Hoo boy, what a way to start the season! Excitement, intensity, edge-of-your-seat suspense and emotions galore! I really loved everything about this episode. Top notch work all around.
Written by Peter Blake
Directed by Mike Listo
Original airdate Oct 3, 2022
Patient #1 – Audrey Lim
Aaron Glassman, Marcus Andrews, Shaun Murphy, Jordan Allen
Internal injuries and haemorrhaging resulting from stab wounds to the chest and abdomen, including liver lacerations and cardiac injuries
- Knife wounds in the chest and abdoment resulting from an attack by a violent attacker (nurse Villanueva’s abusive boyfriend)
- Stab wounds cause internal injuries and significant blood loss, followed by loss of consciousness
- Diagnosis of cardiac tamponade requiring extraction of fluid around the heart, followed by transport to an OR for emergency surgery
- Full extent of the injuries detected during surgery: lacerations to the pulmonary hilum, a small cut to the left ventricle, grade four liver laceration with active bleeding into the peritoneum
- Two possible options to stop the liver bleed
- Partial resection of the liver (would decrease life expectancy by 10 years)
- Angio-embolization (high risk of needing a major blood transfusion)
- Glassman instructs Shaun to proceed with the partial liver resection
- During the surgery, Shaun discovers that the bleeding is confined to an aberrant vessel which makes angio-embolization the better choice
- Embolization results in complications but the bleeding is ultimately stopped
- Lim regains consciousness after the surgery, but blood pressure crashes
- Ultrasound diagnostic reveals a ventricular septal defect (VSD), indicated surgical solution is a GORE-Tex patch
- Due to lack of available bypass machine, Andrews decides to use an occluder device for percutaneous closure which wouldn’t require cardiopulmonary bypass
- Seating of the occluder device doesn’t work and results in pulmonary heart failure
- Shaun realises there is a second VSD that that can be fixed with a second device that is angled posteriorly which stabilises Lim
- Upon waking up the next morning, Lim can’t feel her legs, which is first theorized to be post-surgical myopathy
- When Lim can’t move her legs at all, it appears she is paralysed
- It is currently not known if the paralysis is temporary or permanent or what exactly may have caused it
Patient #2 – Dalisay Villanueva
Aaron Glassman, Marcus Andrews
Haemorrhaging injuries resulting from stab wounds to the neck and arm
- Initial concern is the bleed on Villanueva’s wrist, which is staunched with a makeshift tourniquet
- After stabilising, Villanueva is transported to an OR where her injuries are tended to surgically
- Surgical diagnosis is a full thickness tracheal laceration with subcutaneous emphysema, a cut to her jugular vein below the facial branch, shredding of the carotid artery
- Treatment without full access to diagnostic testing bears the risk of a massive stroke if they try to stop the bleeding without anti-coagulation medication
- Surgery is successful and Villanueva makes it through, waking up the next morning, still on a ventilator due to her tracheal injuries
Patient #3 – Ezra
Morgan Reznick, Asher Wolke
Bowel perforation as a result of underlying Crohn’s disease
- Ezra is found in a hospital hallway during the hospital lockdown, suffering from acute abdominal pain
- History of Crohn’s disease (a chronic autoimmune disease causing inflammation of the intestines) and past bowel surgery
- Morgan and Asher take him to an MRI room to escape the shooter who is still on the loose
- Ezra’s condition worsens and will require immediate surgery for a suspected perforated bowel
- Consulting Alex Park over the phone, Morgan is ready to take point on the procedure but with Ezra’s previous bowel surgery history, they would need to do it in an OR
- Morgan and Ezra make it to an OR where she performs the operation
- Ezra survives the procedure and regains consciousness the next morning
Patient #4 – Owen
Aaron Glassman, Asher Wolke
Internal injuries and haemorrhaging from gunshot wounds to the arm and chest
- Owen sustains gunshot wounds from a shoot-out with the SWAT team
- He goes into cardiac arrest but Asher manages to bring him back
- Glassman and Asher repair the injuries surgically
- Thanks to Andrews deciding that Owen will get the one operational bypass machine they still have, Owen makes it through the surgery
- He awakens the next morning, handcuffed to the hospital bed under police supervision
Some sort of crisis
The episode starts with Shaun in an autistic shutdown, There’s blood smeared all over his shirt, Glassman and Lea are urging him to pay attention to them, but he stares blankly ahead, his eyes empty and bloodshot. He’s sitting on the OR hallway floor, palms firmly planted to the linoleum in front of him, surgical attire carelessly discarded all around him. Lea and Glassman are kneeling near him, trying to reassure him. Lea carefully reaches over to ruffle his hair—his usual comfort gesture when he’s upset. It does absolutely nothing.
Holy shit, guys. Way to grab us right off the bat and plant that huge knot in our stomachs that won’t quite go away as we traverse further into the episode. I’m as hooked as I’ll ever be, cause this punches me right in the feels.
Last remnants of wedding bliss
We cut to six hours earlier, witnessing Shaun and Lea having that sweet and lovely wedding dance on the hospital roof terrace, still basking in freshly married delight. Lea says she feels married, asking Shaun if he feels the same way. He asks what married feels like, and expresses that he doesn’t feel any different because he still loves Lea more than he’s loved anybody in his life and he’s still incredibly happy.
Come on, how cute are these two? It makes my heart melt how in love they are, and how happy Shaun is with Lea. Not that I think this is in the stars for them, but if the writers ever decide to break them up, I will be so mad. David Shore apparently said there will be nothing but wedded bliss for Shea to come, but I’m not sure that man can be trusted. 😀
Which isn’t to say I’m not prepared for some ups and downs, which all marriages undoubtedly go through. Shaun and Lea’s path has always been a bit rocky, and I expect to still keep seeing some bumps in the road for them, but I hope we won’t have to suffer through more of the will-they-or-won’t-they whiplash of season 5.
Saving Villanueva and Lim
Their wedded bliss doesn’t last very long with the hospital going into lockdown with an active shooter on the loose. Concerned about Dr. Lim’s safety, Shaun decides he can’t just stand by when his help may be needed and rushes to the break room with Lea and Jordan in tow where they happen upon the shocking scene of a bleeding Dalisay and Audrey on the floor.
I loved how they set up the parallels with Steve accident right here. Shaun bearing witness to a traumatic medical emergency situation is certainly bound to bring back those memories, the difference being that now he is well equipped to go into action and try his best to save lives.
Because, remember the pilot episode? “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 [him].” Now he can. Now he is there to do what he trained for his whole life. Now he can save his friends’ lives.
With more help, they get both Audrey and Dalisay into an OR to assess the damage and try to keep them alive. With few supplies and a dire shortage of trained staff, Shaun designates Lea to become their circulating nurse when she asks what she can do to help. Not exactly what she had in mind, but she knows these are extenuating circumstances, and she’s determined to do what’s needed.
I really liked the moment they gave her where she stands by the mirror, giving in to the overwhelming shock of the situation, the short moment of despair before she pulls herself together to get the job done. Go Lea!
Damage control in the OR
The fight for Lim’s life continues after team works tirelessly in the OR, Dalisay is also being operated on in the next room. It looks like both may be able to survive. They run into some complications with Lim, Glassman has to step out to help out with Dalisay’s surgery, but not before he instructs Shaun to remove the damaged lobe of Lim’s liver, despite the fact that Shaun suggests a less invasive but riskier approach that may preserve her full liver. Shaun confirms he will do as he’s been told.
However, as the surgery proceeds, Shaun finds that the bleeding is only confined to one vessel and the embolization approach is the best option. He decides to go that route rather than take out half of Lim’s liver. Lea and Jordan caution that this is against Glassman’s explicit instructions, but Shaun doesn’t seem perturbed and continues with the surgery as he sees fit without informing or running the change of plans by Glassman.
This backfires somewhat when Glassman comes back later and realises what Shaun is doing. He chides both Jordan and Shaun that this wasn’t their call to make, that he should have been consulted, but since they’re already way into the embolization, it’s too late to change course now. Lim’s blood pressure takes a dive and Glassman decides to stop with the embolization to go back to the original plan of resecting the liver to stop the bleed. Shaun, however, vehemently contradicts Glassman again. He can inject gel foam particles to stop the bleed, there is no need to cut her open.
Things get a little heated, Shaun aggressively pushes to do it his way and eventually Glassman lets him. The bleed is stopped, BP rises again and relieved looks are exchanged. Shaun states, “It was a reasonable call.” Who is he trying to convince here?
What with there being some vague hints from a showrunner interview at the fact that Shaun and Glassman will be pivoted against each other this season (again), I wonder if what we’re witnessing here are the first pieces of that puzzle. Shaun doesn’t just defy his mentor’s and superior’s orders during this surgery, he does so twice – first when he changes the surgical plan and then when he insists to stop the bleed through embolization rather than liver resection.
While Shaun is now a senior resident about to become attending, he is still subject to the hospital hierarchy, he should not be going against the clear instructions of his senior doctors. Sure, this was a high pressure and high stakes situation, but it could get Shaun in trouble. Particularly since we now know what the consequences are (i.e. the paralysis), I have a feeling that there’s gonna be significant fallout in some way. And it may become a point of contention between Shaun and Glassman as well.
Liz Friedman said this about it: “Shaun and Glassman find themselves in a situation they haven’t been in before. For so long, Glassman has been a tremendous mentor to Shaun, but Shaun is now in a situation where he doesn’t see himself, at least in certain instances, in need of a mentor in the same way. That change in their relationship is going to be complicated for both of them.”
We already saw in 5×14 Potluck that Shaun is becoming more independent as a doctor and a surgeon, that he feels he is capable of making important treatment decisions. Glassman’s role in this is somewhat dichotomous, he is not just Shaun’s professional superior, he is also a personal mentor and sees Shaun as his son. It must be doubly hard for Glassman to loosen the reins a little and let Shaun trot on his own. This may come into play as the season progresses, although most likely there’s going to be more to it than that. I’m not sure I will like where this is going, I don’t like Shaun and Glassman at odds, but I’m trying to keep an open mind.
The one bypass machine
They think they’re over the worst when Lim wakes up and is alert, but things change in an instant when she has another cardiac bleed and Owen gets shot by law enforcement and needs immediate surgery. Both he and Lim need a bypass machine, but there are only enough supplies to operate one machine.
Both Glassman and Shaun advocate for it to go to Lim, because is there really a debate that Owen deserves the machine more? Andrews isn’t quite so quickly swayed. He decides that Lim’s heart can be repaired with an occluder device rather than open heart surgery, while Owen would not survive without going on bypass.
After Andrews pitches the occluder idea, Glassman agrees that the approach sounds reasonable. This sends Shaun into a rant. “This is not fair. Dr. Lim didn’t hurt anyone, he did, and now we need to help her. She needs the bypass machine.” Be that as it may, Andrews has made his decision: Owen gets the machine. Shaun clearly isn’t happy with that, but what can he do?
Whenever someone says that Shaun isn’t driven by emotions or doesn’t have empathy, please show them this scene. Cause his rant here is pure emotion. He wants to save his friend’s life and would rather save her than the abuser and shooter.
That said, can we talk about the bigger issue here? Cause both Shaun and Glassman were out of line when they initially said Lim should get the machine. This is why doctors shouldn’t treat patients they’re emotionally attached to. Every doctor should abide by the Hippocratic oath, which basically says that medical decisions should purely be based on medical need and not personal feelings or emotional judgment.
Andrews was the one who made the rational and ethical decision. Glassman turned around and finally agreed with him. Shaun was the one who made an error in judgment. Will there be repercussions for that, too? We shall see.
There’s another underlying question here, perhaps. Did Glassman only agree with Andrews to prove something to Shaun or to get back at him? Apparently there’s people who think so, but I can’t agree, because that would be incredibly petty and unprofessional. Sure, he gives Shaun a poignant look, but to me it was merely concern over how Shaun would react, seeing how he was strongly advocating for the opposite.
The crisis is yet to come
They start with the suggested approach on Lim, but then everything just kinda goes to shit. The device isn’t seating in the right position, and the surgeons don’t know why. Lim’s blood pressure drops again, she goes into pulmonary heart failure, and Shaun goes a little postal.
He was right all along, they should have done the open heart surgery, because now Dr. Lim is dying and he can’t do anything about it. This is his brother’s accident all over again, he’s going to lose another friend. Andrews orders for Shaun to leave the OR because he’s suddenly very vocal that this is not okay, that he can’t do this, clearly on the verge of a meltdown.
When Lea isn’t getting anywhere with him, Andrews curtly orders Jerome to get Shaun out of the OR. It’s Shaun’s worst nightmare, because suddenly he’s not just upset that everything is terrible and his friend is dying, now there’s also the beefy Jerome’s arms clasping around his waist, basically lifting a loudly protesting and floundering Shaun out of the operating room very much against his will.
Repeated agitated commands not to touch him do nothing and Jerome sets a struggling Shaun down in the hallway outside of the OR, followed closely by Lea. Jerome and Lea stand at a distance with their hands up in a defensive gesture while a frantic Shaun looks like he might have a go at them, but then rips his surgical gear off of him, breathing wildly, clutching his head, muttering, “Okay,” repeatedly to himself.
He sees Steve falling off the train again in front of mind’s eye, and he suddenly goes very quiet as Lea edges closer. With a deflating exhale, he sinks to the floor, sits there like a statue with his palms planted on the linoleum in front of him. Lea tries her best to reassure him, tells him she’s there while she sits at a respectful distance, trying to give him the space he may need.
A vision of Steve
Shaun’s eyes are wide, the red blood smears all over his belly standing out starkly against the crisp white of his tuxedo shirt. All he can do while Glassman and Lea urge him to focus on them is blink in stunned silence. Sounds and visual cues blur out of focus, and when Lea reaches out to gently ruffle his hair like Shaun himself always does when he’s upset, it triggers a powerful vision.
Suddenly Steve is there, an older, more teenage version of him, telling Shaun how this is one hell of a wedding day. And that has Shaun’s attention. Shaun’s eyes tear up as he tells this version of Steve what has been nagging at the back of his mind all these years. Steve died because of Shaun, Shaun couldn’t save him.
With Shaun locked in his vision, Lea and Glassman are unsuccessful to help him out of the shutdown. Jerome urges Glassman to go back into surgery, and Glassman realises there is little he can do for Shaun, so he walks back into the OR. Lea has the brilliant idea to video call from the inside and show Shaun what’s going on, because surgery is his holy place, the one thing that may just be enough to pull him out of whatever he’s locked into.
Meanwhile, Vision-Steve tells Shaun that the accident or anything leading up to it was never Shaun’s fault, that it was Steve’s decision to leave home and to climb on top of the train because he was his brother, because he loved Shaun and wanted to protect him. Steve reminds him of the bond they shared, of how what he told Shaun all those years ago still holds true. “You can do this. You can save your friend. You just need to look.”
And Shaun looks. He sees the phone Lea is holding up in front of him, sees the occluder device on the screen, and he goes to his Mind Palace to visualise Lim’s heart in 3D. And suddenly the answer is right there. “I know what to do,” he says as he gets up from the floor.
A tangible solution
Back in the OR, Shaun tells his colleagues that there’s a second VSD and they need to place a second device, and indeed that is the answer. Lim’s condition stabilises, and Shaun proudly and gratefully reaches for Lea’s hand – Lea, his saviour, who pulled him out of the shutdown so that he could save his friend’s life.
Andrews thanks him, and Glassman gives him a look that spells fatherly pride and thankfulness that the situation was resolved, that Shaun did well, that he’s glad Lea was there to help. All’s well that ends well, right? Oh, wait…
Declaration of love
They must have transferred Lim to post-OP after that and everyone changed into different clothes, because early in the morning (twenty to six, according to Shaun’s watch), Lea is waiting for Shaun in a waiting area. Shaun is in his usual blue scrubs, Lea is wearing the dress she was going to wear to the courthouse wedding. Shaun tells Lea she should go home and sleep, but she will do no such thing on their wedding night while Shaun waits for Lim to wake up.
Shaun has the courage or maybe the trust to tell Lea about his vision of Steve. She listens, asks him if he chose to believe that Steve’s death wasn’t Shaun’s fault, and he says he’s still working on that. She reaches out to take his hands, reassure him that she’s there to support. When she turns to go, Shaun pulls her back, takes another big leap. “Tonight was very hard,” he admits.
Lea knows immediately he has something important to tell her. As much as she’s told him before to “use your words, Shaunie,” sometimes he knows how to do it without prompting. Having her help him through the shutdown, helping him find his way out of it, he’s realised how much he loves her, how big a thing that really is that she’s by this side, and how grateful and happy he is that they’re now tied together in a lasting bond.
Lea has tears in her eyes because she knows this is a profound declaration of love that he just made an effort to verbalise, and she steps closer and draws him into a gentle embrace, leaning against his chest. He returns the gesture, and they relish the quiet, loving moment after all the intensity and chaos. Lea asks him if he feels married now, and there’s a sweet little smile at the realisation that, yes, he very much does.
Autism consultant Melissa Reiner mentioned in her episode insights that part of Shaun’s dialogue was changed a little after she was consulted. When Shaun said, “Tonight was very hard,” he was originally going to say, “Tonight was very hard for you,” to Lea. Melissa felt that this would not be consistent with how Shaun accesses and voices his feelings, so he just says that the experience was very hard, which could be interpreted for him to recognise that it must have been hard for Lea as well.
The happiness doesn’t last very long, because when Dr. Lim finally does wake up in the morning, it becomes quickly apparent that she can’t feel her legs. Glassman asks her to push against his hands, but nothing happens. Shaun can only conclude what they all realise with growing apprehension. Audrey is paralysed. She and Shaun share a poignant look that I believe we will find out what it means in the episodes to come.
Alex & Morgan’s Journey
After Morgan told Alex that she wants to take the job in New York, we can see that this was a pretty big blow for Alex. While Shaun and Lea are happily married, he’s left with a girlfriend who chose her career over him.
They get separated during the hospital lockdown, with Alex outside and Morgan actually being held hostage by Owen while she and Asher tend to the patient with the bowel perforation. At some point, Morgan has to call Alex for diagnostic advice, but their call is short-lived because of the urgency of the situation.
After the threat is neutralised, Morgan and Alex finally reunite, and there’s mutual relief that they’re both okay. Morgan thought she was going to die today, and she didn’t think about that job in New York, she thought about Alex. Which made her realise how much she loves him, so she e-mailed New York Medical Center and declined the job offer.
They sit down, because clearly there is an important conversation to be had. Alex explains that when she decided to take the job, it became clear to him that she valued her career over him, and he had to face the fact that those priorities are never going to change.
So I guess that’s the end of Parnick right here. Or is it? I’m honestly not sure how to feel about it. I do hope that they find a way to talk about it, that perhaps there is a path for them to find back to each other. But if it doesn’t happen, then I’m also curious to see what other possibilities may open up for the two of them. They deserve to be happy, in whatever way that’ll happen.
The Wake of Owen’s Mess
It all started with the brutal attack on Dalisay and Lim, but that was only just the beginning of what was going to unfold. Interestingly enough, after the attack, Owen ends up in an elevator with Andrews and Glassman, who are both immediately suspicious when they see an injury behind his ear and blood spatter on his shoes. It quickly escalates when Owen manages to grab a gun from a security guard and starts shooting.
Andrews invokes a Code Silver and puts the hospital on lockdown as the police calls in a SWAT team. Danger lurks everywhere, with Owen on the loose and critical patients needing care that is now limited due to lack of staff and supplies. Alex makes it out of the hospital and stays outside while Morgan and Asher roam the hallways and happen upon a critical patient who needs help. Shaun, Jordan and Lea are on the roof and barricade the door, until Shaun realises that Dr. Lim may need his help, so he rushes to the break room with Jordan and Lea in his wake.
Difficult decisions abound for everyone. Will Asher and Morgan’s patient with the perforated bowl make it, can they perform surgery on him in the MRI lab without being detected? Will Lim and Villanueva make it and how can the surgical team save their lives with only limited resources?
While things unfold in the OR with Lim, Owen actually happens on Asher as he’s trying to get a surgical kit to the MRI lab to operate on the bowel patient Ezra. Owen puts the gun in Asher’s face and forces Asher to let him into the MRI lab where he takes Morgan and Asher hostage while SWAT hovers outside the door.
After Morgan makes the case that Ezra may die if Owen doesn’t let them transfer him to an OR, he actually listens and agrees, but only Ezra and Morgan, Asher is stay with him.
Realising the mess he is in, Owen makes a confession to Asher. He tells him that he comes from an abusive family, realises that he himself has become the thing that he hated — a controlling abuser who resorted to domestic violence on the path to ruin lives.
Asher tries to make a stand – both for himself and for Owen – trying to convince him that it’s not worth dying for this, because there is no other way out of there alive unless he gives himself up. And Asher has his own regrets about being out of time to fix his broken relationship with his father. But there’s still time for Owen to repent.
It strikes a nerve, and Owen unloads the gun, gives the ammunition to Asher and then faces his fate. Owen’s next move is clearly a suicide mission. He goes out into the hallway and takes a long look before he points the unloaded gun at a SWAT officer. A shot is fired, Owen is critically injured by the gunshot, but the surgical team manages to save his life.
I loved the intimate and emotional moment Asher got with Owen when he talks about his father’s impending death and manages to get through to Owen about giving himself up. It was a beautiful gesture for Owen to unload the gun and give Asher the ammunition, and by that point it was pretty clear that Owen felt he didn’t deserve to make it out of this alive.
Newly appointment co-showrunner Liz Friedman said in a TV Line interview that they don’t believe in good vs. bad guys. Friedman says, “It is certainly not our intent at all to excuse or justify the violence that Owen carries out. He does a really, really terrible thing, and then has to deal with the consequences of it. He is not running around that hospital thinking that he has done something good. He is running around that hospital filled with regret over what he has done, particularly to Villanueva, and then trying to come to terms with it, and he can’t…”
I think they did a really good job of showing that Owen isn’t a two-dimensional villain. He has layers, he comes from a really terrible childhood, which in a way we can juxtapose against Shaun who also comes from an abusive family background but managed to turn his life around and grew up to become the sweet, loving and inherently positive human being that he is. Shaun made it while Owen did not, which illustrates once more how lucky Shaun was to have someone like Glassman in his life.
Asher and Jerome get their moment when, in the morning after everything is over and done, they are finally in each other’s arms again. Jerome gives tiny Asher the biggest bear hug, and he’s crying in joy and relief as he holds Asher close. Asher whispers in his ear, “I love you, too.”
OMG, Asher and Jerome’s moments were the best thing ever. The relief when Jerome sees Asher in the OR hallway, the grab of his hand to make sure he’s alive and okay. And then of course the bear hug at the end of the episode and their confession of their love to each other.
It’s on my wishlist for season 6 that we’ll see more of Asher and Jerome staying a happy couple, so I hope they don’t mess with that.
It’s kind of a miracle that no one died, because we also see Dalisay waking up after her surgery, a trach still attached to her neck. She thanks Dr. Andrews for saving her life, and he sits with her and takes her hand in a comforting gesture.
I’m so glad that Villanueva actually survived. I wasn’t sure they would go that route, but it makes me very happy that we’ll (hopefully) see her again.
I alluded in my recap of 5×18 Sons to the parallels to an old episode or ER from way back when where they had a similar storyline of Dres. Carter and Knight getting stabbed by a schizophrenic patient and bleeding out on the floor undetected for a while. Carter survived while Knight did not, and I thought they might be going that route here too, with Lim surviving and Villanueva not making it. It’s great to know that they decided to be more a little more merciful and didn’t take Dalisay away from us. I really hope she’s gonna come out the other end and it won’t be the last time we see her.
Things to Further Dissect
Probably predictably so, but one of my favourite things in this episode was the Shaun meltdown that transitioned into a shutdown. It was gut-wrenching and totally got to me. Freddie Highmore is such an incredible actor and I believe he can play anything you will throw at him. He made Shaun’s despair and anxiety tangible and real, had me swallow against a lump in my throat and had me vicariously feel for Lea who so badly wanted to help Shaun but was initially totally shut out by him.
There are so many layers to this whole scene, but let’s start with Shaun’s family and support system. Luckily he had Lea there with him who instinctively knew what to do, who gave him space while staying close enough for him to know she was there, who stayed calm and tried to coax him out of the shutdown, who had the idea with the video call that ultimately provided an anchor for Shaun.
Her touching Shaun’s hair to ruffle it like Steve always did, like Shaun himself always does when he’s upset, it spoke to her familiarity with him, knowing what dials to tune to help him through this crisis. While the connection to Steve was there as soon as Shaun happened upon the scene of the trauma in the break room, the hair ruffle may have given him the visceral jump-start to form the dissociative connection with Steve. It allowed Shaun to explore his own instinctive and perhaps previously inaccessible lockbox of guilt over directly or indirectly having caused his brother’s death.
Shaun’s Lingering Guilt
Shaun has probably been told a million times that his brother’s death was a tragic accident, that he wasn’t to blame for it. It was already hinted at in 5×11 The Family that Shaun felt partial responsibility for Steve’s death when he told his patient Isla that it was both his and Steve’s fault that he fell off the train.
Co-showrunner Liz Friedman said something very interesting about Shaun’s remorse, and about how impactful it was that this meltdown happened in the OR, which is Shaun’s holy place where he feels safe and focused and in control.
“Shaun always finds clarity, and to some extent peace, in surgery. We have always seen surgery as his happy place, so when you want to affect his ability to work in [the operating room], it’s got to be something really big that shakes him. That’s what we loved about this situation with Lim and Villanueva being hurt. It’s a very different thing to do a complicated surgery on a patient versus a complicated surgery on someone who is a friend whom you love.
Shaun is still conflicted, but he is trying to believe that it is not his fault that his brother died. I’m not sure that he’ll ever be completely free of that [guilt], but that notion occurred to him, and I think that that allowed him to get himself clear enough to be able to go and do what was really important and help Lim.”
It was a wonderful and unexpected surprise to see Steve again. Probably many of us thought they were over and done with this storyline, seeing how most of that backstory was extensively covered in early season 1 and how it was already becoming apparent at the end of season 3 that the actor playing Steve was becoming too old to believably pass as a 12-year-old any longer.
This was actually really beautiful, because this version of Steve didn’t need to adhere to any specific age restrictions. Perhaps this older version of him even spoke to the fact that the Steve that Shaun has carried around inside of him has also grown, has evolved into a new Steve whose image was becoming more and more hazy as Shaun matured while the real Steve ceased to exist.
It absolutely hurt to see Shaun’s guilt and remorse over Steve’s death be shown in such a tangible way, to make us realise that even after all these years, Shaun is still carrying that around with him, that it’s always going to be there in one way or another.
I saw someone mentioning on Twitter that they were glad Shaun managed to find some closure regarding Steve, but I’m not sure that’s what it actually was. David Shore said in a season 3 interview that he doesn’t believe in absolute closure for big life events like this. So what we’re seeing here, like Liz Friedman said, was another step in the healing process. Shaun later says to Lea that he is trying to believe his own conjured version of his brother who told him to allow himself to shed that guilt. He is trying, but he hasn’t quite succeeded yet.
It’s an interesting brush stroke on the canvas that makes up Shaun’s life, and it’s a beautiful notion that we saw Shaun allowing himself to move forward on the path to forgiveness. His journey is not at its end quite yet, but he’s made great strides.
What’s also beautiful about this scene is that Shaun has his closest family there with him. Not only is it a rare occasion that Lea can watch him work as a surgeon first hand in the OR, she is also right there when he crumbles, trying her best to help Shaun with whatever it is he is going through.
As close family goes, Glassman’s fatherly concern has him leave his active surgery to check on Shaun. His immediate worry is short-lived, seeing Shaun in shutdown with very little he can do and Lea already there, so with a heavy heart he leaves Shaun with his loving and very capable wife to deal with the more pressing medical matters at hand.
And even though he is just a figment of Shaun’s imagination, Shaun has his brother there with him as well, encouraging him, giving him the confidence that he can save his friend, and being instrumental in pushing the clamouring guilt aside to make way for clarity of mind to figure out why Lim’s occluder device isn’t seating and what they can do about it.
What also struck me about this scene is that it was filmed really beautifully and intentionally. The way they chose audio editing and camera angles, focus and motion really underlined Shaun’s despair, the world fading away around him, everything becoming unstable and unreal, while at the same time this blinding fog of guilt was rising and clouding his reality. The way they played with camera positioning, Shaun on the floor, looking up, Steve standing in front of him, looking down, it was all really well done.
Lea out of her element
Can we also talk about Lea in scrubs? Cause hell yes, that was pretty awesome. We’ve never seen her inside an OR in an active capacity, because of course why would we? But everything about this night was upside down, and everyone was pulling their weight. And if that meant Lea had to suck it up and try to be a poorly trained scrub nurse, she’d damn well give her best.
I really loved how they gave Lea the opportunity to peek into the surgeons’ world, for her to understand what her extended family does when they’re saving lives like this, for her to see Shaun excel first-hand at the medicine, and of course for her to be there when Shaun desperately needed her. This could have gone a whole lot differently if Lea hadn’t been there, and I’m also glad that Shaun acknowledged that later on.
Shaun and Glassy
Did you see the look that Shaun and Glassman exchange after Shaun manages to figure out why the device on Lim isn’t working the way it’s supposed to? The mask Glassman wears makes it a bit harder to figure out what they were conveying there, but I interpreted it as a mix of pride and approval. Despite Shaun’s earlier moment of crisis, he came through and saved a life.
Shaun himself has a self-satisfied smile on his face that probably mirrors what Glassman is feeling. His reaching for Lea’s hand was a sweet and profound gesture how grateful he is that she’s there for him, that she was instrumental in pulling him through a tough time. We know it’s pretty rare for Shaun to initiate physical contact, and it’s always extra meaningful when he does. Another little moment of Shaun’s family being there, his support system at play.
That moment gave us a short reprieve before the next blow is dealt. We can feel pride and happiness for Shaun that everything worked out all right – until it doesn’t.
Music and its relevance
Let’s talk about the music. The episode opens to Robert Plant and Alison Krauss’s “The Price of Love”, which has very gloomy undertones. The lyrics, “That’s the price of love, the debt you pay with tears and pain. The price of love, it costs you more when you’re to blame,” play as Alex is looking from a distance at Morgan standing and laughing with Jordan and then walks away.
They bring this full circle because the song plays again at the very end of the episode as Shaun tells Lim that she’s paralysed while the lyrics snippet, “but you won’t forget her” plays as the camera lingers on Shaun’s worried expression. He actually makes eye contact with Lim here, which he only ever does when something really important or profound is going on.
Most of you know that I try to stay away from spoilers, but I think it’s pretty clear that one of the overarching themes this season will be all the repercussions of the attack, perhaps including Shaun’s cowboy move to go for the angio-embolization, and the paralysis potentially being an aftereffect of that. Dare we even speculate the worst case scenario that Lim could sue the hospital or Shaun for it? Enter The Good Lawyer? Dun dun dun… Definitely an interesting possibility, and one that could create super interesting dynamics.
While the lyrics are ominous for the Shaun scene, they also perfectly mirror what is going on with Morgan and Alex. The song is about a relationship falling apart but the person who is to blame not being able to forget the other person because they still feel love for them.
When you revisit the very beginning of the episode and the look that Alex gives Morgan before he walks away, it’s pretty clear he’s decided there and then that he needs to end their relationship, that she values her career more than him, and that that’s not a situation or a partnership he wants to be in.
If I’m being quite honest, I’m trying to decide whether that was actually a dick move on Park’s part or not, if that’s perhaps a sexist notion. Is Morgan not allowed to have a career? Does she need to stay clinic internist forever just so she and Alex can be together?
The solution here is probably communication and a compromise. Are there not going to be other jobs closer by that could advance her career? Morgan should also have talked to him about it before she took the job rather than just making that decision without his input, without hearing his concerns. So if they want to perhaps work on getting back together, they need to figure out how to communicate better, how to make better joint decisions. Or maybe they just need to face it and move on, who knows? I’m sorry for the Parnick shippers right now, I hope it’s fixable. :-
The other song utilised in this episode was “Warm” by Moncrieff, which they used when Shaun saved the day and the hostage situation was resolved and all the patients were shown as having survived the night. This one’s certainly more upbeat and about how the little things can mean so much and being thankful for having someone to love and cherish. It only made sense for it to segue into the scene where Shaun tell Lea how much he loves her and how grateful he is to be her husband.
That scene was beautiful, too. What I really loved was the subtleties here. How Lea knew not to crowd Shaun’s space, how she only touched his hands after he told her about Steve, how he trusted her enough to tell her about it, how he pulled her back to thank her. He may not have used grand words, but if you peel back the layers, it’s an epic confession of his love to her.
Shaun has probably not had many people in his life that stuck with him through a crisis like that, many people who even know how to help him through these things or try to understand what’s going on. He’s all the more grateful that he now has someone by his side whom he can lean on and trust, no matter what. And his cute little moment of happy realisation and smile despite that horrible night at the end was sweet. All the harsher that we’ll close the episode on the shocking note of Lim’s paralysis.
Speaking of Lim’s paralysis… At this point, we don’t really know what that means. Is it permanent? Is it temporary? Will she be able to fully recover? Was it caused by the stab wounds? Was it caused by the surgery that Shaun pushed for?
Thanks to Ryzza, I was made aware that there is precedent that stab wounds can cause paraplegia. It seems likely that it’s the case here, and I’m sure we’ll learn all about that in the next episode or two.
The more fascinating question is what that means for Shaun. The ominous pan on his face at the end and him seeking eye contact with Lim makes me think that there will be interesting things to come, that possibly Shaun may get blamed for the paralysis, perhaps even legal consequences like I mentioned above.
The way I assume this will pan out is that the paralysis is temporary, but that the healing process will take a long time (months/years?), and Lim will be impaired for a while. If that means a wheelchair, crutches, leg supports, a walker, a cane… who knows?
Keep in mind that one of the new residents, Danica, is an above-the-knee amputee. That could also bring a lot of interesting dynamics and perhaps parallels and bonding opportunities for her and Lim. I’m excited at that prospect, or whatever they have in store for this whole storyline.
Favourite Lines and Dialogue
Lea: Do you feel married?
Shaun: What does married feel like?
Lea: I don’t know. Different. Amazing. More to-have-and-to-holding.
Shaun: I feel like I love you more than I have ever loved anybody and I’m very happy. So the same as before.
Aw, Shaunie. Stop being adorable, okay?
Lea: Is there anything I can do?
Shaun: You can be our circulating nurse.
Lea: I meant more like get people coffee, but…
Haha, I feel you, Lea. But of course she came through and did and excellent job.
Lea: I’m here if you need me.
Shaun: Thank you. I don’t.
Classic Shaun. D’oh. Thank goodness Lea knows how to run that through the Shaun filter.
Asher: My dad’s dying. He has a couple of weeks. At most. Cancer. I just put him a plane back to New York. What went wrong between us will never get fixed. We’re out of time. There’s still time for you.
It was a beautiful plea made by Asher, and he knew how to get through to Owen. Really moving.
Steve: It’s a hell of a wedding day, Shaun.
Cause holy shit, yes, it is! Definitely a day they’ll never forget. I’m trying to decide whether that’s a good thing or not, but at least both Lim and Dalisay survived. If either of them hadn’t, that would have been hard to stomach in the long run if something like that is tied to your wedding…
Steve: You can do this, you can save your friend. You just need to look.
This is Shaun’s mind trying to piece it all together. The attempt at absolving himself of the guilt, paired with a gently urging but reassuring Lea trying to tell him to focus and come back to reality. Everyone’s reaching out a helping hand, and Shaun finds his way to taking it and accepting to be pulled up.
Shaun: I saw Steve earlier. He told me it wasn’t my fault he died.
Lea: Do you believe him?
Shaun: I’m… trying.
I loved how they managed in so few words to really tackle that sea of guilt Shaun is swimming in, to convey that he isn’t quite ready to accept total forgiveness, but that the healing process has made a big leap forward after this night.
Shaun: Tonight was very hard. I would not have been able to help Dr. Lim if you hadn’t shown me the surgery. As much as I loved you before, I love you even more now. I am so happy you are my wife.
Aw, Shaun, stop it. He never needs many words to say the really big things. And Lea immediately knows how to interpret that as the biggest confession of true love. Their embrace afterwards is sweet and gives me life. I love the two of them so much.
Morgan: I thought I was gonna die today, and I didn’t think about that job. I thought about you.
That’s pretty big for Morgan, but apparently it wasn’t enough for Alex. I dunno, I didn’t see this coming, but I’m curious where it’s headed.
As it usually happens with the weekly procedural format, there’s never enough time to cover everything in great detail. I didn’t feel there was much missing during the episode, but there’s a number of things that I’d love to see explored that should happen afterwards, which I don’t actually think we’ll see since it appears that we’ll have the inter-season time jump into fall 2022 between 6×01 and 6×02, skipping over the immediate aftermath of Afterparty.
Glassman and Shaun talking about whether Shaun’s renegade decision about how to approach Lim’s liver surgery was appropriate, at the very least a verbal repetition of the reprimand that he should have consulted with an attending or senior physician before changing the surgical approach. Irrespective of the outcome, he was still a resident at the time and defied a direct order.
Jerome and Shaun talking about Shaun’s forceful extraction from the OR. I’m sure Jerome felt terrible having to manhandle a distraught and very disinclined Shaun, seeing how Shaun repeatedly yelled at him not to touch him. The way they played it, Jerome was obviously more concerned with Lim’s health than Shaun’s mental state, but I think he would want to apologise afterwards.
How would Shaun take that? Would he be resentful because he feels strongly about not wanting to be touched? Would he, in hindsight, see that it was the right call, or at the very least that getting him out of the OR was ultimately helpful?
Shaun and Lea talking about what happened when they get home (or in the days to follow). It’s pretty clear Shaun still carries residual guilt for Steve’s death, and he verbalised that to Lea. The whole situation was super stressful, and Shaun didn’t exactly get through it with ease – he told Lea that it was “very hard” for him (in Shaun speak, that pretty much means awful and harrowing).
Lea was also right there in the OR through most of it. Not only did she first-hand see him in his professional element for the first time, she also saw him totally fall apart (again) and gave her best to try and help him. I think that would warrant an intimate discussion when they’re both a little more level-headed and not fuelled by adrenaline and anxiety – not just to explore Shaun’s experience but also Lea’s, as I’m sure it’s scary to see your loved one in such distress with very little ability to intervene. I don’t think we’ll see that addressed on the show beyond the dialogue we’ve been given in this episode.
A conversation between the surgeons about the morality of the decision to use the bypass machine on Owen rather than on Lim. Both Shaun and Glassman strongly pushed for using the bypass on Lim despite the fact that Owen needed it more urgently. Of course these were extremely extenuating circumstances, but there’s a reason why doctors shouldn’t be treating patients they are emotionally attached to. Andrews made the right call to let the machine go to Owen, and despite the fact that we all understand why Shaun and Glassman said what they said at the time, they should at the very least be prompted to think about the implications.
Season 6 Full Steam Ahead
TV Line published the first part of an interview with co-showrunner Liz Friedman that I already quoted a few things from earlier. Take a look for more details if you like, they do hint at a few more aspects that are to come, but in a very vague, more general sense.
Poor Freddie also had to get on the press junket treadmill before episode 6×01 aired, it seems. There’s a bunch of 5 minute-ish morning show type interviews with him doing promotion for the season premiere where he basically always says the same thing, but if you listen closely, there’s a few interesting tidbits to extract:
Shaun and Lea are going to be talking about whether they want to start a family. He talks about it as a “big decision to be made” that’s going to be a challenge for them. I don’t think it comes as a big surprise that the show would tackle this again after the loss of their child in season 4. Freddie also talks about Shaun and Lea potentially moving into a new home. Are we gonna see a white picket fence Murphy house?
There’s talk about this year being a big transformational year for Shaun. As an attending, he’s going to have real responsibility, he’s gonna be a boss with his own office, he’s going to have to mentor junior residents and delegate some of his work, which will also be a challenge for him. Also no big surprise with what we already knew, and I’m very much looking forward to that new dynamic and his interactions with the two Dannies.
Freddie said he will be directing again this season. Yay! That’s exciting.
Since I try to avoid knowing details about upcoming episodes, I have no idea what’s in store for 6×02 beyond the fact that we’ll be seeing the inter-season time jump now. I can only assume we’ll see Shaun either applying for the attending position or already having been promoted into it.
I can also only guess that we’ll see how Lim has fared after the shocking reveal about the paralysis. I’m sure we’ll discover if she’s in a wheelchair or if she managed to recover some function and can walk again and how that’s going to affect her work and her life.
I hope to see the two Dannies being introduced – i.e. the two new junior residents Daniel and Danica. I’m curious to meet them and see what they’re like as actual persons. Well, actual TV character persons.
And then I’m kinda apprehensive about all the “big fallout” that they keep talking about. Is Shaun in some way responsible for Lim’s paralysis? Is he going to be sued? Is there going to be friction or even a wall between him and Lim now? What is with the whole rift between Shaun and Glassman that they keep hinting at? Am I going to hate it as much as I think I will? Many questions that I think we’ll see answered or at least partially answered on Monday. Can’t wait!
Best Shaun Muffin Face
New section, who dis? Yes, I know this is silly, but Freddie is just so great at the Shaun Muffin Faces. I think it’s worth a tribute. It’ll be fun. Indulge me, ok? 🙂
Although I will say the intensity of this episode really didn’t give us a lot of Shaun muffin faces, so perhaps we should go with most gut-wrenching Shaun expression for Afterparty, cause there sure were a lot of those. Freddie just knocks it out of the park every time.
I think the cast was super excited that the show was back on the air, so there was an exuberance of bts photo sharing, mostly on Instagram. I’m sure I didn’t catch all of them, but here’s a few favourites from the various cast member social media accounts (mostly Bria, Christina and Paige).
Wow. I don’t have much to add, other than to say, this episode is in my top 5 of all time. Everything just worked: the writing, directing, camera work, music, and of course strong acting all around. Freddie always amazes me with his range; he aces the “big” scenes, but he also is master of the subtle, conveying a lot with slightly widened eyes or a tilt of the head…the kind of thing if you blink you miss it.
In the scene where Jerome bodily carried a wildly struggling Shaun out of the OR, I actually feel sorry for Jerome, or rather, for Giacomo Baessato. Apparently Freddie likes realism; he’s said so several times — so that struggle was probably very real. Yes, Giacomo obviously outweighs Freddie, but Freddie is athletic and no wimp so Giacomo probably had a time holding him.
Correct me if I’m wrong, but when Shaun told Lea that he saw Steve; actually talked to him, was that the first time he told anyone about his visions and chats with his brother?
As I write this, it’s just 30 minutes away from the next episode, so gotta go get ready. Beer and popcorn don’t open themselves. Thanks for a great recap!
Yes, I can only agree that the episode definitely deserves to go in the top 5 of all TGD episodes. I also really loved it. Freddie definitely carried this one, and I’m with you on that he has a huge range. The small nuances are always super special, and I love those blink-and-you’ll-miss-it moments as much as the big, obvious ones.
As for the scene with Jerome/Giacomo, I’d like to think that they talk about the logistics and the setup of scenes beforehand. I think Freddie is big on making sure that everyone is comfortable with what they’re doing and that things feel realistic and tangible. I would like to believe that he and Giacomo talked about how they wanted to play this so that it would translate to viewers, which I think it really did. But yeah, carrying a scrawny squirming Freddie/Shaun out of the OR must have been a struggle. lol That whole scene where he later screamed at him not to touch him hit hard. Which is why I’m sad we never got to see any aftertalk about it between Shaun and Jerome.
I think you’re right about the fact that Shaun has never told anyone about how he still has imaginary discussions with Steve sometimes. I think it did speak very much to how much he trusts Lea and how much he treasures being able to confide in her.
God, this episode felt like such a gem, particularly after the disaster that was 6×02. I didn’t like “Change of Perspective” at all. And I will be ranting about it in my next recap. Brace yourselves!