The Good Doctor

You had a blast.

I didn't say it wasn't fun,

but that decade was a crime against fashion.

Tonight's club is my pick, my vibe.

Ooh, which is?

Sophisticated ladies.

I can work with that.

Shaun? Hmm?

Sure you don't feel left out?

I use the time to study less invasive

bowel resection techniques.

Please be home by 11:30.

Hm.

He's got you on a curfew?

Sex schedule. Our window ends at midnight.

It's like I slept on gravel.

Well, that explains your snoring.

Your mattress should be burned.

It's time to end the sleepovers

and for you to ditch the bachelor pad.

You asking me to move into your place?

I'm asking you to move into a new place...

With me.

No neutral zone to run to after a fight.

Making up's the best part.

Well, it can't hurt to look.

This is Trent, his mother, Carrie.

Signs of severe infection on his left index finger.

I'm ordering a CT.

Sutures are inconsistent and crude.

It's a minor upgrade.

I installed a magnet in my finger.

Were you having trouble holding forks?

It's body art.

Yeah, he's 17, immune to common sense.

Art seems like a poor descriptor

given the ugliness of the infection.

The more appropriate term is "biohacking."

I put Neosporin on it and took ibuprofen for the swelling.

That's worked before.

Before?

Show them.

Hmm.

You wanted to see me?

Dr. Glassman, this is Kayla Quinn.

She's been diagnosed with major depressive disorder

as well as chronic neuropathic pain

from a neck injury six years ago.

The pain and depression are besties,

uninvited guests that travel together,

make it so I can't work, can't get out of bed,

can't even think.

That's why I'd like to do this before their next visit.

An anterior cingulotomy seems like the...

Excuse me.

She is a smart, charming, successful woman whose life...

Nice ambush.

She's had over a decade of therapy,

five classes of anti-depressants,

and non-invasive neuro-modulation,

including C.E.S. and full-on E.C.T.

She's desperate for real relief

from her pain and depression,

and she's well aware of the risks.

Get me a complete medical and psychological history

and a couple of residents.

We're just gonna talk about it.

Not sure who's struggling more,

the overwhelmed, super-critical mom

or the sad, self-harming teen.

Trent called it an upgrade.

He's not trying to self-harm, he is trying to self-improve.

Well, whatever the terminology,

he cut into his finger with an X-ACTO knife.

Okay. His technique was primitive,

but considering he lacks formal training

and used only one hand, I am impressed.

Don't be.

Bony marginal erosion.

If the infection spreads, he could lose that finger.

For starters.

It's the modern equivalent of a lobotomy.

"Modern" being the operative word.

We'd be burning lesions into a key brain center.

That could alter her personality,

impair cognitive function...

Her depression and reoccurring acute pain

are already doing that.

Cingulotomies are effective in 67% of patients

with Kayla's symptoms.

With a 20% chance of adverse effects,

like loss of creativity, it could be a big deal.

This is Kayla Quinn.

She launched her own company at the age of 18,

made millions designing scrunchies and bangles.

I discussed this with her.

Her focus is quality of life.

Now, I'm sure she feels that way now,

but once it's done, it can't be undone.

Are there any alternatives that Kayla hasn't tried

or should try again?

Okay.

Let's do the surgery.

Wait, possible amputation?

The infection

is in the bone beneath the magnet.

It would have been better to have brought him in sooner.

I'm a single mom.

Trent... Trent's father isn't in the picture.

You made sure of that.

I got divorced last year.

Trent and I were adjusting.

But then he started hanging out with these idiot biohackers.

Thanks, Mom.

We should remove the infected implant

and start Trent on IV antibiotics.

What about the other implants?

Shouldn't you take them all out?

No! The other implants aren't infected.

Okay. This is not a decision you get to make.

Once a patient is 16, it is hospital policy

not to perform a surgery that's been refused

unless that surgery is medically necessary.

Leaving in the other implants

means Trent's still at risk for sepsis and septic emboli.

Dr. Wolke is correct.

With your consent, we can physically compel

the surgical removal of all your son's modifications.

Good luck. I'm outta here.

Trent.

Trent!

This is much easier than chasing him.

Head frame is secure.

Stand by with the Gamma knife.

Dr. Glassman, please stop what you're doing.

This is Justin Quinn, Kayla's conservator.

I have full authority over my sister's medical treatment,

and I won't allow this surgery.

Kayla sees her psychiatrist weekly,

and I check in with her daily,

but clearly, this is not

a weekend getaway at a cabin in Tahoe.

A chance e-mail from our insurance tipped me off.

She's never lied to me like this.

I was 12 when my parents died.

My memories of them don't seem real,

just clips from a movie.

It was our grief therapist who first diagnosed her depression.

I was 22 and so out of my depth.

Justin and I used to do everything together.

It was us against the world.

I called him Bro-dad.

She was such a creative kid, so talented.

She just had a vision and wanted to run with it.

Who knew scrunchies and glitter bangles could be a business?

Just took off.

Eighteen years old, all that money and no guardrails.

She was out of control.

Clubs every night, the booze, the drugs...

I couldn't help her. I couldn't stop her.

It was during a blackout that I fell and injured my neck.

Everything just got worse after that.

The arrests piled up, underage drinking, possession, DUI.

I thought she was going to prison.

The judge agreed to a diversion program...

She's nearly O.D.'d twice.

...called me a danger to myself.

The judge ruled she was incompetent.

Put my brother in charge of everything.

He took away my life.

The conservatorship saved her life.

All I needed to piss off my parents

were fishnets and heavy eyeliner.

Of course you were a goth.

How many times did you see The Cure?

Four.

Robert Smith was, like, leader of our tribe.

Every lonely teen needs a tribe.

I was lonely, but I was not a rebel.

My rebellion was just being honest.

My family preferred the lie.

Meanwhile Trent is damaging his relationship

with his mom and his body.

That is not his fault.

She is his mother.

Mothers should try to understand their children.

Nice thought, but teenagers are asses.

Scientifically proven.

Their prefrontal cortex is underdeveloped,

leading to excessive risk-taking

and lack of impulse control.

Margins in the soft tissue look good,

but keep an eye out for the infection.

Let's close.

Mr. Quinn.

Your sister's suffering.

It's a roller coaster with her,

good days and bad days.

But your solution is to fry part of her brain.

She could lose her creativity, her personality.