The Good Doctor

Severe Winter Weather Advisories

have been issued from Kansas to western Minnesota.

Severe ice and snow reported.

Temperatures will likely reach below 20 degrees, and wind chill...

Shaun.

Shaun.

Mm. There is a severe weather warning in Minnesota.

You haven't been at work in three days.

I want to be left alone.

I'm sorry she hurt you.

But you are strong.

You're the most determined man I know.

You're gonna get through this.

I wish I was...

Normal.

Everyone wishes they were normal, Shaun.

You need to get up.

You need to do your exercise routine,

then shower, shave, and get to work.

And not because your patients need your help,

but because it'll make you feel better.

I'm not leaving without you.

Your sleep apnea is worse than we'd thought.

You have a condition related to your pseudoachondroplasia

that is narrowing the base of your skull

and compressing the part of your brain

that controls your breathing.

People always say I'm too full of myself.

Guess it's actually true.

Finn, this is serious.

Don't worry. I'm gonna be fine.

We can remove bone from the wall of your skull

and resect a small section of your cerebellum

to reduce brain-stem pressure.

You're... You're gonna cut out a piece of his brain?

It won't affect your intellect,

but it will cause a speech impediment

and some difficulty with balance.

I'd rather you knock a few points off my IQ.

Stop it.

I'm serious.

My "gift of gab" is what you love about me.

Uh, w-what's option two?

I'm sorry, there is no other option.

I'm a salesman. I don't hear the word "no."

Th-There's always another way.

You just got to think outside the box.

We've already done that,

which is how we came up with this surgery.

It's the only way to keep you alive,

so you have no choice but to accept it.

Dr. Murphy is being rude and insensitive,

but he's also right.

Finn, please, I love you.

And I will always be here for you

no matter how you talk or walk.

But you have to listen to your doctors.

I love you, too.

Do whatever you think's best.

Let me guess.

I'm gonna need another surgery.

What's that now, my tenth?

Eleventh.

And I still can't work the farm,

can't drive a tractor, pull a combine lever.

I can't even twist open a bottle of beer.

When we met, you were in an ambulance

and your arms were still in your harvester.

Today you have sensation and almost full mobility.

Now we just need to treat the neuropathy

and improve your strength.

So how do we do that?

I'm thinking a gracilis muscle transfer.

That should improve his grip and relieve some of the pain,

but there's only one way to eliminate all of it.

Tyson, have you given any more thought to amputation

and osseointegrated prosthetic arms?

They'd attach directly to the bones

and nerves in your forearm,

and you can control them just like your own hands.

Function would be reduced in some respects.

Less dexterity, no sensory feedback.

But others, like grip strength, would be better.

And more importantly, you'd be pain-free.

I want to be a farmer,

not a cyborg.

Okay.

The pain's getting worse.

Probably because I've been crazy busy in the O.R.

with Murphy out till today.

He's back?

Only because Browne went to his apartment

and dragged his ass in.

She shouldn't have done that.

He's trying to work this out on his own.

That's a good thing.

DMARDs aren't working.

I know.

Which is why I've been thinking about synovectomy surgery.

You're gonna remove the joint linings in your fingers?

That'll resolve the pain temporarily.

Then what?

It'll give me at least ten years.

And then you're gonna be bone on bone,

every joint in your hand will be mangled and deformed.

What's your plan then?

Who knows what treatments will be available in ten years?

Have you thought about oncology?

Surgeons do the real work.

They cut out the tumor, they cure the patient.

Oncologists just sweep up after.

You want to know an even better job?

Starting pitcher for the Oakland A's.

You want to know why I didn't get that job?

Because the scouts didn't like the way you wore your hat?

Yeah, that, and I was born with this arm.

You were born with those hands.

What are you gonna do,

practice surgery for a few more years

and then spend the rest of your life

not being able to pick up a pencil?

You can pursue another specialty.

You can practice for the rest of your life.

You get rear-ended on the way to work

or you just hate little people?

Neither. EKG is normal.

So you got dumped.

No, I didn't.

It's nothing to be ashamed of.

We were never even going out.

Finn?

I've been worried sick.

Ohh.

Take it easy.

I told you to stay home.

There's nothing to worry about.

Stop trying to act so tough.

You shouldn't have to go through this alone.

Sorry, baby, but you should wait outside.

Let the doctors finish up, and I'll be right out.

He's not going to the O.R. for a while,

so there will be plenty of time to visit when we're done.

Okay.

I'll be right outside.

Is there any way you could make sure

she and Nathalie stay in separate waiting rooms

and aren't allowed to visit at the same time?

No. We're not helping you cheat.

I'm not cheating.

I've always made it clear I'm not ready to settle down,

but sometimes women m-make assumptions.

Oh, and you don't feel the need to correct that?

I understand you don't approve,

but all I'm asking

is for you to help me get through brain surgery

without emotional turmoil

that I assume would be harmful to my recovery.

Okay.

Thank you.

Are you seeing the same thing I'm seeing?

The tendons are encased in scar tissue.

The gracilis muscle transfer isn't gonna work.

It still could. If we attach the muscle

further down the forearm and bypass the scar ball.

It wouldn't hold.

There'd be too much tension on the graft.

We can figure out a way to work around that.

Let's wake him up and put him back in his room

and pull every paper on free-muscle and nerve transfers.

His only option is double amputation

and the osseointegrated prosthetics.

We don't have a choice.

Yes, we do.

And as Chief of Surgery, I just made it.

He doesn't really look the part.

He's a handsome guy with a great sense of humor

and a high-paying job.

He means because women don't like

to be in relationships with men who are weird.

He's not weird. And neither are you.

And a week ago, you were juggling two women,

so stop feeling so sorry for yourself.

Have you ever dated anyone who wasn't tall,

handsome, and neurotypical?

It's not about me.

Talk to me. He stopped breathing,

and I haven't even administered the paralytics.

What just happened?

Pressure on the medulla must be getting worse.

He's lucky he didn't wait any longer to come in.

Let's tube him and get to work.

Wait. Flex his head into position again.

Extend his neck.

What's going on?

Flexing the neck offsets the posterior compression.

But that should take the pressure off, not make it worse.

Doesn't make any sense.

And we're not gonna do brain surgery on him until it does.

I don't see anything different in the flexed-neck views.

Should his C2 bone be curved inward like that?