Season 4 Rewatch: 4×12 Teeny Blue Eyes

The Good Doctor Argentina on Twitter (@TheGoodDoctorAr) is currently running a ’20 Days Countdown to The Good Doctor Season 5’, and on Day 12 it’s time to take a closer look at episode 4×12 Teeny Blue Eyes.

Patient Stories

Patient #1 is Dr. Silas Chambers. He’s a renowned and admired surgeon and comes into the hospital for an issue with his hand that impedes his ability to keep operating. Shaun, Claire and Enrique see him (as one of Dr. Andrews’ cases), and Shaun soon notices certain traits and behavioural patterns that let him conclude that Dr. Chambers is autistic. Chambers vehemently denies it. It’s also what causes his wrist issues, because he has very distinct movement patterns that he seldom modifies, which resulted in musician’s dystonia.

Chambers isn’t happy with the suggestion of physical therapy and wants brain surgery to fix the problem quickly and permanently. Despite Chambers’ discontent with the topic, Shaun keeps pushing the issue of getting Dr. Chambers an ASD diagnosis, even though Andrews clearly told Shaun to back off. But Shaun is invested, and he doesn’t understand why someone would not want to admit that they are neurodivergent. It doesn’t make him a better or worse person, does it?

During surgery, they find out that the planned treatment course won’t help since the underlying problem is the vertebral artery pressing against Silas’s spinal cord. He needs vascular surgery or he’ll die.

Shaun’s persistence eventually gets Chambers to take a diagnostic ASD questionnaire, and it turns out Shaun was most likely right. Chambers softens a bit to the idea of being autistic, and Shaun is happy to see that he may ultimately consider seeing a psychiatrist to get the diagnosis professionally confirmed.

David Shore once said the best episodes aren’t when Shaun learns from others, it’s when we learn from Shaun. And Chambers learned from Shaun that ASD isn’t something he needs to hide or overcome, that he can still make friends if he tries, and that not always being a jerk can have its rewards. Well done, Shaun!

Patient #2 is Oscar. He’s had very severe chronic pain on his face for nine months, and no one has been able to figure out where the pain comes from and what to do about it. Alex, Morgan and Jordan run all sorts of tests, but can’t find anything either. They have a few theories, but nothing really pans out medically.

Oscar’s wife is there by his side, but she divulges to Alex that Oscar had previously been addicted to opioids and it took him a year to kick the habit. Now he’s back on painkillers and she couldn’t take it anymore and moved out. She’s only here because he asked her to. And she thinks he may be faking the condition to get more meds.

When they give Oscar an MRI, they find out he actually has trigeminal neuralgia, which is a form of neuropathic pain. It’s real and not a drug-seeking attempt. There’s a surgery that might help, and they attempt it, but it doesn’t work.

Treatment options after the unsuccessful surgery are pretty narrow, and the best course of action is pain management. However, there’s one more surgery they can try, but it’s risky because of high likelihood of paralysis and not recommended. His wife doesn’t want him to do the surgery, she promises to stay with him to manage the pain. Oscar doesn’t want that. He pushes to have the surgery, and this time, it works, Oscar is finally pain free. A happy ending for him and his wife.

Shaun & Lea

After the big news of Lea being pregnant from the previous episode, we venture into all the big pregnancy topics for this one. Shaun wakes up in the middle of the night, and Lea is not in bed. He seeks her out and finds her on the touch, wrapped in a blanket. Obviously, she has things on her mind.

There are lots of things they will need to consider, first and foremost whether they even want to have a baby at this time. Shaun’s answer to this comes very quickly and easily. “I love you. I want a child, so I want this child.” But Lea isn’t quite so convinced. “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?” They will have to talk about that some more later.

At the hospital, Shaun sees Dr. Glassman to break the news. Of course he does it with his usual carefully crafted eloquence (we have a German saying: ‘to fall into the house with the door’). “Lea is pregnant.”

Whoa. Aaron surely didn’t expect that. He’s stunned into a brief moment of surprised silence, but then he decides to be happy about the news. He probes Shaun’s reaction and potential concerns, which Shaun definitely has. “Yes, sleep deprivation. But I have started looking into an affordable night nurse.” Always with the pragmatic problem solving, our dear Shaun.

Meanwhile, Claire bears witness to Lea chucking up in the ladies’ room, and draws her own conclusions. Lea confides in Claire over coffee in the cafeteria. Lea still has all these doubts. One of her worries is that Shaun’s autism might be hereditary. How high are the chances that their baby might be autistic, too? And should that factor into their decision whether to keep the baby or not? “Let’s say you have a little baby Shaun…” Claire probes. Lea smiles. “Tiny, honest, brilliant guy who adores me. Mini button-down. Teeny blue eyes… And me. A mom…?” This is where our episode title is borrowed from.

At the hospital, Shaun struggles with his current case – Dr. Chambers, who has trouble accepting that he may have autism. While we’ve had several other previous autism cases on the show, this one present a unique challenge for Shaun, because Dr. Chambers wants to stay in denial about his diagnosis, and this seems particularly difficult for Shaun to understand.

Shaun grew up with full knowledge of his diagnosis, and learned to accept and work around it with the help of his brother and Dr. Glassman, and now his friends and colleagues. Confronting someone who vehemently rejects that he’s neurodivergent sends Shaun into a crusade to convince Dr. Chambers of his diagnosis, and make him accept it.

Shaun’s intentions are admirable. He wants to teach Silas that autism is nothing to be ashamed of or need to hide, that you can live a good life and be a good person even with what some people may consider deficits. And when he gets nothing but resentment and anger from Silas, he starts to doubt himself.

Claire finds Shaun outside, upset and alone after his latest incident with Silas, and she talks to him. “Dr. Andrews said to stop talking to him about ASD, but I did 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—” Claire knows about the pregnancy, and Shaun is relieved as hell that he has someone else he can talk to about it. “Is this hard for me because I’m dealing with both things at once?” he asks Claire.

Shaun has doubts that he’ll be a good parent to his child. “How can I know what they’re feeling? How can I comfort them? How can I be a good father?” And that’s only natural. He knows that he won’t always be able to always offer the emotional support that may be needed. And he wants so much to be a good father. There’s no doubt in Claire’s mind that he will be. And I don’t think any of us have doubts that he would be, right?

Back home, Lea and Shaun need to talk about their next steps and the big decision. Both have made lists of pros and cons, and there’s quite a few cons on the list. It’s natural and healthy for responsible parents to have doubts about whether having an unplanned child is the right thing to do. But Lea thinks that, if they’re both having doubts, then maybe it’s not the right time. Shaun tears up, but he agrees that Lea is probably right.

Side note: In one of the earlier scenes in the episode, you can actually see the list that Shaun started making in his notebook. It outlines the following:

HAVING A BABY PRO

  • Help w/ personal discipline
  • 2nd chance at better family life
  • Enjoy talking to kids
  • Pregnancy before 30 ➜ lower chance of breast cancer
  • Childhood disorders correlated w/ age of father
  • Give a child a chance for a good life

HAVING A BABY CON

  • Lea is unsure

Later throughout the episode, Shaun mentally adds more bullets to the pro list (as shown in a ‘thought process’ VFX montage):

  • Order off of kids’ menu without having to answer questions
  • Excuse to buy Science Museum season tickets
  • Excuse to avoid social obligations

There’s a short but touching scene where Lea is asleep in their bed, and Shaun is up, in his pyjamas, taking the plastic scalpel out of a wooden box. It’s still carefully wrapped in the blue cloth, and he takes it out and touches and rubs it, like he used to when he needed an object to comfort and calm him.

This is a testament to two things, actually.
1) The fact that he seems to be keeping the scalpel in a box in the apartment illustrates significant emotional growth for Shaun. He’s become a lot mellower and more even-keeled. There’s no longer a need to have the scalpel as a comfort object on him at all times.
2) Shaun is a great deal more troubled by their decision to abort the pregnancy than he let on towards Lea. He wants to have a child, but most of all he wants Lea to be happy. And it seemed like keeping the child would not make her happy, so he put her needs above his own. Lea’s happiness is always at the forefront of Shaun’s mind, but this feels pretty huge to me.

Question: Why are Shaun’s sleep shirts never crumpled? Wardrobe department, please get on this.

Shaun and Lea go to an abortion clinic together, and Shaun holds her hand while they wait. Lea’s name is finally called, but she hesitates, not ready to go in. She’s thought about it all day, and she’s tried to convince herself for hours that aborting the pregnancy is the right thing to do. But is it really? Do they really not want this baby?

“Maybe it’s not the right time, but will it ever be?” she asks Shaun. “I… feel the same,” he tells her. And thus they make the joint decision to keep the baby. “We are having a baby,” Shaun says with contented reverence in his eyes. Wow. Okay. Baby Shaun with teeny blue eyes and tiny button downs is on its way! Bring on the new family adventure.

The First Year Residents

So finally we’re seeing Enrique doing away with the board shorts, are we? Dr. Chambers remarks on how there should be an appropriate dress code being followed in the hospital, and it’s kind of a miracle that Enrique actually takes it to heart. The next day, he comes in, wearing slacks and a button-down. Jordan can’t help but comment on Dr. Chambers’ demand, “He did improve Enrique. Not kidding. You look snazzy.”

While they treat Silas, Enrique confronts him about being a jerk to Shaun, and Silas goes off on a rampage about how he wasn’t treated with respect when he was a resident, and that respect has to be earned. “Surgeons deal in human lives, not childish fantasies. If you want to succeed, you’re gonna have to be a lot more like me,” Silas tells him. And that plants a seed.

He talks to Claire about it. Enrique realises that he doesn’t want to change. He wants to change what’s around him. Claire later catches him in the locker room where he’s packing up his things. “I’m transferring out,” he tells her. He applied to a program at Johns Hopkins where they train doctors to travel to areas with medical need, and they’re accepting him to enrol late.

Silas’s statements and the talk with Claire has made him realise that a competitive surgical residency isn’t the place for him, and so he’s trying to sneak out. “For the first time I can remember, it felt hard to say goodbye,” he tells Claire before he walks out. And then there were only two first year residents left.

The Others

Alex and Morgan’s constant bickering is still continuing. The one where I actually want to cheer Morgan on is when Alex talks about how pain is an unavoidable part of being a Tae Kwon Do competitor, and she tells him, “Wow, that statement has the absolute ideal ratio of heartlessness, humblebragging and machismo. Bravo.”

Later they meet in the break room, and Morgan starts a whole new round of teasing when Alex blurts out, “I’m attracted to you.” She’s speechless for a moment, and then all the walls go up. “I can’t have a roommate who has feelings for me. You have to move out. As soon as possible.”

And Alex does. Morgan asks if he was messing with her or not, but he confirms that he wasn’t. “Then I guess it’s good we’re not roommates anymore,” she tells him, “Because I couldn’t do this.” And then she kisses him — full on and passionate. She adds, however, “This is a one-time thing. Unless I change my mind. So consider that an incentive.” And they kiss again. So maybe not a one-time thing?

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