Mutations

"Mutations"

Episode Information

Season 3

Episode 12

Overall 48

Airdate:

January 20, 2020^[1]

Viewers:

5.44^[2] million

Writer:

Liz Friedman & Tracy Taylor

Director:

Nestor Carbonell

Episode Chronology

Preceded by:	Followed by:
"Fractured"	"Sex and Death"

“	It's okay not to love them. They didn't make us who we are.	„
	― Shaun to Claire on their deceased parents.

"Mutations^[1] is the twelfth episode of Season 3 of The Good Doctor. It is the forty-eighth episode overall, and originally aired on January 20, 2020.

Synopsis[]

Dr. Audrey Lim, Dr. Shaun Murphy and Dr. Morgan Reznick treat a 25-year-old runner suffering from severe swelling; but when things take a turn for the worse, Dr. Shaun Murphy enlists the help of Dr. Carly Lever. Meanwhile, Dr. Alex Park, Dr. Claire Browne and Dr. Neil Melendez treat two 16-year-old cancer patients who are dating; and Dr. Shaun Murphy and Dr. Carly Lever work toward intimacy^[3]

Plot[]

Following Carly's statement of how she felt about Shaun and Lea living together, Shaun is forced into having Lea leave their apartment as Lea tries to reassure Shaun about Carly. Meanwhile, Claire and Dr. Park are treating Ryan Cooper, a boy who has a tumor on his kidney when his also cancerous girlfriend Angie Valens (with whom Ryan has been doing their chemo together) comes in. She jokes that she lost a tumor and gained a boyfriend, while Morgan, Shaun and Dr. Lim speak to their patient James McDougall who has extremely swollen legs. His usual medication doesn't work as Morgan questions his health. He insists that only running is what saves it, his marriage and life. Lim starts him on broad spectrum antibiotics.

Dr. Glassman is visited by Morgan who insists his therapy for her is working. She admits being queasy and suggests getting a medication that doesn't irritate her stomach. He is persistent that he enjoys working in the clinic and sends her off to work. Claire meets with Neil, as she gently wants to bring up Ryan's determination to bring Angie to prom should not be a factor there. Neil learns about the two lovebirds and calls them "idiots". They review the scans and find that Ryan's tumor is gone, saying that the chemo worked better than they expected and give him discharge forms. He hugs Angie closely, but when they spin around Angie falls to the ground having a seizure. Shaun deals with James, asking them to page Morgan who is busy in the washroom vomiting. Imaging has confirmed the recurrence of Angie's brain tumor, stage 3. The best approach is surgery followed by approximately eight months of chemo and radiation. Her mother Elise encourages her but she finds out they need a few days to figure out the best approach. Angie says she needs to go to prom with Ryan like a normal kid, but Park tells her that her immune system is down and is at risk for seizures. Elise suggests they can get all dressed up after she is recovered and go to the Grand View.

Park tells his colleagues how much prom sucked, getting so drunk and not even making it to the dance. Neil of course was the Prom King and his date was Queen. Claire said she had the dress, date and Breeze who got arrested as Claire spent the night bailing her out. Neil tells Park to go book an OR with the best OR nurses while he and Claire go to Glassman's office. Dr. Andrews is doing surgery with Lim but Shaun does not feel this is cancer at all. Meanwhile, Glassman meets with Neil and Claire giving them options for Angie's surgery. Neil wants Glassman to scrub in as it would be a huge value to have him there; he promises to consider it. Shaun barges into the lab, giving Carly some work to do and informs her that Lea moved out this morning. He really wants to talk things through; she says they are okay but tonight she has plans with a friend that just got fired but Carly would love to see Shaun tomorrow night. She kisses him before he leaves. Morgan gets a jump on things with Andrews, suggesting writing a paper with him, over breakfast. Elise puts some space between Ryan and Angie, suggesting that his immune system is weak and it would be easy for him to pick up a bug and pass it to Angie, something Claire overhears. Claire suggests that Ryan wears a mask but Elisa insists to change the status on Angie's chart to "no visitors".

Carly brings up James' chart and it turns out that he has a genetic mutation that will cause him to drown in the inside. Carly presents the condition to the team and what type or treatment they could give him, but there are too many side effects. She offers good luck but Lim wants her to stay and help, which she agrees. Park and Claire are doing Angie's scans when Angie is depressed that Ryan bailed on her since she got sick. Claire is about to tell her the truth, but Park stops her; he lies saying Ryan was probably busy catching up on school work. She says they made a pact that cancer wouldn't break them but it did. Claire leaves to confront Elise, saying Angie's depressed and could have a negative effect on her surgical outcome, but Elise brushes off Claire's concerned. The team works hard on various treatments for James, trying to find one with the least amount of side effects. Shaun feels it is exciting that they are working together but Carly admits she prefers working with slides and paperwork. He promises her she will be fine. James' wife Majorie wants to know how he is reacting to treatment and Morgan sees improvement, but his potassium is a little low and she asks Carly to give it to him before she runs off to the bathroom again, confusing Carly.

Park, Neil and Claire are reviewing Angie's case; Claire is worried about what she is facing after the surgery, as what she wants is so simple. Neil wants to know if there is a way of doing this without antagonizing Elise and suggests Claire does it. Shaun and Carly are thoroughly enjoying alone time at his apartment; finally reaching spots he has never been before and he is very okay with it. She suddenly rolls off him, as he asks if he did something wrong but she tells him it was her. She thought they were okay and isn't mad, but then his pager goes off and it is Morgan; James has an upper GI bleed. Back at the hospital, they are trying to locate the source of the bleed as the team reassembles. Carly comes in, suggesting they do a transgenetic zebrafish mutation for James; if they can make all these embryos they could have answers for the medication by tomorrow afternoon. Lim tells Carly and Shaun to get working on it together in the lab. There, Shaun wants to know how to make things okay between them but Carly doesn't have an answer, which frustrates him and confuses her. Morgan is seen drinking a drink in the hospital which Glassman knows is due to her vomiting. He feels they should try another medication, reminding her she could throw up into her next surgery. Her solution is not eating any solid food, while Glassman is concerned.

In the lab, they have about 40 fish tanks as Shaun acknowledges Claire is going to be able to throw a party. She asks how Shaun is doing since Ethan passed away but Shaun says he doesn't think of Ethan very much. Claire shares how often she thinks of Breeze after her recent death. He reminds her it is okay not to love her as Breeze and Ethan didn't make them who they are today. Claire comes to see Angie, after finding out that Elise has gone home she says there is one more thing they need to do. Angie is fed up with tests and wants to be depressed in bed but a nurse comes in with two prom dresses; making her thoroughly smile when she learns her date will be there soon. All the medications are in all the fish tanks, as Shaun says it is hard to be patient. Carly reminds him that how the fish's bodies respond to the medications, which was how she felt the last night with him. She thought she was ready to be together but her body has a different response. She admits their mutation was him going to Wyoming with Lea but does think they can find their right medication; giving him hope. Everyone stand in the halls as Angie emerges from her room, Ryan is being helped by Neil putting on his corsage, telling her that she looks amazing. She chose the pink dress, but before he can come to her Neil gives him a mask. The teen lovebirds walk into the residents' lounge, set up as their prom with big beautiful balloons and sparkling lights, dancing to Ed Sheeran. James stops talking and they have no time; there is too much fluid around his heart, they are running out of time and need a medication right now, so the procedure needs to be done right there.

Claire runs to Elise, telling her that it is prom and Ryan has been wearing a mask all night. Elisa nods, giving her Angie's teddy bear and asking her not to let her stay up too late. Shaun is struggling that James is not doing well as they continue to cross off fish with tumors. Angie is brought into surgery the next morning, hugging her mom before she heads into the OR. Angie asks what if she wakes up and doesn't remember Ryan at all. Claire tells her that she will have the chance to fall in love with him all over again. Lim comes in and makes Shaun and Carly choose one, Shaun doesn't say anything so Carly chooses Trametinib; which doesn't mean it is safe one nor right one but is their safest choice. They give James the medication and hope for the best as Carly watches anxiously from the hallway. Shaun looks back but she is gone. Angie's surgery is immobile, Neil feels if he keeps going he is going to kill her, he asks Glassman if there's another option. He stares at the monitor for a few seconds and nods his head. Neil informs the nurses to tell the ICU that Angie is coming sooner than they planned.

Elise is told there is nothing left as her cancer is unlikely to respond to anything. She feels Angie would want to try but she begins seizing. In the meantime, Shaun finds Carly crying in the lab. She admits she found James on Facebook and learns all about their life together. He isn't just a slide but a person, and he might die; this is why she likes to stay in the lab. Shaun feels that it is a dumb thing to say because if she stayed in the lab James would probably be dead already. Her plan gave him a chance; a beautiful, perfect idea from a beautiful almost perfect person. Then he tells her that her ear lobes are loped sided. Carly leans into Shaun to hug her.

Neil and Claire apologize for not being able to save Angie, just as Ryan and his father walk to them Elise breaks down. Ryan rushes to hug her as she sobs over the death of her daughter. Claire excuses herself, as does Neil. Morgan tells Carly and Shaun it was a nice call on the zebrafish and both can see that James is alert and talking to Majorie and Lim. Together they take hands and walk off smiling. Andrews wants to meet weekly with Morgan about their paper, lunch every Tuesday in the cafeteria. Morgan returns to see Glassman, admitting he is right about another medication as she needs solid food.

Neil chases after Claire, who says she is just tired. He reminds her of the loving thing that she did. Claire is angry, shouting she can't be angry at someone for dying. He reminds her that isn't true and she lets out her frustrations on how she was sick and trying to get better. Neil knows this is about Breeze. Claire hates feeling this way and doesn't know how to stop. Neil feels therapy and time will help and there is one other thing that has helped him. Shaun and Carly are home and she agrees they fixed their mutation. Shaun smiles widely as he lays beside a sleeping Carly.