Season 5 Recap: 5×07 Expired

Winter finale ahoy, how is it already that time of the year? I more or less expected that this one would be a doozie, and a doozie it certainly was, but I have so, so much love for this episode, and it’s gonna go high onto my list of all time favourites. So much intensity, and so much food for thought offered to us on silver platters, served with a healthy portion of upheaval and dismay.

However, I’m all in, and I’m gonna be here with all of you for the considerable wait, keeping the Shea flag fluttering in the icy winter wind, waiting for the milder, more soothing climates of spring.

The Technicalities

Written by Mark Rozeman and Jim Adler
Directed by Mike Listo
Original airdate Nov 22, 2021

Patient Stories

Patient #1 Alma Garcia, a victim involved in a car accident that Shaun and Lea happen to be first on scene for. (Well, if we wanna be nitpicky, patient #1 is actually a random guy with broken fingers in the same car accident, but we don’t see him again.) Alma is 26 weeks pregnant and trapped in her car behind the wheel, with a pericardial effusion (fluid build-up around her heart) that Shaun quickly diagnoses.

Needing to drain the extra fluid quickly without enough time to wait for the ambulance, Shaun crafts a makeshift pericardiocentesis kit from a gas siphon and suctions the extra fluid out into a plastic bottle, likely saving the young woman’s life. He proudly tells Jordan about his heroic resourcefulness when they bring Alma to the ER, but Jordan isn’t particularly impressed. Aw, poor Shaunie was so pleased with himself.

Alma lost consciousness and became unstable en route to the hospital, so she needs surgery to find the source of the internal bleeding. Which she promptly has, and they repair the most important damage, though she’ll need a surgical plan to fix her pelvic fracture later.

Shaun explains her options to Alma after the surgery. She has to choose between external hip fixation, which is less risky for the baby but there’s a high likelihood it would leave her with permanent reduction in mobility. The other option is internal fixation that would greatly improve Alma’s own outlook, but it also requires delivering the baby through C-section, which means possible complications for the baby since it’s only six and a half months along.

Alma has a hard time deciding what to do about her broken hip, but she ultimately chooses to protect her baby and have the external fixation. They go through with it, but then Alma has a delayed reaction to the car crash with uterine bleeding from a placental abruption. They rush her to the OR for an emergency C-section.

During surgery they remove the external hip fixation and begin with the C-section. The preemie is being delivered as planned, and she’s tiny. Her Apgar score is only three, which isn’t good, she’s in distress and not getting enough oxygen. The intubation isn’t helping, which stumps the surgical team. The baby should be pinking up.

Shaun goes to his mind palace and mentally scrolls through possible causes. He lands on a congenital heart defect. There’s a problem with an important blood vessel that’s closing, which is causing low blood oxygen levels. Lim orders prostaglandin E1 (PGE) from the pharmacy to open the blood vessel and establish blood flow.

Side Note: PGE is a smooth muscle relaxant and vasodilator, meaning it opens up the blood vessels. It’s actually mostly used in erectile dysfunction, but is also approved for use to temporarily open up a blood vessel called ductus arteriosus in neonates who have congenital heart disease that obstructs blood flow to the lungs.

If we want to be nitpicky, the terminology used in Shaun’s dialogue isn’t really accurate. Shaun says the baby’s patent ductus arteriosus (PDA) is closing, which is causing hypoxia. However, PDA is a medical condition in itself — it’s when the ductus arteriosus is permanently open, which can also cause hypoxia and other symptoms. In babies with PDA with these symptoms, you want to close the ductus arteriosus, not open it.

If I understand this correctly (and maybe I’m wrong because I’m not a doctor), it would have been correct if Shaun had said the ductus arteriosus was closing, which was causing hypoxia. The “patent” is what makes it confusing. But anyway, I digress.

The PGE gets delivered and Shaun mixes the lyophilised powder in the vial with saline (or dextrose solution) and prepares the syringe to inject it into the infusion bag. They wait for the PGE to take effect, but it doesn’t. Lim starts compressions as the baby goes into v-tach. “What if it’s not a heart defect?” Lim asks forebodingly.

They check everything they can think of. Shaun picks the PGE vial back up. It’s the right dosage, but then he stops short. “What?” Lim asks. “Shaun, what?” He looks up. “It’s expired.”

Nurse Villanueva calls the pharmacy again. Their entire supply of PGE is expired. Shaun has the brilliant idea to use alprostadil instead, which is also PGE but at a different concentration. If they dilute it with saline, it should work. Shaun strips off his gloves and mask to run to the pharmacy. “It’ll be faster if I do it myself.”

They administer the alprostadil, they keep doing CPR, but the baby isn’t improving. Shaun is desperate, he restarts compressions, insists on administering more alprostadil, but Lim knows it’s too late. “Dr. Murphy, the baby is flatlining, there’s nothing more we can do.” Shaun doesn’t want to relent. “No, I can save her!” he desperately insists. Lim’s eyes are on him. “Shaun…”

It’s over. They need to admit defeat. The alprostadil came too late. Shaun’s eyes are wide, his breath is unsteady. “Time of death, 18:23,” Lim announces in a shaky voice. The whole operating room goes dead quiet, time slows down. Shaun’s eyes fill with tears as he rips the surgical mask from his face.

Alma’s baby didn’t make it, but Alma then undergoes the internal hip fixation. Lim later mentions she is resting comfortably and recovering but wouldn’t be conscious for quite some time.

Patient #2 is Sunil Rajant (though credited as Rajani on IMDb), Ilana Reeve’s current husband. Ilana is Dr. Glassman’s first wife. Sunil was diagnosed with Lewy body dementia 2 years ago. He’s has progressive symptoms with more recent bouts of confusion. Ilana asks Aaron to look into whether Sunil would be a good candidate for a deep brain stimulation clinical trial that could slow his cognitive deterioration.

Sunil gets admitted to St. Bonaventure and they run a few more tests on him. As they’re explaining the next course of action to Sunil, he has another confusion episode, and Ilana helps him through it by having him recount memories of his children with the help of a photo.

Side Note: What puzzles me a little is why Aaron doesn’t actually get Shaun on this case. He knows that Shaun is the best diagnostician St. Bonaventure has, and he often has unconventional ideas. It would have been in both Ilana’s and Sunil’s best interest to have Shaun’s brilliant mind weight in on the case. (Yes, of course I know this was a dramatic choice to keep Shaun and Glassman separated over the course of the episode and give Ilana room to make Glassman see where he went wrong with Shaun, but outside of that, this just seems like a bad choice.)

When they examine the MRI imaging, Glassman remarks that the parathyroid gland looks off. He asks about some of the lab values, something about a history of kidney stones, and Glassman is thinking maybe this isn’t Lewy body dementia after all. And as it turns out, it not. It’s a lesion in his neck, and they need to find out if it’s benign or malignant.

When they examine Sunil’s neck again via MRI, they find out that the growth is an invasive malignant carcinoma that has invaded the carotid artery sheath. His prognosis has suddenly become a lot worse.

Aaron gives Ilana and Sunil the bad news. He suggests a non-surgical approach with targeted therapies and radiation. It should give them a few good years. Ilana asks why they can’t operate, but it’s too dangerous. That’s not what they hoped to hear.

Sunil has another confusion episode, and this time Ilana doesn’t manage to calm him down. Park is standing by with an injectable sedative. Sunil gets more upset and angrier, and he violently pushes Ilana away, yelling, “I don’t know you!” She hits the wall behind her, and Park uses the element of surprise to sedate Sunil. Ilana seems to be all right, but Aaron is definitely concerned.

After speaking to Ilana, Glassman takes another look at the imaging and decides after all to try a surgical approach to remove the mass. Ilana deserves to have more time with her current husband, and Aaron decides to take the risk and operate on Sunil himself. The surgery is complicated and doesn’t go without complications, but Glassman is a clever surgical whiz and gets the tumour removed without jeopardising Sunil’s life.

Sunil makes it through the surgery and he’s expected to recover well.

Shaun & Lea

So Shaun and Lea are still scouting for wedding venues. Getting a bit short notice now, guys, isn’t it? They drove out to see a cute little chapel that looks like it’s outside the city (dubbed Mountain Glen Church for the show, though its real name is Minoru Chapel). “This might be the first place that we’ve visited that feels right,” Lea remarks. Shaun seems to agree, but he’s either too eager or trying to deflect (or both) when Lea makes an attempt to talk to him about the omitted reviews. Oh dear, this already doesn’t bode well.

The inside of the chapel is filled with warm light from the modernistic stained glass windows, and the interior is simple but cosy. Shaun and Lea both love it. “It’s perfect,” Lea says, and Shaun easily agrees. But then, uh-oh. The floorboards creak. That’s a no-go for Shaun, maybe even a showstopper. That’s no good.

Side Note: The “It’s perfect,” line might already be telling us that whatever is going to happen will be far from perfect. Because remember Shaun and Lea talking about how their engagement party was “perfect” in 5×01 New Beginnings? And then it ended up being not at all in any way perfect, but actually more like a disaster (which admittedly was a bit hyperbolic). Note to self: Whenever the show mentions that something is “perfect”, expect for it to get trampled on with muddy, steel-capped boots that very episode.

Shaun is positive that the pastor will replace the problematic floorboards when Shaun speaks to him (I think not, Shaunie), and then they can sign the agreement for the church venue. Lea makes another attempt to talk to Shaun about the reviews during the car ride back home (is that really a car-while-driving conversation, Lea??), but this time it’s a freshly happened car accident that keeps them from broaching the subject.

Shaun immediately goes into first responder mode while Lea calls 911. There’s a pregnant young woman trapped in one of the cars, and she has trouble breathing. Shaun to the rescue with a MacGyvered pericardiocentesis thingamabob that he crafts out of a water bottle, syringe, plastic tubing, a bulb pump and duct tape.

We’re taken back to the pilot episode right here, when Shaun made a makeshift whiskey bottle one-way valve to fix a pneumothorax and subsequently saved a boy’s life. Ah, those were the days…

The wedding prep saga continues: During surgery on Alma, Shaun asks his colleagues to wear socks to his wedding — no shoes, just socks. Because of the creaking floorboards. Jordan says hell no. Shaun’s not gonna rob her of her chance to show off her new Bruno Maglis. And she suggests wet and stinky feet are not in Lea’s dream wedding. Shaun looks at her. “That’s… probably true.”

When Shaun presents the options to Alma of having to choose between herself and her baby, he gets frustrated that she has a hard time making that choice. He ends up taking his issue to Dr. Glassman, whom he apparently heard is back in town. I wonder if they also told him about Ilana. Shaun and her don’t have a single scene together. Is Shaun aware she is there? Isn’t she interested at all in saying hi to Shaun (I can only guess no)? Isn’t Shaun intersted in saying hi (I can only guess also no)?

Shaun breezes into Aaron’s office. “Dr. Glassman. I’m glad you’re back, Lea and I have a problem.” And then starts the endless but amusing ping-pong of misinterpretations among the both of them. “I heard,” says Aaron. He thinks Shaun is talking about the omitted review confession that (unbeknownst to Aaron) hasn’t happened yet. Shaun elaborates that he means the squeaky floorboards.

“Is that it?” Aaron asks. No. There’s the pregnant patient who can’t decide on the surgical plan. “Have you talked to Lea?” inquires Aaron, probing about the big review omission confession thing. Shaun shakes his head. “She is no doctor.” Well, apparently that conversation hasn’t happened yet.

And then Glassman casually drops the bombshell on Shaun. “Shaun, I’m not gonna be around. I’m moving. I’m selling my house and I’m moving… to Montana.” He forces a smile, and I don’t know if that’s supposed to soften blow. Because it very much doesn’t.

Shaun’s face falls — so hard that you could probably hear it drop on the floor if that were a thing. He lets out one of those half-sigh-half-ohs. One of those deflated ones that ever so clearly says, ‘I did not expect that, and thanks for the kick in the crotch.’

Shaun dispiritedly plops down in one of the chairs. “Will you still be my Best Man?” he asks Aaron. The abandonment sirens are flashing red now. Glassman is somehow oblivious. “Of course,” he reassures Shaun.

Shaun pleads, “Then you should give me your advice.” Glassman says Shaun doesn’t need it. Shaun makes a valiant attempt at voicing his feelings. “Sometimes I do, you don’t like to give it to me anymore.” How is Glassman not hearing those sirens wail? Shaun is even making eye-contact. Slap some sense into the man, please. Can you not see what is going on with your boy right here?

Glassman blindly rambles on about how Shaun has Lea now, and that he and Lea need to work through some stuff, but that Glassman doesn’t need to be there for that. “And you’ll work it out. Without me.”

Shaun lifts his gaze and looks Glassman right in the eyes after he says that. Long and deliberately and poignantly. That’s a fucking huge thing, it’s like he’s wildly waving the red flag together with the wailing sirens. Aaron, how are you not seeing Shaun’s blatant cry for help here?! JFC. I wanna punch things. Not Glassman. Okay, maybe a little bit Glassman.

Side Note: Guess I was wrong about assuming that Alex was going to be Shaun’s Best Man, because apparently that’s Glassman. Oh well…

I shall go and dig for that broken Schiff/Highmore admiration record, cause I wanna play it again. These two playing off of each other is just 💯 👌 chef’s kiss. I love you, guys. More of that, please. Well, okay, we got more later this episode. I will get to that. In epically wordy and expressive ways and an overabundance of screencaps. Buckle up and brace yourselves.

Side Note: Glassman told Morgan in an earlier scene that he wants his office back. Which is weird, right? Cause he’s packing up his personal belongings here in this scene and he’s about to tell Shaun he’s moving to Montana. So why ask for his office back if he won’t need it? Check it out, though. Morgan already had them put her name tag on the door!

After Shaun’s conversation with Glassman, Shaun decides to pay Lea a visit at home, seeing how Glassman had indicated Lea had things to talk to him about. (Okay, so when Lea repeatedly prompts Shaun about it, he’s evasive af, but when Glassman off-handedly mentions it, he suddenly rushes home?) She wonders why he’s home early when he said he would be working late. Shaun explains he’ll be going back to the hospital afterwards. God, he works too much!

Shaun has the church contract in hand, they need to make a decision about whether to sign it or not. And then he prompts Lea to share what’s on her mind. “Dr. Glassman said you have things you need to tell me.” She sits down because this is a sitting down conversation. Shaun is still concerning himself with the contract, oblivious to the blow that’s going to be dealt.

She starts with the more innocuous thing, telling Shaun that she didn’t exactly go on a business trip two weeks ago, she went to Montana to try and convince Glassman to come home. “Because I was really worried about you.”

That gets Shaun’s attention. “What… were you worried about?” She says there’ve been so many changes at the hospital, and Shaun immediately goes into denial mode. It’s not his ASD, he insists. Lea easily agrees, and I kinda wish she hadn’t, because the hell it’s not! But I get why she wants to appease him. She wants to soften the blow.

Shaun is awkwardly ignorant. He’s still convinced his scores went up because he improved his interaction techniques. “That’s not what happened, Shaun.” He meets her eyes. She makes the confession, tells him she omitted some of the reviews where people said really mean things about him. That’s why his scores went up.

He lets that sink in. She waits. His voice hardens. “I told you I didn’t want you to.” (He did. Very explicitly.) She launches into rambling mode, apologising, rationalising, but Shaun is not ready to hear her. It was wrong. Wrong, wrong, wrong. “What you did was very wrong.”

She reaches out, desperate now. “I’m truly so sorry.” He stops her, pushes her hands away. “No.” It hangs in the air. She stares at him. His next words are final. “Your apology is not accepted.” He takes the church contract and leaves, the door clicking in its lock behind him.

Shaun then spends the night at the hospital. (And looks surprisingly well rested for that fact. God, I wanna be 30 again.) Partly to avoid Lea, partly also to find a better treatment option for his pregnant patient Alma with the broken hip. She seems to have relationship trouble with her boyfriend as well, so Shaun seeks her advice. “He… says one thing, but does something different. How do you know if he loves you?” Shaun is battling with Lea’s confession and the repercussions. How can he know if Lea truly loves him?

It’s not helping when Alma tells Shaun that someone can love you but still let you down. Was that what Lea did? Shaun tries his best to figure out what it all means. “Knowing what to expect of others is difficult. People can be very unreliable. It’s why I always wanted to be a doctor. Science and biology and medicine are very reliable. I like that.”

Side Note: Let it be mentioned that the discussion Shaun and Alma have here somewhat reflects Shaun and Lea’s situation in season 4. Alma and her boyfriend had struggled to make a decision whether to keep their baby, and now that they did and they are forced with a medical situation, Alma has to choose between doing what’s best for her, or what’s best for the baby.

Shaun and Lea also eventually decided to keep their baby, but never had the choice to save her, and I wonder if Shaun is also making the connection here, though he valiantly doesn’t try to get involved to steer Alma in any direction.

There’s also a certain parallel to what’s happening with Shaun, Lea and Glassman right now. Alma is left to deal with things on her own, while her boyfriend is off on a research trip, out of reach and unable to offer support and guidance. That’s probably how Shaun feels about Glassman at that moment. Lea is also out of reach because she just confessed to him that she deceived him.

After Alma opts for the external fixation to protect her child, Shaun goes to see Lea in her office. “My patient chose to prioritize her baby, we did the external fixation, she’s resting comfortably, and you need to correct my scores.” He’s very no-nonsense about it. (Side Note: I wanna know why Lea closed her laptop lid in a panic.)

Lea tells Shaun she can’t restore the data, she can’t undo what’s been done. I’m wondering if that’s because, if she did, it would become obvious that the scores were manipulated? Is she trying to protect herself?

Shaun insists that she tries because the scores reflect his work — and him. She attempts to explain that the algorithm was just badly written, that it isn’t indicating who Shaun is as a doctor. “No,” he interjects, “it should be the same for everyone. The data has to be corrected.” But Lea can’t. The only alternative Shaun sees is for Lea to then tell Salen about it instead. He wants his record clean.

Lea thinks that’s a terrible idea, she could lose her job. Shaun reckons that’s what she’d deserve. “You broke the rules. Maybe you should get fired.” That’s harsh and hits hard, but Shaun is hella pissed. They’re at an impasse, it seems.

The pregnant patient’s case keeps Shaun busy, and he has to go into surgery with Lim and Jordan to do an emergency C-section after a placental abruption. The tragedy with Alma’s baby and the expired medication runs its course, and it absolutely destroys Shaun that he couldn’t save the baby. His mind shifts gears into overwhelmed overdrive.

The hospital’s budget cuts killed a baby. A baby that would have had a fighting chance if the PGE hadn’t been expired. It’s unfathomable to Shaun. He leaves the OR and stumbles out into the hallway. (This was shown in the episode promo but didn’t make it into the actual episode.)

People are going about their lives as if nothing had happened. Shaun’s breath is a wild staccato rhythm and his hand goes into his hair. He needs to go where this all started — the pharmacy. And there, outside the connecting doors, there is his poster.

Some doctors are different. Some hospitals, too. Dr. Shaun Murphy – Autism Spectrum. He doesn’t want to be on that poster anymore, this is not what he became a doctor for. Shaun steps up to the wall and rips the poster in half in one swift motion.

Arriving at the pharmacy, the door flies open and Shaun hurries in. The blindsided pharmacist immediately stammers, “Salen made cuts. We’re behind on inventory. It just… it fell through the cracks.”

Shaun is looking for the PGE, runs along the aisles between the shelves. There it is, on a cart pushed against a shelf. Shaun picks up one of the vials and reads the label. “Expired.” He throws it to the ground, and the vial shatters on impact. The next one the same. “Expired.”

He throws it, throws them all. The whole stash is… “Expired! Expired! They’re all useless!” The white powder covers the linoleum floor in small heaps among shards of broken glass.

Suddenly Lea is there. Who alerted her? “Shaun,” she feebly tries to break him out of the cycle. Shaun is beyond listening. “Shaun, stop, stop, stop.”

Lea rushes right into his comfort zone, her hands on his arms, trying to get through to him, but he pushes her away. She doesn’t have the right to touch him anymore without consent. “You lied to me!” he yells at her. “I can’t trust you! And I can’t marry you.”

He has the church contract right there, and it crumples easily in his hand as he balls it into a fist. Lea silently stares at him with large eyes, stares at the scrunched up paper ball in his hand. Shaun tries to catch his breath, but there isn’t enough air and he starts panting heavily.

Glassman arrives just that second. “Shaun,” he says to get his attention, “Shaun.” Shaun’s breaths are coming in rapid succession, he’s hyperventilating. When Lea turns around to look at Aaron, her expression is desperate and teary and a cry for help: Do something!

Aaron tries to calm Shaun down, tries to connect with him, but it isn’t happening. “Take a deep breath now, okay?”

There it is — a brief flicker from Shaun to meet his eyes, his breathing slowing ever so slightly, the panic lessening just a tiny fraction. Shaun’s eyes are skirting Glassman’s collar, skidding back and forth. “Dr. Glassman,” he ekes out tearily in between breaths, and Glassman’s eyes are calm and never leave him. He’s got Glassman’s full attention now.

And here comes the harsh truth, right out of Shaun’s distraught, overwhelmed, unfiltered mouth. “You are an awful Best Man… and a terrible mentor. You said you would never abandon me, but that’s a lie. A lie. That is a lie.”

Lea hears it too, and it confirms all the fears and concerns that have been bubbling right underneath the surface, that drove her to manipulate Shaun’s scores. Her forehead is drawn into a deep, worried frown, and she can feel each and every ounce of Shaun’s pain as if it is her own.

Shaun goes into full agitation, yelling, arms flailing, voice thick with tears as he yells at Glassman. “Why is everyone lying to me?! Why? You… should have been running the hospital, if you had, the baby would not have died!”

The ugliest outcry you’ve ever heard leaves Shaun’s throat, and his hand goes into his hair, slapping his skull, and all Aaron and Lea can do is stand frozen to the spot as Shaun sobs endlessly, violently, tumbling backwards on unsteady feet until he comes against the wall and sinks to the floor.

Shaun lets go of the crumpled piece of paper, knees drawn up, hands firmly clasped over his ears, his whole body trembling with panic and despair and emotions he doesn’t know how to parse and process. He fights for breath after breath, and Glassman closes the gap and sits down next to Shaun against the wall, close enough to touch. Lea doesn’t know what to do, tears in her eyes, watching the scene unfold in paralysed agony.

“I’m here, Shaun,” Glassman says softly, patiently sitting, waiting for Shaun to dictate the next steps. “I’m right here.” Shaun’s heavy breaths turn to ugly, overwhelming sobs, and then finally, Shaun gives in, lets the walls come down and leans into Glassman. Glassman immediately draws him to his chest, wraps a protective arm around Shaun’s forehead. “I’m right here. I got you.”

Shaun is completely overwhelmed, clinging to Glassman’s arm, the sobs now shaking both of their bodies in unison. Glassman holds onto him for dear life, whispering soothing words into his hair.

Standing there helplessly, Lea edges closer and picks up the crumpled church contract from the floor, then hovers wordlessly two steps away. The episode fades to black with a completely fallen apart Shaun against Glassman’s chest, his sobs echoing hollowly off the pharmacy walls.

Oof. Pick me up off the floor. Cause, holy fuck. This one hit hard. So hard. Epically hard. There’s not enough hyperbole to describe how hard. I had an actual honest-to-God knot in my stomach ever since Shaun rushed into the pharmacy, and it just got bigger and bigger as the scene unfolded.

There’s also not enough hyperbole to express what an acting masterpiece this scene was, not just on Freddie Highmore’s part. Freddie deserves the highest high praise for this one, but Richard Schiff and Paige Spara’s performances also made their characters’ emotions and helplessness incredibly tangible. If I could play this scene on repeat all day, it would still not get old.

Voices have been piping up all over the internet how much Freddie deserves and Emmy for it, and I concur. TV Line deservedly awarded him ‘Performer of the Week’ title, and it was awesome to see Daniel Dae Kim retweet it and congratulate Freddie on the absolutely merited nod.

I have three million things to say about this scene, and I don’t even know where to start because there’s just SO MUCH. Maybe I’ll just sit here and stare blankly at the Word document instead. Hm, no, that wouldn’t be conducive to trying to convey something that would do this episode justice. Well, okay then…

Let’s start with what’s actually going on here. I think we’ve seen this a long time coming. Well, not this one incident with the baby specifically, but we knew and dreaded that things would come to a head eventually, and Shaun would buckle. Not sure we thought it would be this epic of a panic attack slash meltdown, but this felt real and organic. And yes, it hurt like a mofo sucker punch to the solar plexus, watching Shaun come apart at the seams.

Probably pointing out the obvious here, but this breakdown of Shaun’s was the culmination of everything that had slowly been building up over the last several weeks. The Ethicure changes, the constant pressure, the disruption of Shaun’s precious routines, Glassman leaving and being completely unapproachable, to some degree also the wedding preparations, Lea’s score manipulation confession, and then, the final straw, the premature baby girl that unnecessarily died under Shaun’s fingers.

What we probably didn’t see coming was Shaun breaking off the wedding. Was that too harsh, too knee-jerk? And is it the end for the Shea pairing? I daresay no. I have faith in them, in both of them to take the time and re-examine where they stand, re-examine where they both went wrong, and then work out a way to find back to each other. And hopefully they’ll come out stronger for it.

If you’ve paid close to attention during the panic attack scene, you will have noticed that Shaun says to Lea, “I can’t marry you”. He doesn’t say, “I won’t marry you” or, “I don’t want to marry you”. Amy on Twitter brought this up, suggesting that nuance is important.

Lea broke the rules, and in Shaun’s mind, there need to be consequences for it. The immediate consequence is, of course, that the marriage can’t go ahead with how things currently stand, because he needs to re-examine what that means and whether he will be able to trust her again. I will expand on this further in the Speculation Corner, because trust is a huge thing for Shaun, and it’s gonna have to be something that they need to discuss and resolve.

That said, I think Shaun’s wording here is another subtle indicator that Shaun and Lea will find each other again and the marriage will eventually go ahead. It has to, right? They’ve been through so much together. Their bond survived the loss of a baby. I have faith that they’ll get through this, too.

And talking about the baby… I believe that Shaun was hit so hard by the loss of Alma’s baby because he saw his own daughter lying there. His and Lea’s baby was just a couple weeks younger than this little preemie, also a baby girl, and again he couldn’t save her life either. Lea took time to grieve after the loss of their child, but Shaun never did. Granted, his mind works in different ways, but it only makes sense that the loss of their own daughter played into this.

Let’s take a moment to look at Lea’s role in all this. Obviously, she was just as taken aback and shocked as we were at Shaun telling her he can’t marry her. She knew he would be upset about the omitted reviews, but I don’t think she ever expected for it to culminate into that decision.

She had pushed Shaun into somewhat of a corner. Perhaps she also expected him to understand her position and excuse it. But Shaun needs time to process big events with an emotional impact. He ruminates on things. He runs away and avoids conflict, it stews and simmers, and then it tends to explode into something rather drastic, which I think is what we saw here.

What hurts quite a lot is that we could tangibly feel Lea’s helplessness in this situation. She saw Shaun disintegrate in front of her eyes in a really big way, and she realised there was nothing she could do about it. He was rejecting her, was rejecting her help, was actually physically pushing her away. She wanted so badly to reach out, to calm him down, to comfort and console him, but he wasn’t going to let her. Her moving into that situation might have even made it worse.

That’s a terrible place for Lea to be in, because she loves him so much, and there’s absolutely nothing she can do at this moment unless or until he lets her. Hopefully she found consolation in the fact that Glassman was there, that Shaun was at least (albeit reluctantly) letting him into his comfort zone.

Keen eyed viewers will have noticed that while Glassman was holding a sobbing Shaun in his arms, Lea carefully crouched down to pick up the crumpled church contract that Shaun had discarded. That most definitely has some significance. It could perhaps become a physical guide or representation of their journey, their mutual end goal of healing, their history and mutual love. Perhaps we’ll see it being featured as a metaphor throughout the rest of the season, much like they did with the apple or the baseball in earlier seasons.

Daniela had a theory that Lea might actually go ahead and sign the contract and secure the church for the wedding anyway, as a sign of hope or positivity that Shaun will come around, to have something tangible she can show him as a token of her love and commitment.

The biggest journey we see happening in this scene, perhaps, is the one of Glassman. All day, Ilana had been poking needles at the protective layer around his stubborn resolve to pack up and leave San Jose behind. She’d finally voiced what all of us had known all along, had painfully witnessed playing out over the last several episodes: That Shaun was good for Aaron, that he needed him as much as Shaun needed Aaron, and that moving to Montana would be a mistake.

And then there was Shaun, telling him to his face that he felt abandoned by Aaron, that he had been lied to, and that Aaron’s personal and professional lack of support had driven Shaun right into the eye of the cyclone that was now whirling full force through the pharmacy.

Aaron saw what was probably one of the biggest meltdowns from Shaun he’s witnessed in years, and it finally (fucking finally!) opened his eyes and pushed him into action. With Lea currently miles out of reach for Shaun (or vice versa), Aaron saw that he was urgently and desperately needed, and that very last shot of them holding on to each other was one of the most heartbreaking and most beautiful scenes I’ve ever witnessed on television.

We don’t really know all that much about Shaun and Aaron’s relationship from their early days. We do know that Aaron took a 14-year-old Shaun home with him the night after Steve died. We know that he went into the foster system thereafter, that he was put into different foster families over time. A lot of fans have been speculating that, at some point, Aaron actually took him in and had Shaun live with him, though that’s not confirmed and just guesswork based on certain dialogue or behaviour.

In 5×06 One Heart, we were given more hints about their relationship from Shaun’s med school days, where we saw Aaron as a supportive mentor and father figure to Shaun — visiting him in his dorm room, helping and guiding him, and then finally that book on his passenger seat, ‘Understanding your Child with Autism’.

It’s ironic when you juxtapose that with the scene in Glassman’s office in 5×02 Piece of Cake where he says to Shaun, “I’ve got no wife, I’ve got no kid, I’m soon to have no job…” In 4×08 Parenting we had Lea refer to Glassman in the presence of Shaun as his “grumpy second dad Glassman” and Lea calling Glassman Shaun’s “parent” in a 1:1 conversation between the two.

When did Glassman stop believing in his fatherly relationship with Shaun? Was he absolving himself of the responsibility by justifying that he never officially adopted Shaun or explicitly verbalised his father role to Shaun? Was he going off of Shaun explicitly telling him in the past that he didn’t want Glassman to be his father? (1×13 Seven Reasons: “I don’t need a father, I hate fathers.”)

During his panic attack in the pharmacy, Shaun referred to dialogue from the med school flashbacks, where Glassman had told him he’d always be there for him. Something Shaun has always steadfast believed in, and to an extent Glassman had always been there for Shaun. Until recently, when he misguidedly believed that Lea would replace him and he could just slink away and out of Shaun’s life.

So there we were, Shaun in no uncertain terms showing and telling Aaron how isolated he felt, how much those feelings of abandonment had festered and manifested. Hopefully it was the eye-opener that Aaron needed. In a way, it’s sad that it had to come that far, because both Shaun and Lea had surely been giving him enough signals over the past weeks. I really hope we’ll be seeing some conversation in future episodes about all this, although of course the 42-minute format of the show doesn’t always allow for long, intimate dialogue.

One more interesting thing to note is that autism consultant Melissa Reiner mentioned in her episode insights that the writers had originally written the ending of this scene so that Shaun curls up in a fetal position on the floor, but she advised them that it would feel more organic if he sat down against the wall, which is what they ultimately went with. And I think it worked incredibly well!

It’ll be interesting to see where they go from here. How did that last scene play out beyond what we saw when the screen faded to black? Did Glassman take Shaun home to Shaun and Lea’s apartment? Did Glassman take Shaun home to his house to decompress for the night without the “disruptive factor” of Lea there?

Would Shaun be receptive to Lea’s presence immediately after the meltdown, would he want to keep distance for a bit? Probably something we’ll never know and have to draw our own conclusions about. But I think it’s not too far-fetched to say that things between Shaun and Lea will be touchy in the near future, and the atmosphere in the Murphy-Dilallo household will be stone-cold for the time being, with likely a fair amount of good ol’ avoidance tactic on Shaun’s part to be witnessed.

And yeah, it’s a pretty brittle and sour-tasting bone that we were thrown and left to chew on for four months. Not exactly a mirthful and upbeat loose end to leave us dangling on into the festive season, and I’ve seen some fans online being salty about it.

Personally, I want to choose to stay positive. It’ll be a difficult but ultimately rewarding journey to see Shaun and Lea finding their way back to each other. They will learn more about each other and come out stronger for it. It’ll be beautiful to see them finally reunite and love each other. And I’m very much looking forward to that. On the off-chance of that not happening, well, shame on you, writers, but then I’ll live with that, too, and just write all the AU fan fiction. 🙂

Glassman’s Journey

Glassy gets down to business, he’s now selling his house in San Jose. Oh wow. So the road trip is now becoming a relocation. Have to admit I hadn’t quite seen that coming. While Glassman’s talking with the realtor on the front steps, there’s a surprise visitor approaching. She introduces herself as Ilana Reeves, ex-wife. Another whoa moment. Or maybe an uh-oh moment?

Ilana (played by the wonderful Ann Cusack) has come to ask for Aaron’s help. Her husband Sunil has been diagnosed with Lewy body dementia and he’s dying. Aaron also casually drops the news that he and Debbie “didn’t exactly work out” and that he’s moving to Montana. The house looks like it’s already half packed up in boxes.

Ilana came to ask if Glassman can look at a clinical trial that uses a brain stimulation technique to see whether it would be worth for them to consider as a treatment option for Sunil. She wants someone who will give her the truth, someone she can trust. And that’s Aaron.

Ilana and Sunil are thrilled when Aaron finds out that Sunil doesn’t actually have Lewy body dementia but a lesion in his neck. She runs after him to give him a grateful hug. “I didn’t expect a miracle, but thank you.”

Aaron is about to run off, but Ilana barges right in and punches through his walls. She knows him too well. “What happened with Debbie?” she asks. He rolls his eyes. “Why did my impulsive, whirlwind marriage to a gun-toting barista not work out? Hm.” She says he looks hurt. He deflects. She says she knows how he holds on to things. He says he knows how she tries to fix everyone.

“Talk to me,” Ilana prompts him. “Cause I doubt very much you’re talking to anybody else.” He weighs his options, but then he does open up. He clearly trusts his ex, and I instantly love her. “I was myself. And up close and personal, Debbie didn’t like what she saw. She said I was controlling and selfish.” And that’s Aaron Glassman in a nutshell — both Ilana and Aaron know Debbie was right.

Ilana wants to know what’s so appealing about Montana. “Pine trees and cowboy boots and… change. For me. In Montana, no one knows me. And I have no history. And no one has any expectations of me.” Ilana gives him a no-nonsense look. “You’ve done this before. After Maddie…” (For those who don’t remember, Maddie is Glassman’s daughter who died over a decade ago, and though we don’t know the exact circumstances, Glassman still feels guilty because he didn’t do enough to prevent her death.)

Yes, we’ve been saying this all along. Just like Shaun, Glassman likes to run away from things that could hurt him. That’s an interesting parallel. They’re also both stubborn af. Aaron thinks Ilana is out of line to bring up Maddie, and that’s when he’s shutting down that conversation and actually running off. Oh Glassy. Listen to your ex-wife. She clearly knows you better than anyone.

Side Note: Is it a coincidence that Aaron mentions pine trees? This was a bit of a thing between Lea and Shaun in season 1. When Lea took Shaun on a road trip (1×11 Islands), they found a mutual connection of it smelling like pine trees as they discussed Steve’s death and Glassman’s mentor role in Shaun’s life. Shaun later bought a scented tree with pine aroma to remember Lea by after she moved back to Hershey (1×13 Seven Reasons). In 1×15 Heartfelt, she sent him a “Pine Tree Playlist” to listen to. I’d like to think this wasn’t a coincidence.

The fact that Ilana knows Aaron better than anyone is also proven by her calling Aaron on his bullshit around not offering Sunil a surgical option. She’s in his office, waiting for him, confronting him about it. “You’ve built your career on surgeries that most people think are too dangerous.” He knows she’s right. “Yeah, to quote you, because I’m an unsufferable egomaniac.” Ah, I can only imagine how things must have been in the first marriage Glassman household.

Ilana is adamant with Aaron. “But that’s who we came to see!” Here’s more proof that she knows him too well: “You come alive in surgery!” Now we know where Shaun got that from. (I don’t mean his genes, obviously. But he learned from the best.) And Ilana also knows the sensitive spots to poke where it hurts the most. “I think you’re scared. Of failing me again.” Aaron looks at her for a long moment, then sighs. “Yeah, I wish that were true.”

The conversation between Ilana and Aaron gets interrupted by Sunil having another confusion spell. This time he gets inadvertently violent and pushes Ilana into a wall. She hits her head quite hard, and Aaron takes her to the clinic to examine her. She insists she’s fine, and Aaron seems to concur.

As he hands her a cool pack and some pain meds, she apologises for laying into him earlier. There’s another apology coming. Ilana confesses that she used to blame him for what happened with Maddie, but he doesn’t want to hear it. “No, don’t, please stop. Don’t do that.” But she insists because he needs to hear it.

“For a long time, I did blame you. I could barely look at a picture of Maddie without being reminded about how angry I was. And how angry I was at you trying to replace her with Shaun.”

But that’s not what it was. “Shaun wasn’t meant to replace Maddie, my God,” Aaron counters. “Nobody can.”

Ilana has found peace with Sunil and his family. And she sees now that Shaun has been that a little bit for Aaron. She takes his hands. “I’m so glad you found Shaun.”

They’re both tearing up now, and Aaron admits, “You’re right. I am scared. If I operated on Sunil and he died, I’d be responsible for you losing someone you love… again.” But then he makes a decision and promises he’ll take another look at the imaging. Maybe this egomaniac can come up with something, after all. (Richard Schiff and Ann Cusack really carry this scene, and it’s beautiful.)

After Aaron saves Sunil’s life, Ilana gives him a hug and thanks him. And then she gives him a long look and says, “Don’t go to Montana. You still need Shaun. He makes you better.” Aaron ponders that as he watches Ilana and Sunil celebrating the good outcome. That’s quite some food for thought.

Side Note: Remember episode 3×20 I Love You? When Lea tells Shaun that he makes her more? Shaun makes everyone better. That’s beautiful, and it’s true. (Except when he’s being stressed times 3 million by hospital takeovers. Then sometimes he brings out the not so good in people.)

Alex & Morgan

Morgan is discussing the clinic progress with Salen over mutual workout sessions. Things seem to be going well. The clinic is referring patients (oh, excuse me, clients) for elective procedures, spend is down, and Morgan would love to pick Salen’s brain on how to better rub elbows with the nurses. Salen is impressed. “You excel at striking the right balance between enthusiasm and obsequiousness.” (Confession time, I had to look up what obsequiousness means. I love learning new words!)

And then Salen invites Morgan and Alex to a double-date with her and Marcus. Morgan isn’t quite sure. “Marcus… Marcus Andrews?” she asks. Yep, the very same. Morgan is bamboozled. That was quite the reveal.

Morgan breaks the news about the dinner invite to Alex in the surgeon’s lounge, and Alex is less than thrilled. “As intriguing as that pairing is, dinner’s a hard pass.” Morgan then proceeds to bribe him with tickets for him and Kellan to a UFC fight in Vegas. Still no.

Glassman enters, deadpanning, “Salen and Andrews. They may have one soul between them.” Heh, Glassy. You have a point. (Interestingly, I missed that line on the first viewing.) Glassy also can’t help but remark on Morgan’s new job role when she offers to help coordinate the trial for Sunil. “Oh, that’s very kind of you, are you sure you’re gonna have time while you overhaul my clinic into an Ethicure profit center?” He also wants his office back. That’s good.

Morgan is really not above taking bribery to the next level. She drove twenty minutes to a petrol station to buy a special brand of potato crisps (or chips for you Americans) for Alex that he was angry about when Salen had them disappear from the vending machines.

He asks if this is a bribe. “No, it’s just chips,” she tells him. And a declaration that she will respect the boundaries he sets. It does win him over, though. He agrees to the dinner with Salen and Marcus, provided Salen foots the bill. We never get to see the actual dinner. I wonder if it took place… But probably not, knowing what happened with the expired medication.

Side Note: Hey, remember the orchid that Morgan swiped after she spoke to Salen about the clinic in 5×06 One Heart? I saw people asking whether it would appear in “her” office. And it did.

The Others

50 Shades of WTF (a.k.a. Salendrews) is already starting to see some trouble in paradise. Cause Salen blabbed to Morgan about them seeing each other and Andrews isn’t as down with that as Salen thought. (Dr. McGinley – Differences Count is there in the background. Spot the poster, remember from last week?)

“As the boss, you are free to do what you like. As a partner, that’s not the way it works.” Salen didn’t expect that, and she apologises. She butters him up by telling him how much she loves his smart, and his funny, and his looks, and his choice in socks. She’s excited about being with him. (Is she really?) It works. He’ll make the reservation.

Side Note: Salen also installed self-serve/self-pay snack bars around the hospital Heh. No doubt another ploy to reduce staff and attached salaries.

The Fallout

After the death of Alma’s baby, Lim seeks out Salen, whom she finds in the relaxation lounge. She’s on the phone with someone, and Lim bluntly says, “Hang up.” Salen sees the anger on Lim’s face, and Lim lays right into it. “We just lost a baby because this hospital wasn’t prepared.”

She goes into the whole expired drug story. “Did the money you saved pay for your water wall? This hospital’s priorities, your priorities, are upside down, and today that killed someone!”

Salen goes very quiet. She knows this is bad. She asks how the mother is doing. How does she think? Salen will make sure there’s a grief counsellor standing by, and Lim tells her to better call her lawyers, too.

There are tears in Salen’s eyes now, we do know she’s not completely heartless, but she immediately switches to damage control business mode. “Dr. Lim. Until we’ve done a thorough M&M and identify what changes need to be made, discretion is in everyone’s best interest.” Lim is incredulous. Is Salen suggesting they lie to the mother? No. She’s suggesting that they all have exposure. Lim was involved, the residents were involved, even the nurses.

“Audrey. This is a tragic day. We cannot allow a single event to derail everything we do here.” Lim looks at her coldly. Salen leaves without another word, her expression also hardened.

Side Note: Let’s talk about the PGE expiry and the scientific angle of it. Shaun said the drug was expired. We didn’t learn how long it was expired. Because, the thing is, drugs don’t normally lose all of their potency overnight after the expiry date. It’s a gradual process and varies from drug to drug, formulation to formulation, and is also dependent on storage conditions.

PGE has a T90 (90% potency remaining) of around 10 days if stored at room temperature, and around 106 days if stored at 4 °C. This being a hospital pharmacy, they would have known to store it in a fridge. So how long has the stuff been sitting in storage? In order to significantly lose that much potency, it must have been close to a year, maybe longer. Is that realistic? Especially since the Ethicure takeover was a lot more recent than that. This timeline seems iffy, but The Good Doctor is not known for their timelines being realistic, so there.

I also looked into whether PGE is actually indicated to be used for increase in blood circulation in babies, and it is. It’s approved for erectile dysfunction in adults and temporary opening of the ductus arteriosus in neonates. I had initially thought they might be going for a legal angle of PGE not being approved to treat this condition and thus it being what you call off-label use (which is a thing), but that doesn’t seem to be the case here. That’s a good thing for the doctors from a legal POV.

So if we assume there’s going to be some kind of lawsuit attached to the death of the baby, what will the angle be? Looks like off-label use is off the table as an argument. Can PGE become toxic over time? I haven’t looked into that, but it’s unlikely and then the baby would have probably had other symptoms than just flatlining. Most likely this will simply be about what’s on the surface: the drug being less potent because it had been stored well over the expiry date.

What seemed foreshadowy was that we saw Shaun personally handling the medication. He was the one who mixed together the PGE (it comes as a lyophilised powder and has to be mixed with either liquid saline or dextrose solution) before it is injected. We saw Shaun doing this. We also saw Shaun picking up the alprostadil from the pharmacy and mixing that together. He, too, was the one administering it to the baby’s IV bag. I’d like to think that wasn’t a coincidence, and it makes Shaun vulnerable to whatever the fallout will be.

What we also shouldn’t forget is that the treatment with PGE immediately followed an unverified diagnosis made by Shaun of a congenital heart defect that he basically plucked out of thin air because it seemed the most likely option at the time. Because of the urgency, there was no test or imagining done to confirm that diagnosis. He said it, they accepted it, then gave the baby PGE.

Lim even verbalised, “What if it’s not a heart defect?” Yeah, what if it wasn’t? It would mean Shaun went wrong, which would also mean his part in the baby’s death would be much more momentous than just expired medication handling.

Salen indicated that there must be an M&M to follow — a Morbidity & Mortality conference, usually an internal hospital meeting where the treating physician presents a case review in front of other staff to outline what happened, how the condition was treated, and point out potential errors and learnings. It’s basically sharing of lessons learned, and cautionary tale so that other staff don’t make the same mistakes in the future.

If we look at the 30-second promo for episode 5×08 (yes, spoilerphobe me made an exception and watched that one), here’s what we know, although I would advise caution on reading too much into it because they cut these promos in ways that can be deceiving.

  • Salen says, “You killed a baby,” but that part is just audio edited onto a visual of Shaun staring blankly into space, lying in his pyjamas on his couch, so we don’t know whom she says this to. That edit wants to make us believe she’s accusing Shaun, but that could just be misleading video editing.
  • This is followed by Shaun, Jordan, Glassman and Lim in a conference room with Salen. She tells them in no uncertain terms, “Nothing like this ever happens again.”
  • We see Salen sitting at Alma’s bedside, talking to her. It’s unclear what that means, but it looks like Salen is getting personally involved. Could be any number of things. Could be Salen actually being a decent human being, could also be Salen doing damage control and ensuring that the communication with Alma is in her and Ethicure’s best interest.
  • Lim is going on the warpath against Salen: “I’m taking her down.” She is convinced the expired medication and thus the death of the baby is Salen’s fault, and she seems to be hellbent on dethroning her. With Lea’s help she is collecting data and evidence that Salen’s policies have endangered patients. Salen is not taking this lightly and confronts Lim outside the hospital. “You try to destroy it all, you’re never gonna forget it.” The boxing match is being rung in.
  • Glassman seems to want to dissuade Lim from going up against Salen, because he knows there will be consequences. Perhaps not just Lim losing her job, perhaps for other doctors or the whole hospital.

So all of this leads us to believe that there will be dire consequences for all involved parties. We can only speculate if that means Salen will try pinning this on the surgical team for mishandling, will try to find fault somewhere, or will even try to make Shaun her scapegoat and fall guy because he was the one offering an unconfirmed diagnosis and handling the medication. Lim will likely try to find ways to pin it on Salen for gross negligence due to budget cuts and staffing shortage at the pharmacy. Whatever it’ll end up being, it’s gonna be ugly with collateral and/or targeted damage.

Speculation Corner

Team Splits

This episode has really split the fandom in different supporting teams with very different viewpoints, and following the discussions has been… interesting. Here’s what I’ve seen posted online (but let it be said that this doesn’t necessarily reflect my own opinion).

Team Anti-Shaun

There are those who judge or even condemn Shaun for being so harsh towards Lea, saying he acted like a selfish jerk, that he refused to listen and talk to her, that he judged her prematurely, that he was unnecessarily rebuffing, that he crossed a line telling Lea she deserved to get fired, or even cited physical abuse because he pushed her away from him.

Some fans seem to think that because Lea acted out of love when she manipulated Shaun’s review scores, it means it can’t be wrong, and that it doesn’t give Shaun the right to be angry or hurt.

I can see some of those arguments, but my personal view on this his vastly different. I think Shaun has every right to feel angry and hurt. A lot of that is rooted deeply in his childhood trauma. Trust is a big thing for him, and there’s a constant underlying fear of being abandoned because of his autism. Andreas (who is autistic himself) has mentioned that Shaun has a deficit in emotion regulation and perspective taking. And Shaun has problems understanding and reading lies and deceit. All of this plays into that.

Up until now, he always saw Lea as the person he loves most in the world, the person he could a 100% unequivocally trust, the person who knew him well, who knew that he would have to rely on her being honest with him.

Shaun himself is pretty much incapable of subterfuge. It’s not something he understands, does himself, and (most importantly!) easily recognises in people. Most of the time he can’t tell when someone is lying to him or deceiving him. So he very much relies on trusting people not to lie to him.

When Lea confessed her review score manipulation to Shaun, it wasn’t only the action of the review omissions against his explicit request that hurt him. What cut even deeper was that she betrayed what he thought was an unwavering trust in her being honest with him. It shook his whole view of her as a person, because he’d never expected her to deceive him that way, and it makes him question whether she could or would do it again.

It was voiced by Glassman in 5×06 One Heart that Lea’s actions were patronising. And Shaun sees that, too — sees that she didn’t regard him as an adult who could take care of his own problems, sees that she condescendingly treated him like a child. How could Shaun not question wanting to commit to spending the rest of his life with a person who doesn’t treat him like an equal?

He’s had enough of that to deal with his whole life, it’s an additional blow that it’s coming from a person he loves and trusts, a person who lovingly barged into his life and always treated him like Shaun, and not like a problematic individual with autism. Glassman was right when he told her, “When did you stop doing that?”

So if you consider all that, can you still honestly say that you think Shaun acted like a selfish jerk? I’d hope not. If you ask me, his feelings of betrayal are perfectly valid and understandable. His belief in the one person he could unfalteringly trust has been shaken to the core. We shouldn’t condemn him for it, and we can only hope that he will work on trying to understand Lea’s motivations and viewpoints, that they can talk to each other and work it out.

There’s another thing I wanna mention that Andreas is also incredibly passionate about: Shaun’s lack of acknowledgement that his ASD has anything to do with the review scores or his current struggles with the Ethicure situation.

In a way, Shaun has been allowed to grow in a sheltered environment during his residency. He’s had not only a good support system but also a very tightly knit safety net. Andrews, Lim, Glassman, the other residents and even the hospital board have been in his corner in one way or another, often covering up or counteracting for his fuck-ups or shortcomings. There have been several instances where he should have faced consequences but didn’t.

It’s debatable as to how much slack he should be cut as a person with ASD, but there’s also a valuable lesson to be learned for Shaun that he has been denied at times, namely that his ASD can’t always be an excuse or justification for his behaviour, and that he shouldn’t always get away with impunity. While a person with ASD cannot always control how they react or behave, it’s also not necessarily right to not be held accountable for the consequences. And that’s a valuable lesson that both Andreas and I believe Shaun needs to learn more of.

Shaun has been steadfast and assertive in insisting that his ASD does not make him a less capable doctor — at least where the client satisfaction scores are concerned. And that, quite honestly, is a fallacy on his part. Someone needs to sit him down and talk to him about that, crack open that sun-dried ground and sow the seed of doubt that will let him re-examine that self-assessment and see the flaw in his argument.

I’m not sure who that person would be right now. Likely not Lea, though she’s the one who’s been witnessing most of that first-hand. Perhaps Glassman, but I don’t know how aware of all of that he is. Perhaps it could be Alex, or even Jordan. But, please, someone make him open his eyes to it. I think that could also go a long way towards his healing process with Lea.

For further reading, I encourage you to look at this thread from Remy on Twitter if you’re interested in an autistic person’s view on Shaun’s actions and reactions.

Team Anti-Lea

There have always been viewers who felt that Lea was the flighty, manic pixie girl type who didn’t deserve Shaun, who felt that Carly or Claire would be a much better fit for Shaun. And Lea patronising Shaun was grist to their mill to argue that Shaun should break off their relationship and get with someone more deserving of him.

It’s undeniable that what Lea did was wrong (Shaun called it very wrong, and he had a point). However, I’d like to think from a rational angle we can understand why she did it. It came from a place of love, a place of desperation and a place of wanting to help someone you deeply care about and want to protect. It doesn’t justify or excuse her actions. But it explains the motivation.

Lea immediately knew it was wrong to do it. She even knew it was wrong before she did it, which was why she tried to call Glassman at the time. And yet, she did it anyway because she saw Shaun fighting a losing battle.

It goes back to the argument of Shaun failing to acknowledge that there will always be things that his ASD won’t let him succeed in or excel at. His refusal to do so drove Lea further into the tunnel at whose end was the review omission button. And that’s something that the two of them need to talk about, and hopefully Lea will have learnt a lesson not to do anything like this again in the future but rather try to talk to Shaun about it.

Team Anti-Glassman

I think we’re all frustrated with Glassman this season. It’s infuriating to watch him plough his way out of San Jose into the boondocks with his blinders on, completely ignoring Shaun’s needs and his cries for help. It’s especially infuriating because we, as viewers, see how much Shaun struggles with the feelings of abandonment that Glassman is completely blind to because Shaun is not openly communicating them to Glassman.

We’ve been watching the slow burn with dread, because we could all see it coming, could all see it culminating in the perfect storm that would hit at the end of Expired.

And as much as we’ve all wanted to shake Glassman by the lapels and slap some sense into him, we needn’t forget that he’s a deeply flawed human being, and stubborn as hell at that. It also perfectly meshes with how he’s been portrayed historically. He’s inherently controlling and selfish (one of the reasons why both his marriages didn’t work out), and he’s been known to run away from facing difficult situations. He ran away after Maddie died (which Ilana totally called him out on). He’s running away again to avoid having to deal with Shaun and Ethicure.

Is it a dick move on his part? Oh, for sure. But what also comes into play here is that his actions, just like Lea’s, aren’t out of malicious intent. He truly believes that Shaun doesn’t need him anymore, that perhaps he’s even doing Shaun a favour by cutting the cord and letting Shaun learn his own lessons, letting him learn how to solve his problems without constant mentoring.

It’s been painful to watch Shaun wrestle more and more with Glassman’s progressing distancing and estrangement. A lot of us are protective of Shaun and we want him to do well and be happy. And it’s easy to condemn Glassman for not seeing or even selfishly ignoring the warning signs.

Just keep in mind that what Glassman is seeing is not the same as what we, the viewers, are seeing. He’s seeing a Shaun who now has Lea by his side, taking care of his needs, a Shaun who may be struggling somewhat, but who seems to be capable of solving his own problems. The one time Glassman actually did get involved (the billboard), Shaun took matters into his own hands and resolved the situation. And then Salen even told Glassman that Shaun would do better without being coddled.

It prompted Glassman to conclude him mentoring Shaun is no longer needed, and that he can afford being selfish and doing something that he thinks is best for him. He may have proceeded down his path if Shaun’s panic attack hadn’t put a spoke in the wheel right there that brought him to a screeching halt.

With that, what we saw in this episode may be the first steps to Glassman truly healing from all of his failures — new or old. He has lots of underlying issues from the past, too. There’s the death of his daughter Maddie that he feels partly responsible for. We’ve learned that Ilana accused him of replacing Maddie with Shaun, which surely at least subconsciously created more feelings of guilt. Ilana verbalising that she’s now forgiving him for it and absolving him of that guilt will hopefully go a long way.

Ilana was a godsend in more than one way. She was the much needed catalyst for Aaron to re-examine where he might have been going wrong. She saw and told Aaron that Shaun was good for him, she saw and told Aaron that moving to Montana would be a mistake, and then, culminating in that huge Shaun meltdown, Aaron himself finally saw first-hand how much shit had been raining down on Shaun, and how much damage it did that Aaron wasn’t there — both physically and emotionally.

Question is, where does it go from here? All of this may be the first step to patching up the damage done. Will he rethink moving out to Montana? At the very least, I’d like to think he will make more of an effort to support Shaun, such as not ignoring calls, and actively reaching out. And maybe actually turning up to the tux fitting appointments for the approaching wedd— Wait…

As suggested by the 5×08 promo trailer, Glassman will at the very least be there throughout the immediate aftermath of the expired medication debacle. I’d hope that he won’t sell the house and stay in San Jose after all, having his eyes opened by Ilana and born witness to Shaun’s emotional turmoil and fragile state of mind. One can only hope!

Team Anti-Salen

Ever since they introduced the character of Salen, she’s incited controversy. Many fans hated her right from the get-go, because she was manipulative and disruptive, and caused upset for our favourite characters. She’s the type who will pretend to be sympathetic but at the same time slowly stab a shiv in your gut and turn it while she smiles at you.

She’s not an immediately likeable character, but she’s also not meant to be. Personally, I find her incredibly intriguing, and while on the surface I loathe her for her business practices and profit-first/human-second mindset, you can’t deny that she has a heart in her somewhere, and that her actions aren’t coming from a malicious or predatory place.

From a storytelling and writing perspective, I love the introduction of Salen. She’s brought a level of cohesion and a new perspective to St. Bonaventure. She’s interacting with everyone, and she’s bringing out sides in people that are interesting to watch.

There’s also been a fair amount of backlash towards Salen for repeatedly comparing her ADHD to Shaun’s ASD. And I get that people have an issue with that, but I also think you need to listen closely to what Salen is saying. Because she never actually pitted the two conditions against each other. All she’s saying is that both she and Shaun have neurological conditions that makes them different, that presented and still present challenges in their lives, and that bind them together in a struggle of neurodivergent people trying to fit into a neurotypical world.

Listen to her dialogue from 5×04 Rationality here where she talks to Glassman. “Nobody made accommodation for my ADHD. That was hard, but it made me stronger, smarter, more resourceful. We have different problems and different strengths, but I know, if you keep patronising [Shaun], it’ll backfire.” She explicitly says that her ADHD and Shaun’s ASD are different. Her point is that they both have similar struggles. It is not her saying that ADHD and ASD are the same.

In all of this, let us please not forget that Salen Morrison ≠ Rachel Bay Jones. Rachel is a professional actor who plays a character who was written that way for her to portray as realistically and tangibly as possible. The fact that we dislike Salen so much is tribute to Rachel’s wonderful acting skills. Please don’t hate on Rachel for Salen. Instead, let’s show her some love for her great work and for breathing life into a character that we’ve grown to love to hate.

And then we also have…

Team Anti-ABC

Many fans are angry at the long hiatus. Currently it is said that the show will come back in spring, whatever that means. There was a tweet from the writers that got deleted that gave a date of April 4th, but likely ABC wants to keep it vague for now to maintain flexibility, in case their miniseries they want to put in the TGD spot in January will tank and they might bring back TGD sooner than anticipated. (Ngl, the premise of that show doesn’t exactly sound like it’s gonna be a huge hit.)

What makes this long hiatus sting even more is that it ended on such a discordant note. Shaun seems to be at odds with everyone, the Shea marriage is hanging in the balance, there’s an impending internal hospital war and possible attached lawsuit, and fans are left to stew on that until well into next year. Four months seems like a long time with such a sour stench in your nose, right?

Personally, I’m not too worried. Yes, the long hiatus sucks balls. But I have faith in the writers that they’ll bring Shaun and Lea back together. It’s going to be a bit of a journey, but it’s full of possibilities.

Last but not least…

Team Pro-Writers

Hey, that’s my team. I volunteer as team leader!

No, but seriously. I wanna express my sincere appreciation for the tireless Good Doctor writers and creative and production team who continually bring us new episodes to enjoy. You’re all doing an outstanding job, particularly Mark Rozeman and Jim Adler with this fantastic episode that gave us so much to marvel at. I’d treat you to a round of home-baked German advent cookies right now if I could.

Looking Forward and Looking Back

I already covered a bit of what we can likely expect playing out for the rest of the season. The 5×08 promo clearly shows us that there will be a clash of the Titans (Lim vs. Morrison), and that Shaun and other doctors will get caught in the crossfire.

What’s currently unclear is how much Shaun will be personally blamed for the death of the baby, and it’s certainly possible that the called off wedding will become the least of his problems. But if that were to happen, it would most definitely hit Shaun incredibly hard.

Let’s go back to the pilot episode Burnt Food and remember that beautiful speech Shaun made when he was asked why he wanted to become a doctor.

“The day that the rain smelled like ice cream, my bunny went to Heaven in front of my eyes. The day that the copper pipes in the old building smelled like burnt food, my brother went to Heaven in front of my eyes. I couldn’t save them. It’s sad. Neither one had the chance to become an adult. They should have become adults. They should have had children of their own, and loved those children, and I want to make that possible for other people.”

To think Shaun is now being accused of or in some way made to feel responsible for killing a baby, that would wound him deeply. And it’s gonna hurt for all of us. We’ll have to see if or how that plays out — if it does.

I’m also curious as to how Lea will be inserted into the whole situation. We saw her helping Lim gathering data to help overturn Salen. If Shaun is caught in the crosshairs of a legal or responsibility battle, she might also in some way be professionally supporting Shaun through all this. It could certainly help in patching up their personal differences.

Talking about Lea… There’s something noteworthy that Andreas pointed out on Reddit. The Good Doctor is all about foreshadowing, right? Sometimes it’s hard to tell how much of it is intentional, but remember Lea’s nightmare about the outdoor wedding in 5×01 New Beginnings?

In her nightmare, a storm was brewing just as they were getting married, it started pouring rain, thunder clapped, and Shaun jumped out of the way. Then lightning struck and a burning tree fell on her unexpectedly and unprotected with Shaun fleeing the scene and out of reach. Sound familiar?

It’s also interesting to go back to some of the earlier season 5 episodes to re-examine some of the dialogue there. Again, in 5×01 New Beginnings, we had the mother with the two boys she had passed her cervical cancer onto, whose brother had an alcohol problem. The beautiful Shaun moment in that episode was that Shaun told the mother that people aren’t always perfect, but sometimes it’s exactly those imperfect people you need in your life. Maybe someone should remind Shaun of that, it seems apt and relevant to his current situation.

And since we’re already rewinding to old episodes, it hits particularly hard if we look back at 4×08 Parenting. Because there is Lea, sitting opposite Glassman, and he’s concerned about how much Shaun loves and trusts Lea. “And you make Shaun happy, which I guess is a good thing, but it also means you can make him very, very sad. And that worries me, frankly.” Lea tells him she’s not planning on hurting Shaun, and Glassman says that it’s rarely intentional.

And now we’re right there. Lea has hurt Shaun, and of course it wasn’t intentional. Kinda interesting that Glassman isn’t as concerned now as he was about a year ago, him being all blasé about Lea’s review omissions, and insisting Shaun was gonna be fine and Lea could solve that problem on her own. What happened to, “I feel every single high and every single low, I’m not gonna stop worrying about him, even if he doesn’t need me to?” Huh, Glassy?

The Good Doctor Returns This Spring

Now all we have left to do is wait until spring 2022 (most likely early April) to see how the story of our good doctor and his colleagues and friends will unfold further. Right now it seems like that’s an eternity and a half, right?

There’s still a good deal of chatter on Twitter, Instagram and Reddit about the show (I don’t follow the Facebook groups much, but likely there, too). Some of us are doing advent calendars with daily images right now, leading up to Christmas. The cast and crew are still shooting new episodes until mid-December, and we might hear little tidbits from the set here and there (for those unafraid of spoilers who enjoy that kind of thing).

We could organise rewatches and other fun fandom activities in January and onwards to stay engaged and not forget all about our favourite characters. I know that I’m planning to delve more into writing fan fiction and doing fanart, perhaps make more than the one fanvid I posted the other day. And I plan to definitely not forget about dear Shaun and his friends!

Let us not despair. April will be here soon enough, and until then we still have each other! ❤️

State of the Shea

Kelli Lawrence’s entry on her State of the Shea blog also sheds some light on the episode, and asks many different questions about the episode. You can read it here.

Missing Scenes

Will be added later, stay tuned.

2 thoughts on “Season 5 Recap: 5×07 Expired

  1. Well, a thorough analysis of the episode again, TeeJay! Now, that the episode has been covered in detail, and with plenty of time to kill, allow me to take a shot on the bigger picture that has been painted on our screens. For taking a step back might allow us to see a little clearer what could lie ahead.

    Every season of the show probes some grander themes. So far, there has been an abundance of parent/child cases of the week that tackle every possible angle of family. This led many of us to believe that a return of Marcie Murphy is imminent for some much-needed healing to take place, as well as Glassman finding peace from his troubled past.

    And in fact, Expired already delivered some of that. Though, I start to believe that the lack of variety in themes touched by the cases was also a disguise for the season’s basic theme, something that is existing in the back of our minds but wasn’t touched at all by the show so far: very soon Shaun won’t be a resident anymore. With all the consequences.

    Therefore, I would call season 5 the time of transition.

    The idea of transition can be found in any of the ongoing plots. The hospital is transitioning from one owner to another with the powers-to-be shifting, and career paths taking new, unexpected directions.

    Glassman has become lost in transitions taking place in rapid succession – from husband to bachelor (again), from powerful hospital president to defeated poker player, … from steering the career of his surrogate son to the ride in the backseat of the Striped Tomato.

    Andrews is transitioning from the calm life of a devoted husband to seeking the thrill of walking the line; and Lim is about to learn that chief of surgery comes with a lot more political in-fighting than this adrenaline-drunken trauma surgeon had signed up for.

    Morgan is shifting gears from being a career-driven bitch to … ah well, let’s say keeping the ambitions while becoming a decent human being off-duty; assisted by Park no longer being like a stone, but becoming an emotionally available, supportive boyfriend and father (perhaps).

    With Salen, change has come to St. Bonaventure – and change ain’t easy for the titular character, as The Good Doctor kept reminding us lately.

    Yes, Shaun is struggling and, to no one’s surprise, fans are feeling for him. That is successful storytelling. Yet, the episodes also made sure to remind its audience that Shaun’s brilliance as a surgeon comes with some downsides: he is easily irritable, struggles to stay in control of his emotions, and often enough fails to consider different perspectives (Salen made that point in the server room, as well as Lea later on) to the point that he becomes plainly self-righteous and arrogant.

    How Shaun handled the situation with Walt, a medical layman who was to be treated like a consulting physician (5×04 Rationality), is a prime example of all the things going wrong: Shaun failed to take into account the office and corporate politics, he could not control his emotions and acted totally inappropriate (which is a nice way to say that he had a violent outburst, throwing things like a toddler) to the point that Andrews asked him to leave the room and took him off the case (to protect him from making the situation even worse). Yet, Shaun failed to see how he acted unbecoming of a professional doctor of a high-profile hospital and kept wailing about knowing to be right but no one listening.

    Fun fact: I hear the same stories from real people with ASD in real work situations and they keep complaining about the same: that they were right, and the others weren’t listening.

    Less of a funny fact: fictional or real, in any case the underlying problem isn’t the malice of others, but the blatant ignorance of the multidimensionality in neurotypical communication that is inherent in ASD. Those individuals steadfast believe that only the factual side of Schultz von Thun’s communication square is to be considered. What a pity that neurotypicals regularly tend to disagree. Throwing books and yelling at patient’s relatives might qualify as some self-revelation and even undermine any existing work-relationship… Just saying…

    Anyway, Andrew’s reaction to Shaun’s outburst fits well into the pattern of others covering for Shaun, as TeeJay already reminded us. Andrews might have taken him off the case to diffuse the tension, but he didn’t write Shaun up for his misconduct. Instead, Andrews made sure there would not be any written evidence of it. Shaun was let off the hook, again.

    Which has such a tradition with the show that even Shaun’s low point – getting drunk and paying Lea a visit with a baseball bat – never had any consequences, since Lea obviously had chosen to let it slip due to his ASD and her own conflicted emotions.

    The legal dimension of attempted damage to property aside, all these incidents have send a certain message to Shaun: that he can act out all his ideocracies (sex toys on Lim’s desk, anyone?) and even bad temper without serious repercussions. That he gets along just fine. It fed into a deceptive self-content. That others have to be held accountable for any breaking of rules he happens to believe in (e.g. Park in One Heart), while he even could break the law if it only would soothe his inner turmoil.

    Smash Lea’s car up because I feel hurt? Sure! Omit reviews? Get her fired! I feel so betrayed! I can’t marry you! Hypocrisy, thy name is Shaun.

    Moving on from the sarcasm and back to the theme of transition – with Shaun on the brink of becoming a fully-fledged doctor and husband, the question of accountability and responsibility arises. And here, the brilliant diagnostician appears to be short on change.

    Emotionally, Shaun very much is an adolescent in transition to adulthood. With all the painful struggles usually attached to it. He’s just about 15 years late and happens to work in an environment that heavily relies on teamwork and communication. And when he makes a mistake, people might die. (Hello again, Dr. Andrews 1×01!)

    But to conclude a long train of thought, taking all of this into consideration it actually might be a good thing for the character to be held accountable for mistakes he made in the treatment of the baby. It might provide a necessary impetus for Shaun to decent to the dark dungeons of his precious mind palace.

  2. P.S.: The family-themed cases of the week tie nicely into the Ethicure plot as well, considering that Salen likes to speak of the “Ethicure family”. A figure of speech that makes herself the caring mother of doctors she guides with a strong hand.

    Now, some of these “adolescents” are about to rebel against her new stepmother and civil war is looming at St. Bonaventure. I’m eager to learn what alliances will be forged and broken, who will be divided by the battle lines, and who will be caught in the crossfire.

    Interesting times ahead, to be sure.

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