fit to make it?

They manage to deliver the first baby, but the contractions aren’t stopping, and it looks like the other baby is now due as well. However, with Jordan’s help, they can stop the contractions, and Shaun’s plan actually works. Both babies are saved!

Shaun & Lea

“Move from Bhujangasana into Adhomukha Shvanasana and hold that.” So Lea is a yoga enthusiast, huh? (It’s okay, I can relate, and this made my yoga nerd heart skip a beat.) Shaun doesn’t like it as much, though. “I like that you like it.” Yeah, Shaun, we need to work on your hand placement and your elbow orientation.

When Lea suggests they finish vinyasa flow next time she comes over, Shaun tells her, “You shouldn’t come over anymore. You should move in.” Oh dear. It’s too soon, Shaun. And thus starts the discussion of, ‘Are we ready? Do we have enough trust? Is this different from when we were roomies/pals/buddies?’

Shaun fails to understand that living together as a couple means more commitment, more trust. Lea isn’t sure they’re quite there yet. “Copernicus 1543,” Shaun whispers in Lea’s ear. “It’s my banking password.” Aw, Shaun. Stop being adorable.

Shaun’s next lesson is that context matters. He chastises Lea that work behaviour is not the same as home behaviour. That’s exactly like two roommates living together being different from a couple living together, right? “Once our feelings change, everything changes,” Lea explains. She isn’t sure that Shaun’s really getting it.

They have a conversation about moving in together in the break room. Lea admits that she can’t imagine not living with Shaun a year from now, and thus if it’s gonna happen anyway, then why delay the whole thing? She presents him with the happy news that she’s made her decision, thinking Shaun would do his little happy dance, but he actually doesn’t. “So you want to do it just because it’s inevitable?” Yeah, pretty much. But then he decides he doesn’t care, and is just happy that he’ll have Lea back with him.

I love Shaun when he’s happy. And I love Shaun and Lea together, because that makes him happy. Happy!Shaun is my jam.

Lea moves back into the apartment at the very end of the episode. (And she brings the baseball back with her.) “Feels like home again,” she says. Shaun agrees while he puts the pasta on the dinner table. She tells him, “Maybe you’re right. Maybe things are the same.” Shaun disagrees. “No. You were right. It’s not the same. It’s better.”

Dr. Murphy’s Teachings

One of the recurring themes this season is honing Shaun’s skills as a teacher and mentor. And the First Years get to learn along with it. What can go wrong?

Shaun knows full well he’s not great at teaching and doesn’t particularly enjoy it, so he tries to hide from his teaching responsibilities by finding a distraction at the Clinic. Morgan isn’t shy to tell him, “First Years aren’t distractions, they’re Godsends. They’ll do anything you want. Scut work, follow-up, coffee runs…” Shaun interjects, “I don’t like coffee.” Morgan knows how to bait Shaun, “Apple runs,” she corrects. (Of course Shaun later realises that Morgan was wrong, and First Years aren’t Godsends, they’re actually a lot of work. Who would’ve thought?)

Shaun’s teaching capabilities are also on the Attendings’ minds. Andrews knows that Shaun will struggle somewhat with the assignment, so he sits down with Shaun and asks him how his First Years are doing. “Jordan talks too much, and Olivia talks too little. And Olivia doens’t know where the jugular vein is,” he adds under his breath. Andrews does not think Olivia is that oblivious (Anatomy 101, right?), so he encourages Shaun to give Olivia a little extra attention. It’s a confidence issue, not a knowledge issue.

Shaun questions whether that’s unfair to Jordan, but Andrews counters with a question of his own that throws Shaun quite a bit. “Was it unfair to the applicant who didn’t get your position because Dr. Glassman thought you needed some extra attention?”

The extra attention Shaun promptly gives Olivia is the two of them practicing on a patient dummy. And Andrews was right. Olivia indeed knows where the jugular vein is and aces the mock central line placement. “Didn’t you have first case jitters?” she asks Shaun. “No,” he tells her. Well. His first case wasn’t exactly routine with time for stage fright, was it?

What Shaun also struggles with is realising he’s now not just responsible for his own work anymore, he’s also responsibe for every mistake that his junior residents make. He runs to Dr. Glassman with this conundrum. “How is it fair that I get blamed for a First Year’s mistake, and how can I help that person without being unfair to the other one,” he consults the list in his notebook, “and how fair was the preferential treatment that you gave me, and how fair was it to the other first year resident who didn’t get placed because you helped me, and how fair was–” Glassman has to stop him there. “Only four questions at a time, that’s my limit.”

Shaun keeps arguing fairness, but Glassman tells him it’s not always about that. It’s about figuring out his students’ needs, and then catering to them. That stumps Shaun again. “How do I know what they need?” When Glassman suggests it might be an emotional issue, Shaun panics. “Then I definitely can’t give them what they need!” Glassman’s answer is simple. “You can ask them.” About their feelings. Uh oh.

Shaun tries this out the next time he speaks to Olivia. “How do you feel?” he asks. “Okay,” she says. “How do you really feel?” She frowns. “Really okay…?” But then she starts talking. She’s terrified of firsts, and she was sometimes laughed at in school when she couldn’t deliver under pressure. Shaun can definitely relate to being bullied in school.

At the next chance they get, Shaun lets Olivia place an IV, and she does great, so he figures he has fixed her. But then Morgan points out to him that Jordan has a problem with people in authority, and Shaun needs to fix that too. Oh no. Another riddle to solve. Which he eventually does. Jordan wants to be reassured that Shaun will cover her ass if she happens to screw something up.

After they’ve wrapped up their twin pregnancy case, Shaun seeks out Dr. Glassman. “I can’t teach,” he proclaims bluntly. “I learned that Olivia needed help, so I helped her and now she feels sick because I helped her. Morgan says Jordan needs help, but Jordan says she doesn’t need help, but Jordan’s mad because I didn’t help her.” Glassman hits the nail on the head when he responds, “Okay, that sounds tricky.” Shaun confirms. “That was my point.”

And then Grumpy Second Dad Glassman says something really beautiful to Shaun. “You’re a wonderful teacher. Been learning from you since the first day we met.” The tiniest hint of a wistful little smile on Shaun’s face is everything.

Interestingly, just today we got a new quote from David Shore (the showrunner), that fits perfectly into this whole conversation. “As I’ve said many times, the show is at its best not when Shaun learns but when we learn from Shaun.” And we constantly do.

With all the lessons Shaun’s been given, he draws his own conclusions, and it’s beautiful in its own right. He gives Olivia a list (!) of all the things she did right on the case. “You can hack it,” he tells her. Jordan gets a list of all the things she did wrong on the case. “I’m covering your ass.” Well, there we go, Shaun. Glassy was right. You’re an awesome teacher.

The First Year Residents

While they’re treating the young pregnant woman, Kenzie, we learn a bit more about Olivia and Jordan. Olivia seems to have self-confidence issues. She bumbles on the placement of a central line and Jordan actually has to take over.

Asher and Enrique get to know each other a little better, too. Asher tells him about how he grew up in a hasidic family but hasn’t spoken to them in four years except one sister. He knew the consequences of leaving, so it’s not like he’s allowed to have regrets, right? Enrique’s father was a real estate agent who cares about two things: teeth and taxes.

When Jordan talks to Morgan, we learn that Jordan isn’t averse to risk taking. She tells Morgan that, if she’d made the safe choice, she’d be living on an army base in Germany, married to first lieutenant Blaine Buckman.

Big reveal here, because it turns out that Olivia is actually Marcus Andrews’ niece. She remains adamant that she doesn’t want any special treatment from him, and he promises he’ll be hands off. But will he really be? Shaun outs her as Andrews’ niece in front of their pregnant patient and Jordan (he Googled it, he couldn’t trust her resumé), and Olivia feels awful. Her uncle seems to think she can’t hack it as a surgeon.

At the end of the episode, she talks to her uncle about it. He just wants to help, be a mentor, but Olivia doesn’t want his help. She wants to know that he trusts her to do it on her own. “I love you too, but I have to make this work,” she tells him.

Claire also has some good advice for Asher and Enrique. “Opposing points of view are great, as long as you actually listen to the other point of view. You’re carrying baggage that is affecting your decisions. Figure out what you’re carrying.” Claire would know about that, wouldn’t she?

The Others

We see Claire and Audrey hanging out together to play PlayStation. It’s nice to know that the two keep bonding beyond their regular meetings to talk about Neil, though the supervisor/subordinate relationship will certainly complicate things a little.

Alex comes running into the hospital and is uncharacteristically late, feigning car trouble. Morgan gives him a look. She knows something’s up. Morgan then goes on a pranking spree — she hides all the size L scrubs so that Alex has to go into the OR clad in size M, and it looks ridiculous. He’s not amused when Morgan brags it was her.

Alex tries to find meaning behind Morgan’s weird pranking escapade and reaches out to her. The way he sees it, she’s angry because she sacrificed her career and her hands, and she’s taking it out on him and Claire. Of course Morgan being Morgan, she doesn’t let anyone get close and brushes him off.

Later, when she confronts Alex about his non-existent car trouble, he admits he just finalised his divorce with Mia. Kellan is 18 now, so they don’t have to deal with any complicated custody stuff. He opens up to Morgan. “I know it’s been over for years, but when it’s really over, it hurts. And I’m pissed at myself for being hurt, and now I’m pissed at myself for admitting that to the coldest person I know.” Morgan’s response is to offer to him to move in with her as a roommate, seeing how she has the extra space. He politely declines.

Later that day, at night, Morgan is home, watching a movie, eating take-out, when there’s a knock on her door. Surprise! It’s Alex with a suitcase. She invites him in, and thus Alex moves in with Morgan. And they were roommates!

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