After what I thought was a bunch of rather meh episodes in 2023, this one was definitely a very pleasant surprise that gave me all the smiles and some of the feels. Everything about this episode hit the right marks, and I have two thumbs up for Team Moran, Renaud and Moline. 👍🏼👍🏼
Written by Thomas L. Moran & David Renaud
Directed by Rebecca Moline
Original airdate 06 Feb 2023
Patient #1 – Bob Wachowski
Audrey Lim, Asher Wolke, Daniel Perez
Progressive right-sided heart failure
- Bob is Lim’s patient whom she’s been treating for a number of years
- He urgently needs a heart transplant due to progressive heart failure but since none is currently available, Lim suggests a very risky surgical ventricular reconstruction (SVR) that she presents as the only remaining option to Bob
- Imaging shows that there is almost no viable cardiac tissue, which would be needed for the SRV surgery, but Lim isn’t overly concerned and says she still wants to go ahead since there may be more healthy tissue than they can see on the imaging
- Asher isn’t convinced the surgery has good enough survival chances, so he suggests alternatives to Lim, but she shoots all his ideas down as non-viable options for Bob
- Further tests reveal that Bob also has a defective heart valve, so now they need to add a valve repair to the reconstruction surgery
- The next morning they start with the valve replacement, which goes well, but there isn’t enough viable heart tissue for the reconstruction due to spontaneous apoptosis (cell death)
- Brainstorming possible solutions, Asher suggests to do what they normally do in babies with Ebstein’s anomaly: bypass the defective right ventricle and divert deoxygenated blood back to the lungs
- Lim thinks that could actually work, and it would buy Bob the time he needs
- They go ahead with Asher’s suggested approach and Bob recovers enough to have a few more years to wait for a matching donor heart
Patient #2 – Kelli Manning
Shaun Murphy, Jordan Allen
Initially a suspected intra-abdominal cyst, later diagnosed as invasive hydatidiform mole
- Kelli was admitted to the hospital as a consult to follow up on a suspected cyst in her abdomen
- Shaun orders a needle biopsy and a CT to confirm
- The CT reveals that the growth is not a cyst but an invasive hydatidiform mole, a growth that forms inside the uterus at the beginning of a pregnancy and would have resulted from a mutated fertilised egg
- With Kelli being only 13 years old, this is now a case of statutory rape, even if the sex she had was consensual
- As they wait to operate the next morning, Kelli’s blood pressure skyrockets, Shaun suspects she could have a stroke
- Kelli goes into critical bradycardia which they manage to get under control with medication
- The next morning, Shaun and Jordan perform the procedure to remove the growth, but Kelli’s blood pressure drops quickly after the tumour has been evacuated – she goes into shock and eventually into flatline
- Shaun visualises what may be wrong and suspects a thinning of the uterine wall caused a perforation and internal bleeding
- They do an impromptu laparotomy that stops the bleeding
- Kelli wakes up from the surgery and seems to be doing as well as expected
- Shaun tells her and her boyfriend that the trauma from her uterine surgery was severe and she needs to abstain from having sex for at least six months while she recovers
The Shaun & Lea Family Journey
As Shaun and Lea are having breakfast at the hospital cafeteria (pancakes, of course), Dr. Glassman drops in. Shaun’s “good morning” greeting is rebuked since there’s nothing good about this morning. Glassman’s house has a termite problem and it has to be tented.
For those who don’t know what that means, there’s literally a tent being erected around the house and the house is then flooded with a gas that’s toxic to termites and will kill them. Shaun mentions it in the conversation when he talks about how Vikane gas doesn’t damage clothes but it affects food. They also call this process fumigation.
Lea asks where Glassman is gonna sleep for the time being, and Shaun spontaneously invites him to stay in their guest room. When Lea insists that it won’t be an intrusion, Glassman reluctantly agrees to that arrangement.
After a bit of consideration, Lea has to admit to Jordan that maybe she was a little too adamant to agree to Grumpy Glassy staying with them. Having him sleep in the next room, sharing a bathroom and living space suddenly seems like it will be an intrusion after all. It kinda sounded like it would be a recipe for disaster, didn’t it?
It turns out that it’s not as much of a disaster as anticipated. Glassman is actually a very organized and easy to accommodate house guest. His cooking is fantastic and he seems to enjoy it. He’s very tidy and kind of meticulous with how to plan and arrange chores and personal activities, down the minute how long it takes to sauté the vegetables. You know, kinda like someone we know and love…
We already learned in the past (in Potluck in season 5) that Shaun doesn’t eat garlic, presumably because he doesn’t like the taste. Now we learn that Lea seems to be allergic to it. Garlic-free zone in the Murphylallo household.
The next morning, there’s another positive surprise. Glassman has already left the house when Lea gets up. Shaun is on his way into the shower after his morning exercise routine and he tells Lea that Not So Grumpy Glassy already made coffee and bought croissants. In that case, maybe they could use the extra time they don’t have to spend on making breakfast for a mutual shower and some 🍑 🍆 🚿.
That evening, they find out that Glassman is not only passionate about breakfast, he also treats Shaun and Lea to another home-cooked meal of amazingly delicious fried salmon with rice and broccoli. He divulges that the secret is fresh thyme and a little bit of lemon zest, which Shaun makes sure to document in his notebook. Before they can dig in, Glassman gets a call that there’s more repairs to be done to the house—the roof rafters also have to be replaced.
Lea asks why he doesn’t just buy a new house, seeing how this one is now getting to the stage where he needs to replace and refurbish and repair things at regular intervals, but selling the house isn’t an option. There are lots of memories attached to it, Glassman shares, since it was the home that Maddie grew up in—Halloween events, birthday parties, and Maddie coming down the stairs in her prom dress. After hearing that, Lea knows he can never sell that house, to which Glassman almost tearfully agrees.
Hm, funny that he was overly ready to “sell that house” when he was about to move to Montana in early season 5… Were all those bittersweet memories not that important at the time?
We shall mention that Lea knows Shaun makes it a habit to leave his bathrobe hanging on the outside of the bathroom door so that it doesn’t get moist from the steamy air. An important detail, because the next morning, Lea gets up and sees Shaun’s bathrobe hanging on the door with breakfast already on the table again, so she goes into the bathroom to de-robe herself and sneak into the shower. Only it’s not Shaun she finds there, but a shower gel lathered Glassman who borrowed one of Shaun’s bathrobes. Eep! 😱
When Lea discusses that whole embarrassing disaster with Jordan, she also mentions how much Glassman and Shaun seem to be alike—what with all the meticulous details and having everything in a certain order and basically both being super neat freaks. When Jordan talks about the apple not falling too far from the tree, Lea aptly surmises that somehow in this case, Shaun is actually the tree.
Back in the Murphylallo apartment that same night, with his house now ready to move back into, Glassman has his suitcases packed, ready to go home. He also invites Lea and Shaun over some time for another round of salmon out of his Viking oven. As he’s about the leave, he gets another phone call. A neighbour is calling, and it looks like he has more bad news for Glassman. Uh oh, what is it now?
There’s a fun callback to an old episode, 2×14 Faces, and it’s a little bit of an easter egg. Shaun refers to a neighbour who stole Glassman’s lawnmower, which seems to have been a part of the Faces episode script at some point, but ended up on the cutting room floor.
There’s a reference in a deleted scene from Faces on the season 2 DVDs, where Shaun and Glassman mention settling scores and a neighbour two houses over who borrowed Glassman’s lawnmower. You can also see a lawnmower prominently displayed inside Glassman’s house when Shaun and Glassman get back after their road trip to find Robin Demayne. So I think we’re to assume that there was some neighbourhood feud going on with a neighbour stealing Glassman’s lawnmower, which Shaun now hearkens back to.
Turns out the bad news is about the worst news you can get about your house. Shaun, Lea and Glassman drive there right away, and all they can do is just stand and watch helplessly while the beautiful house is completely ablaze. A firefighter explains the exterminators disconnected all the smoke detectors and an electrical fire in the kitchen ran rampant and spread through the whole house before they could do anything about it. So much for never selling that house…
Lim and the Probies
This time around, the two probies Asher and Danny are with Lim – the chief herself feels it’s her duty to ensure she takes the problem children under her wing. Their medical case is a long-time patient of Lim’s with progressive heart failure, and the surgery she proposes to save Bob’s life is incredibly risky with many uncertainty factors involved. Asher is enthusiastic at first to get to be part of a complex surgical case with the chief herself, and Lim thinks his enthusiasm may just be feigned to get off probation early.
However, after Asher looks at a few reviews of patients where Lim’s suggested surgery has been tried, he becomes much less enthusiastic. There hasn’t been a single successful case in the past for a defect similar to Bob’s that he’s found, and he thinks Lim is too personally involved and too hellbent on saving Bob’s life to accept that this surgery is not a great option for Bob.
This, however, is a dilemma. Both Asher and Danny are on probation and very junior to Lim. Is it their place to tell the Chief of Surgery how to treat her patients? How do you juggle the obligation of having your patient’s best interest at heart but also not undermine your boss’s authority?
Asher keeps pushing the envelope of challenging Lim and her approach, even tries to raise in front of the patient that there may be alternatives to what Lim is suggesting, but Lim is very adamant that her approach is the only option Bob has left, even if it’s risky.
Danny is very cautious and restrained on the matter. He has everything to lose and a reputation to re-earn. He can’t go and openly oppose the Chief of Surgery, seeing how he’s already come close to losing one of the most important things he has to live for. So Danny bows down while Asher keeps pushing.
Asher and Danny talk about all of this in the locker room after work, because Danny isn’t cool with the fact that Asher put him on the spot with Lim when Asher wanted Danny to back him up but Danny was not inclined to do so.
They’re both on probation, but it means different things for them. Asher’s was a slap on the wrist for colouring outside the lines, but Danny has everything to prove that he’s not gonna mess up again, that he’s actually a reliable surgeon who can be trusted with responsibility and patient care. “I’m in a holding pattern while everybody watches if I’m actually a surgeon or a junkie.”
Ultimately, Asher is the who ends up being proven right, because when they repair Bob’s valve and then start on the reconstruction surgery, they find that there’s not enough healthy tissue to execute Lim’s plan. They are now pressed both for time and a new solution, otherwise Bob will not make it out of this alive.
Asher has an inspired idea to try a different approach that will buy Bob a few years until they can find him a new heart, and Lim later praises him for the good work when the surgery works and gives Bob those few years he really needs. Asher not getting any time shaved off of his probation, however.
Andrews drops by Lim’s office later to tell her she did a good job with the two probationers, which I think Lim takes with a grain of salt, seeing how Andrews didn’t really see the full extent of what was going on.
With Bob saved and mixed feelings left behind, Danny makes a phone call and asks to meet whoever is at the other end—we can guess it’s either his sponsor or his dealer. Turns out it’s the latter, who offers Danny “a little bit o’ white” in exchange for a good amount of money. Danny wavers, obviously struggling with the decision.
Thankfully, this times he decides against it, or we have to hope that he did, because he’s sitting in the pews of the church across the street, listening to the gospel choir rehearsing by the altar while he holds on to the pendant around his neck. Jordan finds him there, late for the choir rehearsal.
Clearly, she can see he’s struggling, his eyes are a little red-rimmed and teary. She decides to sit with him, even though he tells her he’s okay, and together they quietly listen to the choir’s rendition of the Talking Heads’ “This Must Be the Place”.
Jordan and Shaun’s patient is ethically and morally difficult for Jordan. It’s a 13-year-old girl with a tumour that can only have originated from a fertilized egg, meaning that their patient must have had sex at this young age.
Jordan gapes when the girl’s mother calmly tells Shaun and Jordan that she knows her daughter has been having sex, and that she’s not concerned. Her daughter’s boyfriend is the same age, she has made sure that they are on birth control and practice safe sex, and she much prefers this to her daughter sneaking around behind her back.
While Shaun has no issue with this, Jordan is appalled. At 13, this is technically considered statutory rape, even if the sex was consensual. A child this age should be enjoying her innocence and her childhood, she should not be living out her sexuality.
It’s somewhat frustrating to Jordan that no one other than her seems to have any problem with this. Shaun says there’s no legal ground to report this to the police or Child Protective Services and makes it clear to Jordan that he, as the attending on the case, is the authority figure on this. The mother is fine with it as well. There is very little to be done.
It also sparks a conversation between Lea and Jordan about sex as such. While Lea is still basking in a serotonin high from the yummy croissant breakfast and unplanned shower sex as the beginning to her day, Jordan admits to Lea that she hasn’t had sex in years and that she intends not to have sex again before marriage. To Jordan, sex is not a fun part of life to be enjoyed casually. In fact, it makes her feel more alienated from God, which in turn makes her feel bad about herself.
Lea is a tad judgmental about it, tells Jordan that that seems extreme and also a little sad. And of course that’s hurtful. Lea, however, apologises to Jordan later. She didn’t mean to demean Jordan’s life choices. It’s her decision how and when to enjoy and live out her sex life. Jordan kindly accepts the apology, and perhaps that’s a topic we’ll revisit in a later episode.
Morgan has another appointment with her fertility specialist and she pushes to try another round of embryo implantation. Her doctor says it’s too soon, but Morgan wants to move ahead as quickly as possible. She really wants to get pregnant.
Things gets more complicated when Andrews approaches Morgan about a new and really good job opportunity opening up at St. Bon’s. Andrews has just signed a contract with a Contract Research Organisation to open up a clinical trial hub at St. Bonaventure where they will run several clinical studies for this CRO. And he’s looking for a person to manage the partnership and become Principal Investigator on all of the trials. Of course he thought of Morgan as the perfect person for the job.
Morgan tells Andrews she want to think about it, seeing how that sounds like a very demanding job when she had just made the decision to prioritise her desire to be a mother over the desire to advance her career.
During the day, Morgan runs into Alex who has a day off but had to drop in to pick up tickets to Young the Giant (a band, apparently) that he wants to see with Kellan that night. Morgan takes the opportunity to ask him for his opinion on whether to take the job offer or not.
Alex shares with her that, in hindsight, he wishes he hadn’t missed so many of the important and often very memorable moments in Kellan’s life, such as school plays, baseball games or camping trips. Morgan already has a great job that can accommodate motherhood, and she should be happy with what she has and focus on being a parent. Maybe not what Morgan wanted to hear, but she values Alex’s insights.
When she runs the job offer by Lim, Lim’s advice is to decide what is most important to Morgan and then commit fully to that. Morgan probably already knows what’s most important to her, so this is strike two for not taking the job offer.
Morgan’s epiphany of sorts comes when she speaks openly to Andrews about it. She tells him that she’s flattered he offered her the job, but that she really wants to prioritise motherhood right now, and she doesn’t think that would allow her to also take on a demanding new job at the same time.
What Andrews shares with her is that he knows where Morgan is coming from, because his mother had just that demanding job that had her always on the phone or always being somewhere, but he also remembers his childhood fondly, because his mother was always there when it mattered, and to this day he still consults with her on difficult decisions. “There’s more to being a great mom than parent-teacher conferences.”
Morgan finally decides to take the job, and we see her shaking hands with the executives to introduce herself and, together with Andrews, go over their plans.
Things to Further Dissect
Burning Down The House
Interestingly, I totally didn’t see the ending of the episode coming, when probably I should have. I’m not always the most clever of people when it comes to putting two and two together in terms of story prediction. Then again, I also hadn’t seen any photos or behind-the-scenes material that might have suggested this early, and I much prefer it that way.
In fact, when Lea and Glassman started talking about all the memories of Maddie that are tied to the house, I somehow thought they might offer to buy the house from him so that he still has visiting rights and it stays in the family. Obviously what actually happened was the exact opposite, and now he’s forced to bury all those memories once and for all. Quite a drastic 360° there. (Not quite 365° but, you know…)
If we think back to The Good Boy, Glassman was also recounting a lot of memories of Maddie there to Lea. It’s possibly a little bit of a setup of Glassman becoming a grandfather, of him being pushed in the direction of relinquishing his old life he may have been stuck in a little bit and accept that new chapters are still to come, that he has a lot of love still to find in the here and now – be it romantic or otherwise.
This now also begs the question of what’s gonna happen next. Is Glassman going to buy a new house for himself, maybe downsize a little? Of course another possibility could be that he teams up with Shaun and Lea and they try to find a property together that suits their needs.
No, I’m not suggesting that Shaun and Lea move in with Glassman to share the same living space. But there are surely houses where you can have two separate fully equipped units that don’t necessitate being around each other if you don’t want to, but that can offer being close to each other when you’re so inclined. Could be a great way to have Glassman more involved in seeing his grandkid(s) grow up.
That’s just one option, of course. It’s probably more likely he’ll just buy a smaller house somewhere and Shaun and Lea will eventually do the same for themselves.
The Apple and the Tree
When Lea talks to Jordan about Glassman and Shaun having a lot of the same habits and idiosyncrasies, they use the metaphor of the apple not falling far from the tree, and Lea mentions that she thinks somehow in this case Shaun is actually the tree.
Fans have long waited for some kind of confirmation that Shaun lived with Glassman for an extended period of time, which was hinted at here and there in the past. During the cancer recovery arc in season 2, for example, Shaun knew certain more intimate details about Glassman’s habits, such as how long it takes him on average to shower.
There are more indicators now in 365 Degrees that solidify the assumption that Shaun must have lived with Glassman for a longer amount of time, presumably in his later teen years after he got shuffled around the foster system for a while. It would certainly explain why Glassman has a predilection to keep things in their set place, because Shaun would have drilled that into him, like apparently, by the state of their always meticulous looking apartment, it has also rubbed off on Lea.
Not necessarily connected but somewhat related is that I thought the subtle hints here and there how much of a love sponge Shaun really is were kinda cute. He was so excited when there was an opportunity for Glassman to come stay with them for a few days. Kinda like, “Aw yis, I can have Daddy close again!” He also got proudly excited when he could tell Lea how awesome Daddy was that he got them croissants, he even underlined it with some up and down bobbing, there in the bathroom doorway. Aww.
After all the rejection he’s experienced as a child, Shaun has made so many friends since he came to San Jose, and I think she still soaks up all the love he can get whenever he finds it, be it platonic love from friends like Claire or Park or Lim, or deep romantic or familial love from Lea or Glassman. It’s so heart-warming and makes me happy.
Glassy, the Foodie
Not sure if the writers truly paid attention to consistency this time around or if this was more of a happy coincidence, but it’s great to see that Glassman can apparently cook very well and also enjoys it. Daniela made me aware of this: Back in episode 1×03 Oliver, there was a scene between Andrews and Glassman where Andrews berated Glassman for shunning the cafeteria food and Glassman said he’s unfortunately not allowed in the cafeteria kitchen. So it seems like Glassman has always been a foodie.
There was another food reference with Lea apparently being allergic to garlic. Which, as I mentioned above, is curious since Shaun also doesn’t eat garlic. And remember the anecdote Lea told Morgan about the Atomic Wings incident a few years back, when Lea had diarrhoea and Shaun helped her through it with medication? Was that also garlic related, or more like a food poisoning thing? We’ll never know, but explosive diarrhoea seems to be somewhat of a Shaun & Lea theme. Hm.
Ask Me About Clinical Research
Yep, I’m that person with the “Ask me about Clinical Research” tag on their lapel. Which is why I got irrationally excited when Andrews started talking about CROs and PIs as if everyone was supposed to be familiar with those abbreviations. Sometimes I love the show for not feeling the need to explain every little detail in lay terms when it’s not actually super relevant to the overall story.
For those of you who are interested in learning what a CRO or a PI is, I’m happy to give you a brief introduction to what Andrews and Morgan were talking about.
Clinical Research and Drug Development
Any medicine—prescribed or over-the-counter—that is accessible to the public has to go through different phases of testing to determine whether it’s safe and effective. This is first done in animals, then you go into healthy human volunteers. Healthy volunteer studies (sometimes first-in-man) are done to test safety and tolerability of different doses, often also to see how the drug is transported and processed in the human body (called pharmacokinetics or PK). If that works out okay, you go into actual patients with the disease to see if the medication is effective to treat the disease or the symptoms or can maybe even cure it.
There are names for these different phases:
- Pre-clinical (computer modelling and animal studies)
- Phase 1 (tolerability, dose-finding and PK in healthy volunteers)
- Phase 2 (proof of concept of the medication in a smaller group of patients)
- Phase 3 (safety and effectiveness in a larger group of patients)
If all of these phases come out with positive study results, the developer of the drug (called sponsor) can go to the medical authorities (like the FDA or European Medicines Agency) to submit the drug for approval.
If the drug is granted approval, it can be made publicly available, and the drug developer is also asked to run more post-approval studies in a larger number of people to catch potential rarer side effects that the initial studies might not have been able to show. Phase 2 studies are usually fairly small, maybe between 30 and 200 patients, phase 3 studies are larger and can be several hundred to over a thousand patients.
A clinical study is a way to do controlled research in a certain group of people to draw conclusions if a drug or treatment is well tolerated and effective in a certain disease or in a certain population or age group. And each and every drug out there needs to undergo clinical testing in these types of research studies.
Clinical research studies all follow very specific guidelines and have controlled environments and fixed parameters that dictate what kind of people or patients can participate and what kind of data will be generated and how the data is later analysed to find out whether the medication is well tolerated and effective. Clinical studies usually only allow a very specific group of people to be enrolled, which is determined by something called inclusion and exclusion criteria.
These criteria can be but are not limited to a certain age range, a certain diagnosis or a disease stage or state, what other diseases the participants can or cannot have at the same time, certain lab value criteria that have to be met, what other medications the participants may or may not be allowed to take at the same time, or certain risk factors that need to be avoided.
All of this is written down in a long document called the study protocol, which tells people how the study is supposed to be done, which kinds of patients can be enrolled, and how the study is structured. Studies also have a fixed number of visits at certain predetermined time points where the study doctors who run the studies locally see the study participants and examine them and do certain tests and collect data. The study protocol is kind of an instruction manual for the study, so to speak.
Traditionally, studies like this are done locally at hospitals, clinics or private practices (= study sites or study centres) with a local study team where study participants are being seen and examined in person, although these days some of this can also be done virtually over the phone or video with the help of computers or mobile apps.
The study staff at a study site typically consists of one or more of the following people:
- Principal investigator (PI):
The person who is responsible for the study at their study centre and has to sign off on all the study data and procedures. A medical degree is required for this position. Each study site needs one PI and there can’t be more than one PI per study and study site.
- Sub-investigator (sub-I):
A person with a medical degree whom the PI can delegate certain tasks to, including seeing patients at the study visits, collecting data, doing exams and running tests, etc. In a large hospital, the setting is often that the PI is the head of the department or someone higher in the hierarchy who only has oversight, and the actual medical scut work on the studies is done by the sub-Is who may be residents or someone lower in the food chain.
- Study nurse (SN):
Someone with medical training who helps out with the medical side of things that doesn’t require a medical degree. This could be running tests like ECGs or blood pressure, taking blood samples, talking to patients about data collection like questionnaires and medical diaries, etc.
- Study coordinator (SC):
Someone who manages the more administrative things related to the study who doesn’t necessarily need a medical degree or medical training. This could be someone doing the data entry, managing the patient scheduling and the correspondence related to the study, etc.
Someone who manages the study medication at the study site and makes sure it is documented, stored, handled and dispensed adequately.
Now, we haven’t talked about CROs yet, which is also something that Andrews mentioned. When you do a clinical study, it’s important that the data that is being collected is accurate and that the patients who are enrolled actually fit the study criteria. So basically you can’t just give a study site a protocol and say: Here you go, now run with it, we’ll look at the data when you’re done.
There’s a whole machinery involved to ensure that the data that is being collected in a study is being checked and verified before it is analysed to have a certain level of reassurance that nothing fraudulent is going on or that errors fall through the cracks. There are companies who do nothing else than make sure that the operational side of the studies run smoothly, and those companies are called Contract Research Organizations (CROs).
Okay, this is perhaps a bit simplified because a lot of CROs do more than just manage studies operationally, but that’s a large part of their core business. They have project managers who ensure that the right people talk to each other, and that the people working locally do their work right and report back on what they’ve checked.
CROs have local people who drive or fly out to study sites to go there physically and check the patient files of the study participants and the study documentation to ensure its accuracy and to train the study staff at the study site. These people are often called Monitors, Clinical Research Associates (CRAs) or Clinical Site Managers (CSMs).
CROs are the go-between between the pharma company who develops and owns the medication that is being tested and the study sites, because often pharma companies don’t have enough people to monitor a clinical study worldwide and to send people to each and every study site. So they hire a CRO who will do that for them because the CRO has the manpower and the expertise.
I could probably delve into this way deeper, but this should hopefully give you a high-level overview of how clinical studies are usually run, and explain some of what Andrews was talking about.
In essence, when Andrews offered Morgan the position as principal investigator, he was looking for someone with a medical degree who could oversee the studies they are planning to run at St. Bonaventure through this Clinical Research Organization. Of course we don’t know the extent of the deal Andrews made, but it sounded like it was some kind of mutual agreement that St. Bonaventure would act as a preferred study site for studies that this CRO is managing that St. Bonaventure is likely to be seeing suitable patients for.
I think Andrews’ plan is to open a clinical trial unit or trial hub at the hospital that is solely and centrally responsible for managing and organizing all the clinical studies run at the hospital rather than every department managing their clinical studies separately. This is not unusual, and many large hospitals, especially the academic centres, often have such trial units.
Morgan is supposed to be spearheading this new St. Bon’s trial unit, including acting as principal investigator on the studies, thus not only project managing the trial unit but also ensuring that the study data that is generated by the study teams is accurate and correctly collected and documented.
The meeting we saw at the end of the episode was likely Morgan and Andrews talking to representatives of the CRO to discuss how this new trial unit collaboration is supposed to look like and what both parties expect to get out of the arrangement and what will be needed from both sides to get everything up and running.
This would be a demanding job for sure, especially during the initial phase of getting everything set up, which is why I get that Morgan was reluctant to take this on. On the other hand, once she has a well oiled machinery running, her working times should be a lot more regulated than shift work at the clinic or in internal medicine. A trial unit manager and PI job would be mostly desk work and during-the-day clinician work, so more like a 9-to-5 job than being a shift-working hospital physician. So in terms of being a working mother, I think that should suit Morgan better than what she’s doing right now.
Let’s talk about Jordan and her attitude towards underage sex. I will admit that, unlike other members of the fandom, I didn’t have a very strong reaction or opinion on this particular topic. I’m definitely more on Shaun’s and Kelli’s mother’s side with this. I definitely think it’s better for a young girl to practice sex safely, responsibly and well educated than do it in secret with the knowledge that she’s going to be punished if she gets caught.
There’s been lot of online discussion about whether it was right or wrong what they presented in the episode, and whether Jordan’s attitude was too judgmental or too narrow-minded. There’s no good answer to this, because there’s merit to both sides, and I don’t think the writers were trying to push any one answer on the viewers. In the end it’s still up to the viewer how to feel about the situation and decide for themselves what they would have done in that situation.
Even though I don’t agree with Jordan’s stance, I can see where she’s coming from. With her strong devotion to Christianity and a belief system where she sees underage sex as statutory rape, that’s her world view that she chooses to live by. But I also think you need to consider each and every person as an individual.
Surely, there are 13-year-old teenagers who are more mature and more responsible than others. You could have a 13-year-old who is still very naïve and dependent on their parents, but you can also have a 13-year-old who is more educated and mature and responsible. It seems that Kelli fit more in the latter category, and perhaps in those cases this whole scenario is perfectly fine. So I think you really need to evaluate the individual situation rather than automatically report the case to social services. Which I’m actually glad they handled that way through Shaun’s attending authority.
Danny and the Drugs
We’re along for the ride of Danny’s ongoing struggles with drug addiction, and another almost-relapse when he seeks contact and actually meets with his dealer, the only compounding factor being the gospel choir from the nearby church that makes him change his mind.
I’ve seen comments that said that they were surprised that Danny got so close to relapsing, what with currently being on probation and the residency he has at stake. Not that I have personal experience, but I don’t think heroin addiction works like that. If it were that easy to just get out of the spiral because you know you have a lot to lose, we wouldn’t be seeing the problems we have today with drug and opioid addiction. There must be some disconnect in the brain that makes an addict crave that high despite all rational thought telling them not to go there.
I’m sure most people went like, “Don’t do it, Danny!” when he was meeting with his dealer. I sure did. And of course there’s that voice that says, “How dare you throw away what you have?” along with it. It’ll probably be a thread that we’ll see being woven throughout the rest of the season in one way or another.
The thing about Danny, for me, is that I wish I was more invested in him and his personal journey. I like the guy, and I’m usually a sucker for those tragic underdog types who struggle and who give us all the angst and the emotional intensity. I don’t know what it is that I’m lacking a connection with Danny’s character. I’m pretty sure it’s not Brandon Larracuente, he seems like a fine actor who plays the role well. Or maybe it is, but just from a purely visual attraction aspect, because he’s just totally not my type. Which is also not at all Brandon’s fault.
It could also be the age-old problem of the large ensemble cast and there not being enough time to really dig into these characters’ lives as much as they should. So far we’re only really seen him work on medical cases, with the addiction aspect mentioned as an aside in conversations with Jordan.
We don’t know anything about Danny as a person other than that he grew up on a farm, loves combines and graduated from opioid to heroin addiction after an acute injury – all of which was provided to us as cursory retold facts with nothing to back it up visually (e.g. in flashbacks). It would have worked so much better and have us more invested if we were actually given the chance to get to know the person behind the pretty farm boy, if we had been shown first-hand what Danny had been and is still going through.
All things considered, however, I’m still interested in seeing where his path leads him and if he’ll make it through the residency. I’m sure there’s more stories to be told there, so I’ll try to keep an open mind.
Audrey “I’m The Chief” Lim
I know I’m not the only one who was repeatedly raising eyebrows at the weird storyline with Lim and the probies. What was that all about? It doesn’t seem like Lim to be the stubborn and narrow-minded authoritarian to her subordinates. It seemed a little out of character, for sure. There was also more eyebrow raising at the end of the episode as to what the moral of that story was supposed to be.
Was it to show us that even Lim can have her judgment clouded by being a little too closely attached to a long-standing patient you’ve been treating for years and years? Was it to show us that Lim wanted to exert her position of power over the residents to draw a more distinctive line between boss and friend, in the wake of getting a little too close to Danni and then having to sever ties?
Or was it merely a shoehorned attempt of providing a springboard for the Danny vs. Asher plot and a means to get Danny into a position of blind subservience that he himself was unhappy with enough to want to seek escapism through another shot of heroin?
Weirder even, the unnecessary scene at the very end where Andrews was telling Lim that she did a good job with the probies. What did that scene serve, really? It was a puzzling 20 seconds they could have used for something else, if you ask me. But okay. I don’t write or direct or edit these episodes. (If I did, they would probably look very different, but they would likely also not draw as many viewers and have led to cancellation after episode 4 or so…) 🙂
Songs and Song Lyrics
Some people may have been wondering why the episode was called 365 Degrees, when that’s not a popular reference (that I’m aware of) and isn’t being mentioned anywhere in the episode. People smarter than me have figured out that it’s a clandestine reference to the Talking Heads song “Burning Down the House” and part of the lyrics from that song. Considering how the episode ended, that suddenly makes sense, doesn’t it?
Talking Heads lead singer David Byrne has said this about the lyrics of the song: “Burning Down the House” wasn’t a song about arson. When I wrote the lyrics in 1982, the title phrase was a metaphor for destroying something safe that entrapped you. I envisioned the song as an expression of liberation, to break free from whatever was holding you back.”
I already alluded to it further up, but if we relate that to Glassman’s situation, then that may be a powerful metaphor in saying that the old house and all those memories of Maddie were holding Glassman back. If he decides to move on and into a new house, then perhaps there’s a little more room to accept Shaun as his actual son, maybe also to open himself up for other things in his personal life. Who knows?
Wild speculative idea: What if they pair Glassman up romantically with Janet from The Good Lawyer? Could be an interesting crossover opportunity with a little bit of switching back and forth, like they are sometimes doing with Grey’s Anatomy and Station 19? Then again, it would be more poetic to just let him enjoy newfound parenthood with Shaun and Lea and grandkids on the way.
Talking about lyrics, they actually used another Talking Heads song at the end of the episode, “This Must Be The Place”, in a rendition sung by a choir. The lyrics of that one are all about home being what and where you choose it, and about finding the right person to feel at home with. Not sure who exactly this relates to, I guess it could be applied to several different characters and where they currently stand, including Glassman and Danny.
Favourite Scenes and Lines
- Shaun inviting Glassman to stay with them. He was so excited and happy and proud at the prospect to be able to help out and give back. Shaun is also wearing one of my favourite Shaun shirts here, so extra win.
- Andrews talking to Morgan about CROs and PIs, but only because that’s my personal field of expertise.
- Jordan talking about how old guys love reading presidential biographies. “Old dudes love reading about presidents. They fantasize about how they would have done it all better.” Oh Jordan, I love you!
- Glassy cooking, because I love Glassy being in his element and in a happy place.
- Shaun being excited at impending shower sex. Because Happy!Shaun is also my happy place.
- Jordan talking about sex not being the be all and end all of things and making a stand for feeling fulfilled and happy without having it. Maybe I was secretly hoping for some asexual representation, but this was good.
- Glassman sharing more memories about Maddie, because it’s always great to get more of a glimpse at our favourite characters’ pasts.
- Asher standing up for himself and fighting for his patient, particularly the locker room scene with Danny. I love Asher, and I love when he gets a little feistier. Comic relief is one thing, but there’s much more to Asher than his cute and fun side.
- The burning house scene. Not because it’s fun to see Glassman’s house burn down, but because I think it’ll propel some new things forward and be a catalyst for hopefully positive changes to come.
The only thing that I wish we could see more of is the aftermath of the fire and what it does with Glassman, which I don’t think we will actually see. I bet they will jump ahead at least to the next morning, more likely to a few days or even weeks after the fire. With all of the memories attached to the house, this has to be a huge loss and shock for Glassman. Which probably the writers want us to imagine in our headcanons rather than show us, but dammit, sometimes I just wanna be shown it!
Best Shaun Muffin Face
No Spoilers, please!
Quick reminder that I love feedback but try very hard to actively avoid any kind of spoilers for upcoming episodes. Please don’t mention any spoilers in your comments, which includes information from episode promos, stills and other official promo material. Thanks, guys!
Thank you very much for explaining the clinical research terms and abbreviations. I had to Google it on Monday and it still
wasn’t that clear for me so thank you!
You’re very welcome, I’m glad it was helpful! It’s a pretty complex business and hard to explain in a nutshell when you’ve never had anything to do with the subject.
I agree with everything you said! You know I respect your writing and love your recaps, that’s a little unusual for me.LOL
I confess I never imagined Glassy as a gourmet cook, but it makes sense when you pointed out that he said he wasn’t allowed in the Cafetaria’s kitchen. An aside: how the hell do you cook without garlic or onions???
You may be right about the accelerated timeline in the next episode (tonight!) re the house fire. It seems, at least to me, that TGD is speeding things up in general, possibly because of Lea’s pregnancy: her rapid recovery from major surgery, despite Glassman’s “a week” comment, and her rapidly expanding baby bump. I know pregnancies show differently, even in the same woman (my two certainly did) but here’s what the bump looks like to me:
Quiet and Loud: 12-13 weeks
The Good Boy: 23-24 weeks
365 Degrees: 26-28 weeks.(a viable baby)
39 Reasons: ????
Fandom has been eager for a Shea baby since Season 4 (where we were sadly disappointed) so they may be trying to fill that need sooner rather than later?
Lim and the Probies: I have a feeling her stepping in to supervise them was more because of Asher than Danny. She wasn’t angry with Danny, but she possibly still was with Asher for his role putting her in an awkward position with the incident with Danica.
Jordon and the 13 year old: I agree that she was out of line here. I really like her, but sometimes she pushes her personal beliefs a bit too hard on other people…something that always irritates me. I liked the way Shaun didn’t disagree directly with her in front of the patient and her mother as he may have done earlier in his career, but rather shut her down by firmly talking over her.
I also agree with your feelings (or lack of) about Danny. I certainly don’t dislike him like I did Danni, but I also don’t feel a connection. (He’s not my type either).