- The Good Doctor is quickly becoming one of my favorite medical dramas, and you continually request it. So, I figured let's just go ahead and watch the second
episode of the first season. (high pitched noise) (subtle music) (car engine revs) (police sirens blare) - That does not look like a
comfortable sleeping position. I wish I was this happy when I
woke up early in the morning. (triumphal string music) What is he measuring? - Where to? - San Jose Saint Bonaventure Hospital. I'm a surgical resident,
today's my first full day. - I'm that floor. (laughs) - I like this show, I don't
know, it gets me happy, it just puts me in a good mood. - This is Mitchell Brand,
I reviewed his chart. He's 55 years old, from Chicago, divorced with two children, you did a radical
prostatectomy on him yesterday. - This is actually very accurate. In a post-op unit, you will get visited by
the attending physician, the head physician, who's
usually the main surgeon. They will have their residents
following them along. Here, in this case, the patient
has a radical prostatectomy, which is a removal of the
entire prostate gland. I have a whole video on the prostate and how things can go wrong with it, so if you wanna check
that out on my channel. The thing about the radical prostatectomy, why it's a difficult surgery, is because there's a lot of nerves in the region of the prostate, amongst other structures that are very anatomically important, including your urinary
system, your semen duct. Going in to perform that surgery, you wanna make sure that
anatomically you're very careful not to damage the surrounding structures, but as we know, things can
go wrong and things happen. - You're late. - Five minutes, we've all been there. - Your first day, no less. It is your responsibility to be here. If you were not, you have
failed in your responsibility, which makes it your fault. - Okay, how can it be my fault? I did nothing wrong, the bus. - This is gonna work out great, the board clearly made the
right choice in hiring you. - Thank you. (scoffs) - I think the attending is being mean, but on the other hand, I think he's right. As a doctor, it's very
important to be on time. There should be no
excuses, because ideally, you should be there early. Being a good resident, it's
ideal to get places early, so that you can review
the charts beforehand, get all of the information,
so that when you are rounding with your attending,
you know all the information. - [Female Doctor] It's
definitely a budding the aorta, and the left kidney. Renal angiomyolipoma? - [Male Doctor] You see
an extensive blood supply? - [Female Doctor] No. - God, I wish I could do this. - She has a sarcoma, a malignant tumor. (intense music) - Malignant? That means it's killing me, right? - Yes! - I get that it may have
features of a malignant sarcoma, but to know instantly,
without a proper biopsy, it could be several things. - So that's it? You just accept my answer at face value? Why? - You're very arrogant. (laughs) Arrogant people don't
think they need to lie. - How long will this be? - Seven minutes. Without any complications, it takes seven minutes to do a discharge examination properly. - Dr. Dunsmear has
already cleared him to go, and we need the bed. - Okay, protocol requires
that the surgical department also clears him. - Why is a patient that
has an ear infection admitted into the hospital? And question number two,
why is a patient that has an ear infection being treated by a member of the surgical team? (laughs) - What are you doing down here? - I'm waiting for her to fart. (whimsical music) Flatulence, but I'm using the word fart in front of the patient to be more casual. (laughs) You're the president of the hospital, so I'll say flatulence to you. - Well, I appreciate that. (laughs) Why are you doing that? - She had her deviated septum repaired, before we can release
her, we have to make sure she isn't suffering from
postoperative ileus. - Postoperative ileus is when
the muscles of the intestines don't move correctly, and it basically, it's
like a frozen intestine, meaning that the gut
is not moving the food, and its remnants, and
the stool further down, and allowing it to pass. This can happen sometimes, one of the first things you
wait is for the patient to pass gas, and then in some cases, if you had something more complicated, like an abdominal surgery, you wait for them to have a
stool before sending them home. - I think that was it. (machines beeping) - You don't have to smell it. - I don't think so. (bouncy piano music) I'll wait a little longer. This is important. - No it's not. - The procedure is called a laparotomy. Your heart sounds good. - I don't know what she was
listening to her heart for, that was definitely just
an add-on for the show, but when we listen to the heart, we listen in multiple areas. When you're listening to one area, you're listening to one part of the heart, then you move the stethoscope around, and you're getting the
other part of the heart, which gives you more information. Then, you move it to the
other side of the chest, where you're listening
to separate arteries, so you can hear what the aorta's doing, you can hear what the
pulmonary valve is doing. - My husband died in a car
accident a couple of years ago. Mark is our only child. I can't die right before his wedding. I can't. - You're not gonna die. - Making promises like
that, I've said it before, it's not wise. We have only so much
control over certain things, especially if they don't
know the grade of this tumor, they don't know the spread of the tumor. - My little girl has a tummy ache because mommy and daddy
won't stop fighting. This isn't a medical
issue, send them home. - It could be intestinal malrotation, which could quickly become fatal. - And every patient in this
hospital could have malaria. That doesn't mean we're
gonna go around testing for every condition we
think they could have. - Ordering random tests
just to make sure that a patient doesn't have that condition is certainly not smart, and I agree with the
senior attending here. What you learn from experience is, when you go on a hunt and start
ordering a bunch of tests, certain tests will come up positive mostly because a lot of those tests have the high possibility of
coming back as false positive. Which then encourages
you to order more tests, which has several effects. The patient gets anxiety. Second, some tests carry risks. For example, if you start ordering CAT
scans on every patient, you're exposing the patient
to unnecessary radiation. On top of that, you may find on a CAT
scan some kind of nodule, some kind of node, which will need further testing, sometimes a biopsy, and
biopsies carry risk. You see where I'm going with this? - From now on, you don't run any tests
you don't have to run. - How do I know if a test is
needed until after I run it? - She'll tell you. - Nurses actually have a lot of experience in knowing what test to run,
which tests are excessive, which tests are very important. In fact, when residents in my
hospital ran rapid responses, the nurses from the ICU
were so experienced, they already knew what
medications to pull up at what dosages even more so than some of the young residents. (heart monitor beeps) - I'm Dr. Claire Brown,
I'm first assist today, and I'll be leading the time out. Patient's name? - Stephanie Willis. - Scheduled surgery? - Excision of indeterminate
retroperitoneale tumor. - Oh, now it's indeterminate. - We don't anticipate any
complications with the surgery. - Thank you, Dr. Brown. - That time out actually happens, it's basically, we confirm
all of the information. Generally, we do it while
the patient's awake, so they can confirm all
of this information, and then we do it one
more time before we start, including, this may surprise you, discussing the site of the operation. Because it has happened, unfortunately, horribly, that we've operated on the
wrong side of a patient's body. There's been a lot of things
procedures put in place that prevent us from making
that horrible mistake, with the time out being one
of the most important ones. - It might be infected. - It's not. - There is some discoloration. - He's 82 years old,
everything is discolored. (laughs) - Blood pressure 120 over 70, heart rate 60, she's holding steady. - I have opened the fascia. - You know what you guys should do? You should screenshot this little scene where she says, "I opened the fascia," and send it to Gabbie Hannah, because she tweeted me not so long ago saying that she can't believe that after we operate on organs,
and we put them back, are they just like floating
around in our bodies? And I told her that everything
is interconnected with fascia, and she had no idea
what fascia looked like, so send her this picture on her twitter, she's gonna love it. - I thought you'd wanna see it. - It looks like puke. - No no no. It's not the regular color. - Puke has a regular color? - Yeah. - It is a bit of an unusual color. We could order some- I'm sending you home! - Are you sure? (laughs) - This is so good! Part of medicine, and
a big part of medicine, and something that I learned
and teach my students is that a big part of
what we do is reassure, because people worry, and
there's a lot of anxiety that comes with people's bodies. Fluids start coming out of random places, fluids change color, we bleed, body aches, our heads hurt, our vision changes, a cough occurs, upset stomach. As soon as you go on the
internet and look at any one of these websites, you could fall down into a wormhole thinking that your headache
is caused by a tumor like this. (snaps) - Claire, tell me you got something. - I've got nothing. This tumor is way bigger
than it looked on the scans. - Hence, why we don't
diagnose people just by looking at scans. - (mumbles) to see her aorta. - That's a problem. (machine beeps) - The tumor is encasing her aorta, meaning that it's fully
surrounding it and engulfing the aorta, which serves to
be the main blood supply to the bottom of the body. - Dr. Melinda sent you a biopsy, when will the results be ready? - When I get to it. - It's very important. - They're all very important. - Let me see the other test orders. I'll tell you which
one's the most important, and you can do them in that order. I'll be honest and fair. (laughs) - In complex surgeries like this, we not only have the
pathology lab on standby, but you could also even have
a pathologist in the room with a microscope, ready to
make the call immediately, especially when a patient
is under sedation. You don't want to extend the
patient's time under sedation just because the pathologist
is busy with other cases. - There is one possibility. If we remove the left
kidney, we might be able to get a good enough view to
successfully remove the mass. - Take out a healthy kidney
to get a better view. That's insane. - The tricky part with this is that if they're not successful, she could die. If they're somewhat successful, she could be incredibly disabled and have horrible
disability from the surgery, and her last six weeks to
live with this horrible tumor are gonna be awful, as opposed to if they
just suture her up now, and she could just enjoy
her last few weeks of life. Even if the surgery's a major success, does that mean they were able
to get the entire tumor out, and now she's completely cured? It could be spread all
across the peritoneum, which is the inside of
the abdominal cavity. To me, this sounds too risky and too much like a cowboy move, but, then again, I'm not a surgeon, nor a surgical oncologist. That's why I would ask
someone who's more of a sub-specialist, which I don't
think any of these people are. - Am I healthy? - Probably. - You're a doctor,
you're supposed to know. - No we're not, nobody
knows anything for sure. Anybody could drop dead of
a heart attack any time. - Who is this guy? Am I gonna have a heart attack? - First of all, don't do this
in an open space like this, because if he starts yelling,
it's not gonna look good for anybody. I have these conversations all the time, patients come in and demand
to know that they're healthy, there's nothing wrong with them. You can't promise that, but what I can do is answer
specific questions that they have about their health. Doctor, my ear hurts,
why do you think that is? And I can say, well, I looked in your ear, and I found that you
have an ear infection. Let's treat it, and see
what the outcome is. You give them reassurance
that it's likely to pass, but you tell them if
the symptoms continue, if the symptoms are to worsen, if new symptoms appear, please return so we can
do a further evaluation. That's it. - The small bowel is
twisted around the superior mesenteric artery. Martine needs surgery, immediately. - We need to confirm with Dr. Melendez. - No, Dr. Melendez is in surgery, part of Martine's bowel is
dying, and killing her with it. - No, you can not make
these calls on your own. Dr. Melendez was very clear. - He was very clear. It's past midnight, which
means it's tomorrow, which means you're no longer my boss. (heart monitor beeps) - Is this the OR scheduler? Yes, this is Dr. Murphy. Prepare an OR for surgery. - As feelgood as this is, an
intern cannot just book an OR, can't schedule their own surgery, no one would ever allow this to happen. Actually, this could be
grounds for expulsion from a surgical program. - Why do all surgeons all
look so frail in these shows? Him, McDreamy. Man, I get you're operating
all the time, but come on. A little deadlift and bench
press never hurt nobody. - Thank you. (upbeat music) I like the minimalist
look for an apartment. Oh, he got a mattress,
look at that upgrade. When I say this show has good writing, I'm not talking about the actual speech and the words that the characters say, that's good, but when I say
they have great writing, it means they think
ahead for each situation, to make it not only
lighthearted, comical, fun, and interesting, but they show
a way to highlight a person who has autism in such a unique light that it's very positive for people who are born or develop this condition. This is probably one of my
favorite shows right now as far as medical dramas go. I'm certainly a fan. The reason I watched
episode two is because I want to learn more
about the first season before jumping into the second season. Now, if there are some good
episodes within the first season you want me to watch, please
let me know down below in the comments. Hit that subscribe button
and the notification bell so you get all my videos, and check out my other content if you enjoyed my medical drama reviews. You'll love it, or your money back. As always, stay happy and healthy. (upbeat music)
