"22 Steps" is the seventh episode of Season 1 of The Good Doctor. It aired on November 13, 2017.
Synopsis[]
Dr. Shaun Murphy has to confront prejudice from an unlikely source when he takes on the case of a patient with autism, and Dr. Jared Kalu has to learn to accept his limitations as a surgeon.
Plot[]
Shaun is staring at some brand new TVs through the electronics store window, while Dr. Glassman comes by to see Claire to see how she is doing after she accidentally killed Jenna. She says she is dealing by getting back to work and putting it behind her, though he makes an appointment for her grief counseling with Dr. Mohan who will say if she is okay to go back to surgery. Neil then arrives at the ER with Dr. Lim where they meet a patient, Glen, who has a broken pacemaker and probably needs his coronary arteries cleared. Shaun says he is 73 years old and cannot have a transplant, so he is dying. Neil says he isn't dead yet, to which Jared suggests cardiac synchronization to make him feel better for the few months he has left. His alarms go off and Claire is ordered to cut is jugular but hesitates, claiming that she drank too much coffee but all the same does it. Meanwhile, Shaun is told to find out how long it will be to get Glen’s bi-pacer in house.
Shaun notices the EMS bring in a young patient, Liam, who keeps trying to fend them off which is mistaken as him being psychotic. However, Shaun approaches them, stating that the staff are scaring Liam who doesn't like people touching him and is actually autistic. Shaun cleans him up, while Liam realizes that Shaun is the same as him. When his parents arrive, all he can say to them is "wrong stop!". When they ask what happened, Shaun says Liam had a laceration to his head, probably a fall, and has cleaned it. Liam says he "got lost!" and his mother is shocked that Shaun was his doctor. His father says the bright lights make him anxious and asks if they can take him home, to which Shaun says he is jaundice and tender when touching him and shouldn't go home. When Glen regains consciousness, Jared explains how he got there, while also stating that he is 28 and that a pacemaker is being flown in later this afternoon and they will prep Glen for surgery then. Shaun explains to Neil what is going on with Liam, while Neil tells Shaun to do an ERCP to clear Liam after that, a few weeks of broad-spectrum antibiotics. However, Shaun appears to disagree. Claire is at the Nurses' Station doing work and checks out a psych questionnaire when Shaun interrupts her, asking if she will help him with the ERCP saying she is good with autistic people.
Jared returns to Glen's room without him on the bed, realizes he is gone and calls a code green. Claire gives Liam the sedative, but he has a respiratory reaction to it which Shaun is able to help with and asks Claire to continue. As she proceeds with the test, she thinks it's nice for him to finally interact with someone else who has autism; he doesn't understand why but they are interrupted when they realize his problem has nothing to do with gallstones, there is so much scarring inside and they cannot even get the camera down. Shaun talks to Neil about the possibility of scarring as being primary sclerosing cholangitis, liver failure and secondary primary biliary cirrhosis, only for Neil to state that they can add cancers to that list as well, as it is a long and ugly one and tells him to find another way to figure it out. Shaun says there is no way to do an MRI as they don’t know how to keep him still. Claire then says he can't have a sedative because he could die from it and they wouldn't know if while he was inside the machine, to which Shaun says they will do it and leaves the room.
Dr. Glassman finds Shaun pacing the floor of Liam's room. Shaun explains that he wants $1,643 for a new television, but Glassman states that Shaun can’t get one since he hasn’t got his first pay cheque and tries to offer him $1,000. However, Shaun refuses and insists he wants his own budget. Jared sits with security who says Glen got onto a freight elevator, but they don't have cameras in the elevators and a couple of floors that the freight elevator goes to. Claire is on the elevator when she gets a text from Glassman saying her appointment is set for 12 noon. She is about the respond when Jared gets on the elevator and presses the basement button, claiming to be looking for a pediatric patient's blanket. Claire smiles and tells him while he's up there he should find his code green. Liam is placed in the MRI, where Shaun begins to talk to him. His father tells Claire to turn down the lights and Liam responds to Shaun as they attempt to start the test. He listens to Shaun, responding to him and they are getting great images. While Liam's father comments on how accomplished Shaun is for ASD, Liam suddenly begins to panic and hits his head before they can finish. His father runs in the room with Claire to pull him out of the MRI as his mother and Shaun look on.
Jared finds Glen, who reveals he broke his pacemaker on purpose because he wants to die. He knows he will just keep getting worse and has no family that will nag him into what Jared wants him to do. He says he is in pain all the time, announcing he knows his rights, can refuse treatment if he wants and the minute he catches his breath he'll leave. He tells Jared to do so, but Jared decides to sit and wait for Glen since he's got all day. Neil informs Liam's parents they cannot treat him until they know the underlying cause; they sign the papers for surgery as there is no other option. Meanwhile, Jessica sits with Glassman, talking about how Shaun is getting a 70" TV. She wants to know why he is so worried about Shaun and reveals that Shaun has been late for work, when he called Glassman at 2:00AM when he couldn't find his screwdriver and Armen wants to kick him out of the building. She reminds him how hard he fought for Shaun to be a resident at the hospital because he know Shaun can learn, but is he willing to let him learn? Claire finds Shaun watching TV in one of the waiting rooms in the hospital; he exclaims that he can see the pixelation and that is not great because an eye with 20/20 vision cannot detect the pixels. She turns off the TV and wants to know why he left after the MRI. He said that he failed, but she says it's not that; she thinks there is something more going on and questions how he doesn't like Liam because he has the same condition Shaun has, while also stating she thinks Liam likes him and looks up to him and Shaun probably understands Liam more than she does.
Jared is waiting for Glen to pass out, so he can get him upstairs before he dies. Glen says he has already lived, married and loved for 20 years, but he is now alone, with no roof over his head and is in severe pain, so it feels like the end of the story. He scoffs that Jared claims to understand and calls him an ass because he suffered because he was rich and only saw his parents at Christmas. He talks about boarding school and when he became a man and ready to tell his parents he was done with them. However, he found that they were gone when he went to their home; they sold the house and hadn't told him. Claire tries to calm Liam down while his mother holds down his flailing arms and Shaun begins to talk to him. He says it is okay to make mistakes and should make more of them. He notices Liam's red eyes and asks about herbal supplements: it appears they caused the scarring in his bowels and they now have to go in surgically and remove the pieces to fix it. Liam's mother thanks Shaun for diagnosing their son, but there is no way he is allowed to be involved in the surgery.
Neil speaks to Glassman, who asks if Neil agrees with Liam’s parents. He also thinks that Shaun can handle the surgery and Glassman tells him to tell the parents to go screw themselves as Shaun is part of the team. Glassman also states that if they continue to disagree, then Neil can offer to find them another hospital to bring Liam for surgery. Jared continues to talk to Glen about how his life changed but when he gets no response, he checks his pulse but Glen says he's still alive and wants to know what happened with Jared's parents. He admits he speaks to them now but they didn’t get him here; it was an ex-Marine at the shelter and a crazy artist girl who convinced him to go after everything he wanted and tells Glen that he isn't alone, even if he thinks so. Glen agrees for Jared to help him. Claire goes to her counseling session but seems to be lying about all her emotions and state of mind. Neil meets with Liam's parents who fear that Shaun won't be able to help Liam while he is on the operating table. Neil says they know their son, but he knows surgeons. He also states that after working with Shaun and even challenging him more than he deserved, Neil has complete confidence in Shaun. The parents still refuse and the mother looks for the bag for Liam’s medications when suddenly, Liam says he wants Shaun.
Jared tells Glen his pacemaker has arrived and will return when he is ready to put it in. Glen admits his wife didn't die; she left him, for which he gave her good reason. Meanwhile, Jared didn't get what he deserved like good parents who loved him, but they were lucky to have him. Jared smiles and holds his hand briefly. Claire seems remarkably well adjusted, which concerns Dr. Mohan. She doesn't reach the requirement to be grounded from work, saying she is a strong woman but she will need to share suppressed feelings she has with someone or those feelings will eat her up. Jared returns to Glen's room with the gurney for surgery only to find his bed empty again. He goes on the hunt for him again while Shaun arrives in Liam's room. However, as he says he is glad to be participating, Liam's pressure is bottoming out and he is going into septic shock. In the OR, Neil quizzes the team, and they are told to do a full-length middle incision of the bowel to find where it is perforated. Neil offers the scalpel to Shaun who takes it, remembering when Steve gave him his toy scalpel. He does the incision and gives the time.
Jared gets a call while the code green is announced over the intercom as Jared rushes off. Meanwhile, Shaun cannot move as he’s found the perforated spot, he has his hands wrapped around it and Neil says he cannot move or Liam dies, which Shaun knows. Neil orders Claire to slowly cut it open and he will suck out the septic contents and flush it with antibiotics. The pressure is tanking and the anaesthesiologist J.L. says they need to finish what they're doing right now. Jared finds Glen on the roof; he says he just doesn't want to do this and once he has his strength back, he's going to climb over the railing and jump. Jared once again sits beside him and tells him how slowly he will die if he just sits there. Glen tells him to give it a rest, give him a DNR and a cab, saying he cannot help him. While Jared refuses to give up, Shaun and Neil come to see Liam's parents, saying they removed two feet of the bowel and he will be okay. His mother hugs Shaun, while quickly apologizing for touching him. Shaun tells them to not feel bad, as they love him and did what was best for him, which he didn't have from his parents. Neil smiles when Shaun says because his parents didn't care about him he didn't have to take the herbal supplement that caused such damage in the first place and walks out.
Jared sits with Glen, who has signed a DNR and shuts off the temporary pacemaker. Jared sits and asks Glen if he feels any anxiety, to which he says no but feels a little pain. Jared gives him some morphine to offset it, while Glen puts his hand on Jared's shoulder and thanks him as he takes his last breath and Jared tears up. In the locker room, Jared walks in and tells Claire about Glen not wanting the pacer and that he was a good guy. Claire finally admits to him about Jenna dying and agrees to talk to him about it, while resting her head on his shoulder. Liam soon wakes up with his parents by his side, while Shaun says his surgery went well and will be able to walk around in two weeks when the antibiotics have cleared his infection. His father quickly wants to dim the lights but suddenly stops and asks Liam if the lights are okay and he says they are. Shaun smiles as he sees Liam and his parents together. Glassman and Shaun are soon watching football, while Glassman is trying to teach Shaun about online banking and budgeting. They are cheering for the game when suddenly Shaun wants to go to the Superbowl. Glassman says that is something he needs to remember when he is budgeting, then says they should both go. Suddenly, the salesperson from the store informs them that is it almost closing time and they need to go. Shaun says he would like to buy the TV, to which the salesperson says they could stay as long as they want, while Shaun and Glassman recline in their chairs and chill out.
Cast[]
Starring[]
Guest Starring[]
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Co-Starring[]
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Trivia[]
- The events of Burnt Food, Pipes and Not Fake are brought up.
- Neil now accepts Shaun as a part of the hospital.
- In the Turkish adaptation's episode, there were some differences:
- Shaun treated Liam and confirmed that he was autistic. In the Turkish adaptation, it was Demir (Jared's counterpart) who did due to Ali (Shaun's counterpart) being transferred to Pathology.
- Shaun mostly participated in treating Liam, but at the same time faced discrimination from his parents over Shaun being an autistic doctor as well, with even Neil vouching for Shaun when they went as far as to bar him from doing the surgery. However, in the Turkish, Ali only played a smaller part in it and never faced any discrimination from the parents, and Ferman (Neil's counterpart) defending Ali was completely absent because of Ali working in Pathology.
- Unlike the American adaptation, this episode took place along with Believe and Breakdown.