Season 5 Recap: 5×06 One Heart

Oh man, phew! After what I felt was a really weak previous episode, the show got its mojo back with One Heart. Because this one hit all the right beats and pushed all the right buttons and gave me all the feels. A round of hugs for everyone, including Shaun, pls.

The Technicalities

Written by April Fitzsimmons & David Renaud
Directed by Sarah Wayne Callies
Original airdate Nov 15, 2021

Patient Stories

Patient #1 is Brandon Thomas, who is wheeled into the ER as “unstable level 1 trauma”, having fallen 30 feet from scaffolding and has multiple fractures, internal bleeding and massive head trauma. (Apparently there was additional or different dialogue here initially about a concert that they ADR’ed but that was still showing up in the subtitles.)

Shaun and Asher treat him, but Alex overhears that the patient is 0 negative. Brandon crashes and they need to intubate him in the ER. He has a lot of internal injuries and they need to do exploratory surgery to know the full extent of it.

Brandon’s father Ed, a military man, asks if he can speak Brandon, but Brandon has been unconscious since his fall. There seem to be some unresolved issues, which Asher also remarks. During surgery, Brandon’s vena cava ruptures. His intracranial pressure has also risen, and the EEG indicates that Brandon is now in a coma.

Asher gives the harsh news to Ed, telling him that, given the extent of Brandon’s injuries, he will likely progress from a coma to brain death. Ed confides in Asher that he hasn’t talked to Brandon in two years and they had some “stuff” to work through, namely that Brandon dropped out of Annapolis (the US Naval Academy) to become a drummer.

Side Note: This last scene took place in the hospital chapel. Let’s rewind to episode 5×03, where one of the ER nurses remarked that they were planning to shrink the chapel to make room for VIP birthing suites. And indeed, the chapel room is now different and much smaller than what we’ve been before. Heh. Salen’s handiwork at play.

Shaun and Asher continue to research how to relieve the pressure on Brandon’s brain while Alex subtly pressures Shaun into talking to the father about considering organ donation. Alex had a patient in mind he knew who needed a heart from an 0 neg donor — a young boy named Ollie, whose mother he called and had her come to the hospital because of the possible availability of Brandon’s heart.

Now that Shaun and Asher are still trying to preserve Brandon’s life, time is running out for Ollie, and Park can see it slipping away. “Shaun, this is a tragedy, no matter how it ends.” Yeah, I’ll say. But Alex was the one who created the mess in the first place.

Shaun has an inspired moment through a flashback to this university days and has a theory that perhaps there might be small, undetected dissection in Brandon’s internal carotid arteries. He suggests placing a stent to increase blood flow to the brain.

When they operate on Brandon, it indeed turns out that there’s a tiny tear in the carotid artery that they repair. There’s also a clot which would interfere with the stent. Breaking up the clot with heparin brings new risks of major bleeds in his organs, so where do you draw the line — likely brain death or a risky blood thinning treatment?

They discuss the futility of the situation, but Shaun remarks that the heparin treatment is not futile. It has a 1% chance of helping Brandon. Lim makes the call and asks to get a heparin drip started.

It looks like the blood thinners aren’t doing what they’re supposed to do, Brandon is going into multi-organ failure, which also means he’s coming closer to the point of no return where none of his organs will be viable for donation anymore. And Alex is livid that Shaun is still holding on to the slim hope of saving Brandon’s life.

Trying to figure out what the next best option is, Shaun suggests using an embroidery technique to save Brandon’s heart. When they tell Ed this, his attention perks up. Can that save his son’s life? No, Shaun says, it’s too late for that now. All they can do now is save his heart and keep it viable for organ donation.

Ed is distraught, he really needs to talk to his son and reconcile their differences. Asher suggests that he does talk to his son anyway, to say what needs to be said, even if Brandon can’t respond.

Ed agrees to organ donation, and the transplant team gets to work. It’s Shaun who hands Brandon’s heart over to Park so it can go to Ollie. Shaun and Asher visit Ed at home later to give him a list of the 63 people who received Brandon’s organs. Ed proudly displays the list on his mantle with a photo of Brandon.

---

Patient #2 is Ollie, a young boy with 0 negative blood type with heart disease who desperately needs a donor heart. Park thinks that Brandon’s heart will be a match for Ollie, so he asks Ollie’s mother Val to fly him out to San Diego so he can have more tests and see if he would be a match.

Ollie’s condition deteriorates while he’s in the hospital, and it’s getting more important that Shaun talks to Brandon’s father about organ donation. After Shaun and Lim decide to put Brandon on a heparin drip, it becomes clearer that the heart donation won’t work out, and Park tells Val that it’s not gonna happen. Ollie is unconscious and on a ventilator by this point, there was mention about ECMO (to keep his blood oxygenated) before.

This one hurts, because Park had pulled Val and Ollie away from a once in a lifetime trip, the one perfect day that Ollie might have had, seeing how his days are numbered and he’s spent his whole life in and out of hospitals. Of course Park feels guilty and is upset, so he takes it out on Shaun by yelling at him that he shouldn’t have done Brandon’s surgery and that he basically just killed Ollie.

When Shaun figures out a way to save Brandon’s heart to make it viable for donation, they successfully perform the transplantation. Park is there when Ollie wakes up and lets him listen to this new heart with a stethoscope. It’s a happy ending for them.

---

Patient #3 is Nira Joseph, who is the health insurance manager for a media company. She’s in the same Barre Cardio class as Morgan, and Morgan wants to fish for getting the media company to sign a health provider contract with Ethicure’s clinic.

Nira comes into the clinic and Morgan suggests vision and hearing exams, and then a full occupational health screen. During the vision test, Morgan finds out that Nira has deficits in her peripheral visual fields, and that her test told Morgan that Nira is going blind.

OMG, I’m screaming at the television right now. Sorry, but I’m calling medical bullshit. That test that Morgan was running looks like a static perimetry test. This does nothing more than make little lights appear in a bowl-shaped instrument called a perimeter. You should do this for each eye separately and cover the other one up, which they didn’t do. The patient also normally presses a button when they can see the light, and the machine records the ones they don’t see.

But yeah, all this test does is tell you how well a person can see things in their peripheral vision. For Morgan to immediately conclude that Nira is going blind is like finding a lump in a woman’s breast in a breast palpation test and then immediately concluding the woman will die of cancer without further tests of what the lump might be. Talk about jumping to conclusions!

They do apparently run further tests, because Morgan consults Alex on the case. It’s an optic nerve tumour. An endoscopic endonasal approach to removing the growth could preserve up to 60% of Nira’s vision, but Morgan wants to do better than that. There’s a novel and experimental proton beam radiotherapy that could clear the tumour and potentially preserve full vision, but it’s expensive and needs special equipment that St. Bonaventure doesn’t have.

Salen isn’t in favour of spending all that money on one patient. And even if it won them the media company’s healthcare contract, the cost of the treatment would be several hundred thousand dollars more than the value of the contract. Salen doesn’t explicitly say no, though. Morgan thinks Nira deserves knowing about all of her options, and Salen leaves it up to Morgan to decide how much to tell Nira.

And what do you think Morgan did? Yes, he made the less ethical and more career focused decision and didn’t tell Nira about the experimental radiotherapy. Also turns out Nira’s surgery was more complicated than expected they could only preserve 50% of her vision. (How do they know that when Morgan only just took off her post-surgery eye patches? God, this is such BS.)

It’s pretty tragic, because Nira is super grateful that Morgan preserved part of her vision and potentially saved her life. Morgan sure feels guilty, but the guilt is quickly washed away by the personal success that comes with it. Salen offers Morgan Dr. Glassman’s office, and I think we’re supposed to assume that with it comes a lead role for the clinic, probably something like interim head or so.

Shaun & Lea

We open on a game of baseball, with Glassman actively playing with a bunch of newly befriended buddies out in Paradise, Montana. (This is baseball and not softball, right? I admittedly know nothing about either, but apparently softball only has 7 innings, and the sign said Inning 9.) He’s getting really into it, but suddenly he’s being cheered on by Lea. Wait a minute. Lea? What is she doing in Montana?

Glassman gets distracted enough to miss catching the ball and the Home team scores once more. Lea confronts Glassman about not answering Shaun’s calls, about missing the tux fitting, about being MIA, about leaving Shaun hanging.

Glassman won’t have any of it. “You came all the way out here to Montana because he’s struggling? Wasn’t he struggling over the billboard thing, right? Turns out he didn’t need me at all, did he?” Concerning Shaun, Glassman has his blinders on, and Lea is just as frustrated as we are. “So you think he’s never going to need you? What are you gonna do? Run away? Stay here?”

Glassman is still on his denial trip. “Shaun’s fine, you are fine, I’m fine, and I’ll call him tonight.” (Which he didn’t.) He sends Lea away to go home.

Back at St. Bonaventure, Shaun tells Park that Lea is away on a business trip (that should be in quotation marks, right?) until Sunday, and Shaun is looking forward to reviewing all the latest case reports. Alex suggests instead they spend some de-facto bachelor quality time together — movies, pizza and looking for trouble.

Shaun, of course, doesn’t like loud movies or trouble. Or olives, mushrooms or anchovies. (With you on the olives and anchovies, Shaun.) Shaun’s up for a quiet movie and pizza, though. “That sounds like a lot of fun.” I’m rejoicing over here, because Shaun and Alex buddy bonding is my jam. (Another item ticked off my season 5 wishlist, thank you very much.)

Just then they are interrupted by a new trauma patient being wheeled into the OR, who fell 30 feet from scaffolding and has severe injuries. Shaun takes care of the patient, and he’ll do anything he can to save this guy’s life, even though things look pretty grim.

It becomes more complicated when Alex realises that this patient may soon become an organ donor candidate, and he has the perfect recipient in mind, because 0 neg donors are pretty rare, and this seems like a great match.

Back in Montana, Lea stalks Glassman to try and bring him around, lure him back to San Jose. She tells him about Shaun’s ongoing struggles with the patient satisfaction scores. Glassman’s first worry is whether Shaun’s job is at risk, which Lea has to negate. She then admits that she omitted some of the negative reviews to bring Shaun’s scores up. (Okay, so it was more than one. Heh.) That captures Glassy’s attention!

Glassman rightly berates Lea about it. “So instead of telling him, you decided to come see me? When did you get so unethical? And condescending. You’re infantilizing him.” Lea’s afraid that Salen and the scores could really hurt Shaun, but Glassman thinks that Lea is hurting him even more now with what she’s doing. (I would tend to agree with Glassman here.)

Glassman bluntly tells her that this is not about Shaun, it’s about Lea and the mess she made. And she better go home and clean it up with Shaun herself. And she absolutely needs to do that, but Glassman also needs to pull his head out of his arse.

Alex and Shaun go head-to-head on the organ donation case. It’s becoming increasingly clear that, barring a small miracle, Shaun’s patient will slide into brain death soon, and the potential recipient of the heart that Alex knows personally slips further into heart failure.

Alex is really skirting the edges of ethical here, he’s subtly pressuring Shaun into declaring defeat and suggesting organ donation as an option. Shaun understandably gets upset, he threatens to report Alex to UNOS for breaking organ donation communication rules.

Side Note #1: Ever since Freddie Highmore mentioned something in an interview about Shaun making actual eye contact always being special, I can’t help but pay more attention to this, and there’s something subtle going on with this scene as well. Shaun is staring at the TV screen the whole time while Alex talks to him, until Alex says, “I’m talking to you as a friend.” Shaun then turns towards Alex, but he never makes real eye contact except for maybe split second fleeting moments. I love when they play with that to underline Shaun’s state of mind.

Side Note #2: Autism consultant Melissa Reiner talked about a line they cut from the script that was likely in this scene where Park accused Shaun and blamed his autism for his obsessive behaviour. She advised the writers that she felt Park was too intelligent to reference the broad spectrum umbrella of ASD as a cause for blame and would be able not to confuse the diagnosis of autism with Shaun’s perseverant behavioural patterns.

Shaun and Asher are still trying to figure out how to help their patient, when Asher closes a neurophysiology book with synapses on the cover that sparks something in Shaun and it takes him back to a memory from 2012 when he was still in med school. (Interestingly, nothing comes up in a Google search for this book title, so it may be something they made up for the show. Is that a copyright thing? Can’t they use real textbooks? Boggles the mind.)

Shaun is in his med school dorm room, pacing with his neurophysiology test results in hand. Dr. Glassman is there to visit, having just arrived on a cramped plane and he’s starving and wants to take Shaun out to get pancakes. However, Shaun’s mind is fixated on something entirely different. His professor took two percentage points off his score for a question that he supposedly answered wrong, when Shaun is convinced his answer is right.

Glassman takes a look, and he agrees that the question is worded ambiguously, but tells Shaun not to worry about it, and can they go eat now? Nope. Shaun needs to fix his test. And he’s going to tell Prof. Fontaine that his question was worded incorrectly. We can vividly imagine how that conversation is going to go, right?

Question #5 was about branching internal carotid arteries and blood flow to the supratentorial brain, and present day Shaun has a carotid artery eureka moment about their trauma patient to potentially save his life.

Alex watches the ensuing surgery from the gallery, and approaches Shaun in the hallway afterwards. Shaun’s patient isn’t doing well, and Alex’s patient urgently needs the donor heart. The donor heart is now becoming unviable because of blood clots, and Alex is pissed. “Your Hail Mary surgery didn’t save your patient, it just killed mine!”

It’s heartbreaking to see that Shaun really struggles with this, because of course he doesn’t like to see a child die in the wake of a potentially wrong decision he may have made. He needs someone to talk to, to weigh options and help him see things more clearly. In the absence of both Lea and Aaron, he goes to the one place he thinks he may still, in some small way, connect with Dr. Glassman — his empty office. I wanna hug Shaun so bad. #HugsForShaun

Staring at Glassman’s empty chair, he goes back to his med school day memories. Somewhat predictably, Shaun wasn’t able to convince Prof. Fontaine that he answered the question correctly. Shaun now wants to take it to the Dean (uh oh), and he wants Glassman to come with him. Here we go with the “he is wrong” again. Shaun’s eternal song and dance these days, isn’t it?

Of course Glassman knows the Dean is a futile endeavour, and a potentially damaging one, at that. He present Shaun with the contents of a paper bag and asks Shaun to pick one of the items in it. Shaun takes one quick look and fends it off. “I don’t care about these things.” Glassman picks one for him and hands him a Craft Kit Embroidery. “It’s good practice for your sutures,” he tells Shaun.

Side Note: Freddie Highmore cracks me up with his expression of sheer, unadulterated yet innocent Shaun distaste and disbelief. Shaun’s attitude towards Glassman totally says wtf Glassy, perhaps even…

Freddie being positively adorable almost ruins the moment, because Glassman is very blunt with Shaun here. “Sometimes bad things happen. Sometimes even unfair things happen. You know that better than anyone.” Geez, punch us right in the gut, Glassy, why don’tcha? Cause, yes, Shaun would know that very well — in more ways than one. “You gotta let ‘em go and focus on the next thing, the next challenge.”

Shaun isn’t really getting it, though. “Are you not coming with me to see the Dean?” Glassman gives him a look. “No.” This clearly kicks Shaun in the stomach. “You said you would always be there for me, to help me.” Glassman’s voice is gentle. “I am. Go if you need to go.” Shaun makes eye contact, because this is important. Glassman assures him, “I’ll still be right here.”

Present day Shaun is staring at the empty desk chair opposite him. Glassman clearly isn’t right there. It can’t be lost on Shaun that that promise rang empty. Glassman hasn’t been there for a quite some time, has he? However, Shaun doesn’t have much time to dwell on it, because the embroidery memory has triggered another idea how to save the patient’s heart.

What I loved about this flashback scene is that we get another glimpse of how much of a father role Glassman has had in Shaun’s life, and how Shaun is eternally lost in his ‘I am right and everyone else is wrong’ fixation. Glassman tries to break him out of it, tries to show Shaun an angle he can relate to.

I also love how Glassman is trying to let Shaun swim on his own, just giving him gentle prods to figure out what the right direction is. He lets Shaun decide for himself if he wants to go to the Dean. He’ll just be there at the end of it all to support Shaun, no matter what he decides.

Also interesting that Shaun’s mind goes right into ‘abandonment mode’, assuming that Glassman won’t help him. It’s both a beautiful and a gut-punching moment when Glassman tells Shaun he’ll unconditionally be there for Shaun, because we know that Glassman is currently anything but there for Shaun.

In a recent interview, Freddie Highmore had hinted that we’d see some flashbacks to Shaun’s university days, and I guess we need to assume it was this. To be quite honest, I had been hoping it’d be more memorable and meaningful than these two brief scenes. Like, an actual episode that was centred around a med school days sub-plot rather than just three brief flashbacks. But I’m whining on high level now. I was very happy with these scenes, and I’m hoping for a med school days revisiting in the future.

At St. Bonaventure, it’s time to tell the patient’s father that it’s time to consider organ donation. After last week’s terribly awkward bumbling Shaun, it’s heartwarming to see Shaun doing well here. He’s collected and he listens. He tries very hard to be empathetic, and it’s going well, also because he has Asher by his side who gives support at the right time. This is the Shaun we hope to see more often, the one who doesn’t brute-force inopportune random statements on people. The one I wish we could have seen in the previous episode a bit more.

It’s a very symbolic moment when Shaun hands over the heart to Alex to be transplanted into Ollie. It’s a silent apology, and it’s beautiful.

The next morning, Lea leaves the hotel she’s stayed at to go home. Glassman is there and offers to help her with her suitcase, which she declines. Glassman seems to feel the need to explain himself. “People have always tried to accommodate for Shaun’s differences. Compensated, overcompensated…” Lea doesn’t want the lecture, but Glassman actually knows he was one of those people. “Took me forever to get to from where you started. You always treated Shaun like a person instead of a problem. You always saw… Shaun. Why did you stop doing that?”

She is incredulous. “You left.” How does he not realise this? “So what,” he asks, “so you panicked?” Yes. She did. And Glassman is now poking around in open wounds and Lea is close to tears. “We’re getting married, and he’s not always easy, and I’m pretty much always a screw-up and… it’s just… it’s too much.”

Glassman assures her that it’s not. “You don’t need me anymore. You’re kind, and you’re patient, and resilient as all get-out. You’re the right person for Shaun, Shaun’s the right person for you. If you could just trust that, you will have the most perfect imperfect marriage.”

Lea wants to hug him right now, and Glassman actually takes a step back. No deal on that one. “You don’t need me,” he reiterates. God, I wish he wasn’t so damn bone-headedly stubborn. Cause it’s not true.

This scene was beautiful, though. Many fans had longed for an honest Glassy-Lea conversation, and we got one, and I’m happy. I didn’t get out of it all that I had been hoping for, but I’m still super happy. For a long time, Glassman had been somewhat hesitant towards accepting Lea as a future daughter-in-law. But now he finally tells her that she’s the right person for Shaun, and he is a 100% supportive. God, we really needed that. Thank you.

I wonder whose idea it was for Shaun and Asher to see Brandon’s father to give him the list of the 63 people whose lives Brandon saved or improved. I would love to think it was Shaun’s, and he does say that he came to give Ed the list, and that’s beautiful. Anyone saying Shaun can’t be empathetic clearly didn’t see this side of him. Shaun, you did good. Really good.

That night, Shaun comes home to an empty, silent apartment. He has a paper bag that he sets down on the kitchen island as he sits down and reminisces. Back in med school, Shaun hands Glassman the meticulously and beautifully finished embroidery piece. Because Shaun will never bow down in defeat to any challenge, right?

Glassman wants to take him to get pancakes, and Shaun has to clear away a book that’s lying on the passenger seat of Glassman’s car. ‘Understanding Your Child With Autism’ reads the cover. Shaun looks at it for a long moment, then looks at Glassman. He doesn’t say it out loud, but he doesn’t have to — the quiet gaze clearly says to Glassman, “I understand what this means, and I love you for it.” Such a pivotal, poignant moment, and it makes me want to go back to episode 1×18 and their “I love you more” exchange.

And this makes present day Shaun’s current situation even sadder, even more tragic. He desperately wants to connect with Glassman, with the only father figure he trusts and who’s always been there for him. He takes out his phone, but of course there’s only the empty shell of Glassman’s voicemail at the other end.

“Hi, you haven’t reached Aaron Glassman, so I’ll call you back. Some time.” And that’s exactly what Glassman’s been doing of late. He’s called people back. Some time. Maybe. Or never. It must hurt quite significantly for Shaun to feel that connection severed. He’s lost someone who had told him he’d always be there for him. It hurts us, too.

We now see what’s in the paper bag as Shaun retrieves the item from it. It’s an embroidery kit that he looks at and opens.

Another punch to the gut, and this one hurts bad, because it tells us just how desperately Shaun is looking for a connection right now. Not only does he want something tangible to bond with Glassman, he chooses something tactile, something he can physically touch and spend time with that takes him back to a crucial moment in their relationship, something that Shaun really wants to hold on to.

The song “Satellite” by Ben Abraham is playing in the background here, and the lyrics are (as usual when songs are used on the show) very apt. “When you think you’ve lost the light, stuck in a starless night, lift your eyes and watch the sky, I’ll be your satellite.” Shaun sorely misses Glassman, feels lost and afloat, and Glassman is hovering in an orbit far away out of reach, and Shaun currently has a really hard time looking up to even find him in the vast, storm cloud-laden sky.

This scene made me cry, and rightly so. I don’t think I’m ready for what’s to come, whatever it may end up being.

Side Note: Yes! Here it finally is, the long-awaited explicit non-explicit show of acknowledgment from Glassman that he feels Shaun is his son. And in true The Good Doctor fashion, it was orchestrated subtly through ‘show, don’t tell’ that they do so incredibly well. I still wish we could have an actual conversation between Shaun and Glassman where it’s being asserted verbally, and that isn’t from some 10-odd years ago. But again, I’m very happy with this beautiful notion, and I have much love for every single Shaun-Lea-Glassman scene we got this episode.

Glassman’s Journey

A lot of us right now are probably going, “Wtf are you doing, Glassy?” There is so much proactive detachment here from Glassman that it hurts — for Shaun quite literally. What really gets to me is that the disparity between Glassman’s and Shaun’s motivations is super evident to the viewer, but it’s not to the characters, which makes it so painful to watch. We all want to scream at the both of them to just sit the fuck down and talk to each other.

This whole Shaun-Glassman arc seems like an epic slow burn right now, and we’re left guessing where this’ll eventually end up going. I will expand on this a little more in the Speculation Corner.

The Second Year Residents

No Jordan at all in this episode, but, yay, we learn more about Asher’s past. I’m so stoked, this was also something on my season 5 wishlist.

The family story of the patient Shaun and Asher are treating (Brandon) hits very close to home for Asher. He’s all too familiar with a father whose expectations he couldn’t meet, and a father he hasn’t been communicating with over these differences for several years.

During surgery with Lim, Park and Shaun, Lim mentions that she and her father became closer after he was diagnosed with cancer. Asher contributes, “I wish that my dad would get cancer to make him bond.” Clearly, there are old wounds there for Asher, including a letter his father sent some years ago that Asher never opened. I also wonder if Shaun was pondering this, cause his dad got cancer, and they surely didn’t bond over it.

Most of the conversations with Brandon’s father are handled by Asher in this episode, and I wonder if this was an organic process, or if Shaun proactively kept in the background to a) provide Asher with more learning opportunities and b) not complicate a difficult and emotionally fraught situation.

There’s a moment in the hospital’s chapel where Brandon’s father tells Asher, “Your dad must be very proud.” Asher doesn’t think so. “He wanted a rabbi. A straight rabbi. I failed at both, so he disowned me.”

And because Asher knows how crucial it is not to leave important things unsaid, he advocates for sharing what’s on Brandon’s father’s mind, even if Brandon can’t actively respond to it. It’s not too late to say goodbye.

As Asher listens to Brandon’s father talking to his son, he makes a decision. It’s time he let go of his own refusal to rebuild a possible connection to his family. Back home, he gets the mementos box out of his closet and sits down to open his father’s letter. He’s touched and tears up as he’s reading it. I hope we’ll see more about Asher’s family in upcoming episodes!

What we learn from this scene:

• Asher has a racing bike he keeps in his flat
• Asher seems to like Musee bath products
• Asher was living in Brooklyn at the time the letter was sent
• Asher’s father’s first name is Yosel

Alex & Morgan

I already featured most of the Morgan storyline up in the patient stories, but just to briefly recap:

• Morgan goes to Salen with a proposal how to make the clinic profitable. Someone in her cardio class is a health insurance manager for a larger company who are looking for a new healthcare provider. If Ethicure scores that contract, they could make several hundred thousand dollars.
• Salen likes the idea, but Morgan has a bargaining chip in play. She wants to close the deal herself, and if she’s successful, she wants full control of the clinic and its budget.
• Her cardio buddy comes to the clinic to get checked out, and Morgan discovers that she has an optic nerve tumour. Removing the tumour through conventional means would mean an outcome of a maximum of 60% remaining vision.
• There’s a new experimental therapy that could remove the tumour and preserve up to 100% vision, but it’s not a profitable option since it’s not covered by insurance and it would cost more than the company healthcare contract would fetch the clinic.
• Salen more or less says no to the experimental treatment but leaves it up to Morgan whether to let the patient know or not, assuming that the clinic would not get the contract if Morgan informed her about the option but told her St. Bonaventure wouldn’t pay for it.
• Morgan chooses not to tell the patient and offers the conventional treatment as the only therapeutic approach. The surgery doesn’t go as well as planned and the patient comes out with only 50% remaining vision, but is still grateful that her life and partial eyesight was saved because she had a routine healthcare assessment performed that other providers wouldn’t necessarily offer.
• Morgan manages to close the contract, and Salen gives her Glassman’s office, presumably together with an interim head position for the clinic, like Morgan asked.

There’s been quite some discussion around this in online, first and foremost whether Morgan is qualified or senior enough to even be offered this position. Surgical residency usually lasts five years, but Morgan switched to internal medicine, which has a residency of three years. I think we can assume that she is no longer a resident, though the show never mentioned that she’s now an attending or a fellow. It’s a bit vague, and we can only guess where in the hierarchical structure Morgan is currently placed.

Is Morgan qualified for the job? That’s a good question. We don’t know if she has experience or training in administrative matters. She might just be a natural. It’s also somewhat questionable whether it’s ethical to offer someone a vacant position without first publishing an official internal and/or external job posting. (Not sure how this works in the US, but in Germany this can be illegal and employees who might have wanted the job could theoretically sue the employer.) Then again, we know that Salen isn’t always about doing things ethically or by the book, and she usually gets away with that shit. As she does here too, apparently.

That leaves the discussion of whether what Morgan did was ethical or contemptible. If you ask me, it was definitely not ethical. If there’s a better treatment option, even if it’s experimental, as a patient I would like to know about it, even if I can’t afford it. What should also be considered here is that the other option was “experimental”. They often use that word on the show like you can just ask a patient if they want the “experimental” treatment, and if they say yes, then they’ll get it.

I’ve said this before, but it doesn’t really work like that. Experimental treatments usually mean the drug or technique is in clinical trials. You have to find a trial that’s open for recruitment, that has a study site nearby, and where the patient meets all the entry criteria. You can’t just give any patient any random “experimental” treatment. Granted, this was a surgery technique and not a drug, so I’m not sure how that would work here.

The experimental surgery might also come with additional risks that the conventional technique doesn’t have. So the patient would have to carefully weigh their options. But the fact remains that Morgan acted selfishly to advance her career. Is that a terrible thing? Does that make her a bad person? I think that’s up to every individual viewer to decide for themselves.

Noteworthy is that they also referred back to the previous episode that was all about ambition, and had Morgan and Alex clash somewhat over how much ambition is healthy to have. Here, Morgan tells Alex, “Glassman’s basically gone. I see a vacuum, I wanna fill it.” Alex is a bit puzzled. “I thought you wanna be a doctor.” Morgan gives him a no-nonsense look. “Last week you told me I shouldn’t expect you to become more ambitious. The reverse is also true.” Alex wisely shuts up after that.

Side Note: I want to see a scene in the next episode where Shaun discovers that Morgan now has Glassman’s office. It might go something like this:

                     SHAUN
           What... are you doing here?

                     MORGAN
           This is my office now, Shaun.

                     SHAUN
           N-no. This is Dr. Glassman's office.

                     MORGAN
           Not anymore.

Surely, that would really trouble Shaun. Just another nail in the Glassman abandonment coffin, right?

As for Alex, I’m happy to see there’s some more Alex and Shaun bonding going on (yesss, another item on the season 5 wishlist ticked off). I love that Alex suggested to Shaun to spend time together to watch a movie and grab some pizza. Of course Shaun modified that somewhat from what was originally supposed to be a day out at the cinema to a more relaxed night on the sofa with beer and take-out, but it looks like Alex is up for it. Though it makes you wonder how much of that easy agreement was being a friend and merely accommodating Shaun, because I honestly couldn’t guess if Alex might enjoy a documentary about the science of storm clouds.

Another thing we should probably talk about is, geez, wtf, Alex — calling Val about the potential donor heart when there hadn’t even been a consideration of organ donation yet? Sure, we all get why this was necessary for the dramatic story plot, but I don’t even wanna go into how unethical and screwed up that was. Also, isn’t there, like, a system for this, UNOS and all? How can the heart go directly to Ollie just because Park wants that? Wouldn’t UNOS evaluate first who the best recipient is? Sure, there’s such a thing as directed organ donation, but all of this seemed sketchy and construed af.

I also want to come back to the Shaun billboard. Remember how Shaun had asked Salen to reverse his image that was originally mirrored and she said she would but that she hadn’t had the time to do it yet at the end of episode 5×04. This poster now seems to be all over St. Bonaventure’s hallways, and it indeed has Shaun’s image mirrored (noticeable by the name embroidery on the lab coat). You can see it in one scene where Shaun talks to Alex.

And not just that. Salen has also widened the campaign to include other diversity aspects. There’s a poster with a wheelchair-bound doctor in the locker room. You can see it as Shaun and Alex pass by it. It depicts a Dr. McGinley – General Surgery, Ophthalmic Surgeon. The tagline here is, “Differences Count”. And if you pay really close attention, you can also spot Dr. McGinley in the surgical ward. We could play “Spot the Poster” for the rest of the season!

And while we’re talking about this scene, did you notice the little arm-touch on Shaun’s part? Shaun doesn’t initiate casual physical contact with anyone unless it’s someone he’s familiar and comfortable with. The fact that he does it here in a very casual manner, even if it’s just a tiny arm bump, shows us that he truly sees Alex as a friend, as someone he feels comfortable being around. And that’s awesome, and I love these little subtle details so much.

The Others

We need to talk about Marcus. Marcus and Salen. Marcus’s ‘50 Shades of WTF’ is surely continuing. So now they’re officially dating, or what? She’s invited him to a food truck outing in the park, and they’re eating soft tacos with deep-fried crickets.

Side Note: It shall be mentioned that the ones Salen is eating are actually vegan, as the “crickets” look like carved and modelled red beet pieces with thin vegetable sticks stuck into them. More likely to accommodate Rachel, the actor, than Salen, the character. Hill Harper said on Twitter he was eating real crickets while Rachel had vegan ones. Breaks the immersion a little bit when you look at it in HD, but oh well…

While they have their mutual cricket tacos, Salen tells Marcus, “My needs are simple. You gotta smell good, you gotta know I love my work, and I’m not gonna apologize for it. And you absolutely gotta be up for trying new things.” Marcus narrows his eyes and takes a bite from the taco.

When he inquires about how things with St. Bonaventure are coming along, Salen volunteers that there’s some issues with radiology, the pharmacy is spending too much, and the head of paediatrics hasn’t signed his Ethicure contract yet. When she asks Marcus why he so easily signed his Ethicure contract, his answer is, “I’m up for trying new things.”

Andrews reads the subtext and sees another opportunity when he corners John Colson, Head of Paediatrics at the coffee bar later. (Colson wears a hideous tie, btw.) He feeds him some story about a colleague from Seattle who’s sitting over there at the table who is gunning for Colson’s job, which seems to be becoming vacant pretty soon. Colson is puzzled. He’s not moving on. He’s just renegotiating.

Colson walks off, clearly perturbed, and Marcus grins to himself. He sits down next to the “friend”, who is actually just a random visitor Marcus doesn’t even know. Mission accomplished.

It’s payback time when Andrews invites Salen to his house and they share some Mezcal. Salen, of course, gets the worm that’s contained in some bottles of Mezcal (actually a larva of a moth that can infest agave plants — Mezcal is a distilled, strong alcoholic beverage of South American origin, made from agave plants). She drinks it without batting an eye.

She’s appreciative of Marcus helping out with her little Colson problem. She takes a whiff of him and comments, “You smell good.” Then she takes off her cardigan and walks over to the stairs that lead up to his bedroom. “You comin’?” Yes, he very much is.

Oh man. I’m kinda down with this, actually. I still don’t know if he finds her appealing, or if it’s a purely opportunistic move on Andrews’ part, but yeah. Works for me either way.

Speculation Corner

So where are we going from here, then? It’s really hard to speculate, because I’ve been majorly wrong before, and I try to avoid episode promos and anything that speaks to future episode content.

Sometimes bits and pieces leak through (goddammit, Twitter!), like apparently Shaun going to have some major meltdown in the next episode. I mean, that’s not surprising, and it feels like it’s been a long time coming. The abandonment noose is tightening around Shaun’s neck, and he’s starting to really feel the pressure now.

I feel now like my ‘Glassy ends up in Casper’ speculation was wrong. Which is fine. If we do get some more Marcie stuff this season, it might be triggered otherwise. As for where Shaun is currently at, I think it’s safe to assume we’ll see things coming to head in the upcoming winter finale (yes, that’s tomorrow’s episode — 5×07 “Expired”).

There’s a million different directions things could go, and I wouldn’t know where to start, but the one that seems fairly likely is that perhaps Lea will heed Glassman’s advice and tell Shaun about the omitted reviews (the fact that it was more than one makes this kind of a big deal). Shaun will likely get very upset, and with both Lea and Glassman estranged, his emotional support system rug is being pulled out from under him, which sends him tumbling into zero gravity limbo.

As to what the consequences of this will be is anyone’s guess, and a major meltdown might end up being the least of Shaun’s problems. I think we need to brace ourselves for the high likelihood of the winter finale ending on a cliffhanger. As for how dramatically cruel that cliffhanger will be, who knows…? I’ve always hated cliffhangers with a passion, to the point where sometimes I would wait a week and watch both episodes together. I will loathe the writers for amping it up (if they do), because there’s no way I will wait with watching 5×07 until whenever 2022.

I’ve had some fun with discussing a bit of fan speculation with Daniela, based on something that apparently Andreas has been throwing out there. What if something drastic happened to Shaun that would draw Glassman back to reconnect, something that he couldn’t possibly ignore? Like Shaun ending up injured or sick, in grave danger, perhaps even something life-threatening.

Seems a bit tropey, maybe, but it’s also something that would make perfect sense in this situation. If we wanted to spin this into something a little more concrete, we could postulate a scenario in which Lea confesses her review omissions to Shaun. He gets very upset to the point where he just packs a bag and leaves (which I’ve talked about before, actually).

Wherever he ends up, he gets critically injured, which of course Lea and Glassman learn about and go to be with him by Shaun’s side. Lots of worrying, lots of regrets, lots of angst and drama and finally, hopefully, The Fucking Talk™. And I swear to God, if the show doesn’t actually do this, I’ll write it in a fan fiction. 🙂

What do you think? Too predictable? Too corny? Let me know in the comments.

Oh, I also need to mention this. I’ve seen lots of comments online where people are seriously worried that Glassman is being written out of the show. Of course we don’t know what’s being discussed in the writers’ room, but personally, I’m not too worried. Part of this season’s character arc around Shaun is his relationship with Glassman. And in order for both to really realise just how much they still need each other, Glassman needs to be physically away from Shaun.

I don’t see this as a sign that Glassman is severing all ties and won’t return. I’m positive his return will happen and it’ll be cathartic and beautiful. After all, it’s been said that he will have a role of father to the groom. Why would David Shore say that if there was gonna be no wedding (which was also thrown out there by viewers) and no Glassman?

As usual, all of this is mere speculation, and I’m gonna be waiting for Tuesday with bated breath when I can see the episode!

State of the Shea

For more reading and other fans’ perspective on the episode, youn can find Kelli Lawrence’s State of the Shea episode analysis here.

Missing Scenes

I’ve written missing scenes in fan fiction form to glue together or expand on what we saw in this episode. Feel free to check out my fanfic titled ‘It’s Hard To Dance With A Devil On Your Back’ that I’ve posted on AO3 that’s a collection of gap fillers for all the season 5 episodes aired so far.

---