- "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. And I want to make a lot of money so that I can have a television."
- —Dr. Shaun Murphy to the board of directors at St. Bonaventure Hospital.
Dr. Shaun Murphy, a young surgeon with autism and savant syndrome, relocates from a quiet country life to join the prestigious St. Bonaventure Hospital's surgical unit. Alone in the world and unable to personally connect with those around him, his only advocate, Dr. Aaron Glassman, challenges the skepticism and prejudices of the hospital's board and staff when he brings him in to join the team. Shaun will need to work harder than he ever has before, as he navigates his new environment and relationships to prove to his colleagues that his extraordinary medical gifts will save lives.
It begins with Dr. Shaun Murphy perfectly placing down his toy scalpel, brushing his hair in perfect place then returning to the mirror and messing it up before he puts on his jacket and heads out the door. He follows a white line only he can see from the front porch, walks through a field and visualizes children playing around a school bus in a junkyard; a soccer ball lands in his feet and he has flashbacks to when he was being bullied and beaten and his friend took on everyone abusing him. He gives the ball back and travels by bus to San Jose Airport, where he stands and absorbs all the sounds and noise around him. He holds a piece of cloth in his hand as an accident occurs and a young boy falls into the ground bleeding, someone rushes over claiming to be a doctor disagrees so Shaun tells him he would be in the right place if his patient was an adult, but he is a boy and he needs to put pressure higher up. Shaun walks up and takes over, realizing he has glass in his belly but says he will be fine and introduces himself as Dr. Shaun Murphy, a surgical resident at San Jose St. Bonaventure Hospital.
At the hospital, Dr. Marcus Andrews talks about autism, describes it to the board and asks if it sounds like he is describing a surgeon. Dr. Aaron Glassman says he ins't "Rain Man" his own affairs. Aaron asks if it is necessary to have a special meeting with the other members of the board, questioning his hiring of a doctor with autism. He is told to stop taking this so personal and Aaron is reminded that it is his hospital but the money it takes to run it comes from the foundation she controls, so they are ordered to play nice. Aaron is told to justify his decision for slipping him past the board. Aaron says he met Shaun when he was 14 and yes he does have autism but he also has savant syndrome, having genius skills in several areas. He sees things and analyzes things in ways none of them could comprehend; which are assets for any doctor, particularly a surgeon. Andrews plays it off that Aaron hired him because Shaun is like a son to him, but Jessica Preston silences him with a crude comment.
While Dr. Jared Kalu is rudely woken by Dr. Elle McLean who is in search of Dr. Claire Browne because Dr. Neil Melendez wants to operate on a patient but Claire hasn't gotten the consent forms signed; as soon as she walks out, Claire pops up from under a blanket and says she is just a bitch because she doesn't like him. Jared feels its silly that they're hiding their relationship but she admits they don't have a relationship, they have sex but if he wants people to know he is screwing her, she tells him to go for it. Meanwhile, back at the airport Shaun realizes the boy's veins are "popping" in his one arm, again the doctor doesn't believe him as he explains the left arm is in distress and asks if someone has a sharp knife and when no one has one he tells the other doctor to start CPR as he is going to stop breathing soon and walks away. Claire meets with the patient and asks him to sign the consent form, when he tells her he isn't scared she said he should be and begins to explain how they are going to cut his chest open, stop the heart, repair it and then restart it. She says wants a second opinion, but she continues to ramble about how he is preparing to say goodbye possible forever to his children. She says she is telling him all this because she can't deal with lies, so if he is honest, she can help him. He finally admits he is scared.
Shaun walks up the TSA and asks for a knife, when he scoffs at him Shaun says he needs a narrow tube, high proof alcohol, tape; the guard wishes him luck with that but says he is not going to give him a knife. Shaun says its a medical emergency, and asks for a knife he sees the top of the sharp objects bin; so when the guard refuses again, Shaun grabs it and runs but is tackled by two other guards as the first one calls him an idiot. They boy's mother rushes up to them telling them Shaun is trying to save her son's life. Dr. Melendez tells Claire that their patient's problem is in his heart, not his head; She says he not psychologically ready for the surgery but Melendez says he is physically ready and teller her to get the consent as he is prepping the OR right now. He says he is her superior, she says that doesn't mean she is wrong; he says maybe not but she needs to act like she is wrong. She asks him to let the patient wrap their head around what is happening. Melendez asks Jared id he can get the form signed and hands him the paperwork when he says yes. Jared tells Claire he will do it because Melendez is his boss and she is just the on he is screwing. Shaun returns to the little boy, as everyone watches in awe and wonder while he works. He envisions what he has to do and makes an incision while the parents watch in terror. The doctor is impressed that Shaun created a one-way valve and shays Shaun saved his life; people clap as the parents hug Shaun.
Aaron calls Shaun, who hasn't arrived yet. He tells Jessica that what she said was disrespectful and was a mistake, when she made that comment about Andrews' nephew. He reminds her that the only reason she was in St. Bonaventure was because her grandfather founded the hospital and she would fear the board of directors. She tells him to not make this debate personal because if he does, he will lose. In the ambulance, Shaun is happy they are on their way to St. Bonaventure. He observes the parents holding their son's hands and he has flashbacks of petting hiss pet rabbit while his father complains that he can't act like a normal human being, he says this is the third school he has been removed from and he doesn't blame them because as parents they can't handle him either. He grabs Shaun's little face and shouts demanding to know what Shaun did this time, when he gets no response he hits him and throws his rabbits to the wall as his brother looks on. Shaun gets distraught when he notices the boy's ECG changed and the EMS worker makes fun of him, telling the parents he is just concerned about eh 20 year old equipment while traveling in a vehicle going 40 miles an hour.
Dr. Melendez works with Jared, when Claire notices something white, wondering if its his lung. Melendez learns he was exposed to TB when he was younger and says its an abscess that is going to explode, shooting puss into the air, he begins to crash as they struggle to save him. The surgeon is informed of the 8 year old boy on his way in and tells Claire he doesn't need her, the patient will be fine and sends her to deal with the trauma patient coming in. As Claire takes in the new patient, Shaun doesn't have any ID but is insistent that it is his heart; she says he is fine and if he doesn't contain himself she will have him removed from the building and she rushes off to the OR, when Shaun attempts to run after her, security locks him out of the building. In the OR, some of the surgeons are impressed with how Shaun saved him, still having no idea who he is. Claire suggests having a ECG done on him, but the surgeon says based on his stats his answer is no, wondering if he missed anything and Claire says no. Shaun tries every door to get in the hospital but security stops him at every entrance, as he stands in the pouring rain. Shaun looks up and remembers hearing the doctor, Aaron says the rabbit is dead and a young Shaun says everything smells different when it rains. Aaron suggests they bury the rabbit and Shaun gets upset saying the rabbit cannot go to heaven because he needs him there; his brother promises nothing like this will happen again as they are not going back home, they have each other and that's all they need.
Back in the boardroom, Dr. Andrews says they cannot have a surgeon who doesn't communicate, he needs sympathy, and empathy, questioning if Dr. Murphy can do that when he cannot even be relied upon to show up for a job interview; he wants to know if there are any other young surgeons that don't have this issue, Aaron tells him no and they should hire him because he is qualified and because he is different, reminding him how long ago it was they wouldn't hire a black person nor a woman. He says if they hire Shaun they would give hope to those people with limitations, so they feel they have a shpt. Andrews and Aaron continue to be on opposite sides of the issue. During the surgery, Melendez feels something has changed and something is different. Claire admits there was this "weird guy" who kept insisting the boy needed an ECG; when his stats drop he orders the team to do an ECG and tells Claire to come with him to find her weird guy. Melendez asks Shaun why the ECG and he stutters; Claire asks him why but while he is explaining they got a call saying it came back normal and just wasted their time. Shaun begins to visualize everything again and Claire tells him to come with her.
Shaun and Claire are shown the ECG results and Shaun asks to see them over and over; Jared says it looks normal to him but Shaun tells him there is a deformity in the right atrium. He is told even if he is right it wouldn't manifest there; but Claire defends him saying it could happen by a glass going through his jugular and entering his bloodstream to the heart. The board voted on whether they should hire Shaun but before the vote if final, the receptionist bursts in and tells them to look on any media site and it shows Shaun saving the boy and apparently he is one of the hospital's doctors. They learn the boy is in OR 2 and Melendez isn't sure he will make it. Aaron and Jessica watch from the gallery and he tells her he isn't always going to be there to protect her because everyone loses eventually. They watch Shaun as he intently watches the surgery as he regresses back to when him and his brother live in an abandoned bus. His brother says their mother loves them but she knows its better for them to live in this way. Shaun asks his brother if they can get a television, he says "no" because they're poor living in an abandoned school bus, the then presents Shaun with a toy tool box as a present, Shaun immediately picks up the scalpel from the cloth in his pocket. In the OR, Dr. Melendez tells Dr. Browne she was right.
Aaron joins Shaun in the cafeteria, saying he saved that boy's life and Shaun says his name is Adam and he is hungry. Aaron tells him the board reconvenes in 45 minutes and asks Shaun to stay there until he gets back; Shaun agrees, thoroughly enjoying his food. Aaron talks to Melendez who says thankfully there is a cure for time and stupidity called experience and Shaun suffers from a bad deficit. He says he would like his help and when he doesn't think he will get his help; he wants to know the kid's story and why its so important to him, reminding him making things personal is a sure way to screw things up. Aaron walks away and Melendez asks Jessica if she's proud or disappointed, she doesn't want to pick either and they kiss. Claire sits with Shaun, feeling he is curious about the place and the people but Shaun says Aaron gave him a map of the hospital and found the rest of town online. He wants to know why she was rude to him when they first met, then nice to him the second time and now trying to be his friend. He wants to know which time she was pretending; they are interrupted but Aaron who informs him that the board room is ready.
Dr. Andrews returns furious because the decision was already made and Aaron says if he probes to be nothing than excellent he will be immediately released and he will resign as president of the hospital. Andrews continues to complain and Aaron says he would love to make him happy and hire someone who doesn't make a mistake; he asks if Aaron can accept that he will make mistakes none of the rest of them will make because it won't be him who pays the price. Allegra Aoki asks to hear from Shaun before they decide his fate. When asked about why he wants to become a surgeon, Shaun goes back to his youth and talking to his brother and why they need friends while they broke into a garage where they are climbing over and old train, his brother loses his footing and falls far below onto the concrete floor; Shaun looks down in utter disbelief. The board is getting irritated that Shaun hasn't said anything yet, but then he talks about the day the rain smelled like ice cream, his bunny went to heaven in front of his eyes, and the day the copper pipes in an old building smelled like burnt food, his brother went to heaven in front of his eyes. He couldn't save them and it was sad that neither of them had the chance to become adults and experienced life events like having children and loving them and he wants to make that possible for other people. With tears in his eyes he says he would like to make a lot of money do he could have a television.
Everyone shares glances and Dr. Shaun Murphy is welcomed to San Jose St. Bonaventure Hospital and they are very proud of him they shake hands and everyone claps. Aaron tells Shaun that Melendez' team is going into surgery if he is interested; Shaun rushes out of the board room and gets into scrubs with a smile on his face he enters the OR as a nurse helps him with his mask and gloves. Melendez calls in Shaun "Murphy" who gets to see the piece of glass that was killing Adam. He look at the scalpel and remembers his brother telling him to never forget that he's the smart one and can do anything and he is proud of him. Melendez says he is a nice, smart kid but its literally true that this is his first, but doesn't belong in St. Bonaventure, as long as he's on Melendez' team all he's ever doing is suction. Shaun takes it in stride saying he saw many surgeons in medical school and he is much better than them, and could learn a lot from him. He says he is very arrogant, and asks if he thinks that it helps him be a better surgeon or hurts him as a person; and wonders if it is worth it.
- While making the one-way valve, Dr. Shaun Murphy says water instead of alcohol when referring to the liquid in the whiskey bottle.
- This marks the only appearance of Irene Keng as a series regular.
- When Hill Harper was cast, the press release stated that his character, now named Dr. Marcus Andrews was then Dr. Horace Andrews who was reportedly the head of surgery at hospital.
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