Season 6 Recap: 6×20 Blessed

Well, we were finally “blessed” with a resolution to the Glassman brain conundrum, not that I particularly love the outcome. But I like it more than what had been speculated before, so I’ll take this as a small win. Some good stuff in this episode overall. Oh, also: We’re getting a season 7!! Yay!!!! 🎉🥳🍾

The Technicalities

Written by Thomas L. Moran & Jim Adler
Directed by Gary Hawes
Original airdate 17 Apr 2023

Patient Cases

Patient #1: Eddie Richter

Treating physicians:
Marcus Andrews, Morgan Reznick, Jordan Allen, Asher Wolke

Diagnosis:
Epidermodysplasia verruciformis, small duodenal mass requiring surgery

Case notes:

• Eddie is one of Morgan’s clinic patients, she asks Andrews for a surgical consult on the duodenal mass
• Andrews orders an MRI and a biopsy to better assess the lesion
• The tests reveal the tumour has significantly damaged the bile duct, requiring surgical resection and possibly major GI reconstruction
• Andrews orders an additional octreoscan (a special type of scintigraphy with contrast medium) to confirm that Eddie’s liver, pancreas and lymph nodes aren’t involved
• Eddie starts vomiting blood and loses consciousness – the tumour has caused a severe duodenal ulcer and major haemorrhaging in his upper GI tract
• Andrews wants to solve both the GI bleed and excise the tumour in one pancreaticoduodenectomy surgery (Whipple procedure)
• The surgery goes very well, the tumour is removed and liver and pancreas are working great post-surgery
• Eddie goes into ventricular fibrillation and isn’t responding to chest compressions or epinephrine, they try to shock his heart back to sinus rhythm
• Eddie’s underlying condition contributed to forming blood clots, they run the code for a while but Eddie doesn’t survive

Patient #2: Ricky Rios

Treating physicians:
Aaron Glassman, Shaun Murphy, Daniel Perez, Jared Kalu

Diagnosis:
Multiple cerebral aneurisms

Case notes:

• Ricky is one of Glassman’s clinic patients and aspiring pro athlete, presenting for follow-up on a possible concussion from being hit in the head with a baseball two weeks ago
• An MRI reveals multiple cerebral aneurisms
• Additional tests show that one of the aneurisms is low-lying at the basilar trunk, which makes it very difficult and dangerous to clip
• Glassman wants to first clip the most complicated basilar aneurysm first, then the ipsilateral posterior communicating artery aneurysm that may rupture soon and then clip the internal carotid artery aneurysm
• Before they can start the procedure, Ricky experiences a severe thunderclap headache and double vision, indicating that the PCOM aneurysm has ruptured
• They relieve the intracranial pressure surgically and then need to decide on one of two possible treatment plans
  • Clip the two smaller aneurysms now and bypass the ruptured one, or
  • Coil embolization of the ruptured aneurysm and clip the other two aneurysms after Ricky has recovered
• Ricky decides he wants to have all the aneurysms fixed in one go, even though the risk is much higher
• During the surgery, Ricky has a brain bleed that they manage to stop and continue with the repair
• Ricky wakes up from the surgery with no noticeable aftereffects and should make a full recovery

Patient #3: Aaron Glassman

Treating physicians:
Shaun Murphy (sort of)

Diagnosis:
Transient ischaemic attack

Case notes:

• Following up on the indications of executive dysfunction in Dr. Glassman, Shaun shadows Glassman on his medical case
• Shaun observes an episode of minor memory loss and an angry outburst that could indicate a lack of impulse control, which is still rather inconclusive
• After Glassman talks to his patients about knuckleballs, Shaun re-examines Glassman’s latest brain scan again
• He concludes that the lesion showing on the scan is the result of a TIA (“mini stroke”) with an unusual visual presentation that has caused irreversible damage and is resulting in the loss of executive function

Shaun’s Journey

• Lea and Shaun have invited Glassy for a blueberry pancake breakfast, except Lea forgot to add the blueberries to the batter
• The whole breakfast isn’t just a cosy get-together, Shaun wants to discuss the elephant in the room: Glassman’s potential mental deficits
• Of course Shaun isn’t very apt at sugar-coating the whole thing, so he comes right out with the fact that he’s concerned Glassman may no longer be fit to operate on patients and that Shaun wants to notify Dr. Lim of the situation
• Glassman gets his hackles up immediately and tells Shaun in no uncertain terms that he’s gonna be super mad if Shaun talks to Lim about this
• Shaun knows he doesn’t have enough conclusive evidence, so his next plan is to gather more data through direct observation
• The direct observation comes in the form of Shaun clearing his schedule to basically shadow and babysit Glassman on his next big medical case
• Glassman of course realises what Shaun is doing, but grudgingly indulges Shaun’s antics and lets him tag along for their case that actually turns out to be more than just mildly medically interesting
• While Shaun sits in on Glassman talking to his patient, Glassman has trouble remembering a certain medical term that he should be familiar with, and Shaun quickly fills in the blank
• While they later discuss treatment approaches in the Surgeon’s Lounge, Shaun’s persistent questioning of Glassman’s tactic gets Glassman to lose his cool and yell at Shaun in front of Danny and Jared, which Shaun remarks may also be a sign of lack of impulse control
• Lea drops by Shaun’s office that night to pitch the idea of going out for meatballs at Beroni’s (Baroni’s? Barone’s?) that she has a sudden craving for despite the inevitable indigestion that will follow a few hours later
• Shaun is still stuck on his Glassman problem, so he initially rebuts Lea’s dinner plans, saying he needs to keep working while Lea eats
• The big question that Lea poses to Shaun is whether he thinks Glassman is a danger to his patients, which Shaun has to answer with no, not yet
• Lea also gently prods Shaun into realising that the Glassman problem can wait for a few hours, and it’s time for meatballs, stat!
• Lea pays for it the next day with the expected indigestion, of course, much to the chagrin of her colleagues who have to pay witness to her audible burps
• Shaun keeps observing Glassman, and when Glassman asks how he’s doing in Shaun’s eyes, Shaun tells him he hasn’t gathered enough data yet to come to any definitive conclusions
• Glassman is clearly fed up with the whole thing, but not only is Shaun still striving for the gathering of more evidence, he has also realised that it’s time to repay the kindness Glassman did for him for all these years – that it’s now time for Shaun to look out for Glassman, even if the latter doesn’t want him to
• The complex surgery that Glassman is performing together with Shaun and the residents proceeds with a hitch of a bleeding complication, but Glassman thinks quick on his feet and solves it
• When Glassman later talks to the patient about baseball and knuckleballs, Shaun has a eureka moment and has figured out what Glassman’s brain function issue is
• He then goes to Lim first to report back what he thinks is wrong with Dr. Glassman: He suffered a mini-stroke and the lesion visible in his brain scan is an unusual presentation of the permanent brain damage that it left in its wake
• Lim confirms what Shaun has suspected all along: Glassman shouldn’t be doing surgery anymore

Morgan’s Journey

• With Morgan having grown attached to Eden, the baby with Turner syndrome she saved in the last episode, Lim tells Morgan that social services is having trouble finding foster parents who are willing to take care of a baby with lifelong special needs
• Park catches Morgan changing Eden’s bandages and singing to her and asks her if she should be getting so attached since she’s gonna be discharged soon
• They find a couple who want to foster to adopt, but when they come to see Eden and Morgan tells them about Eden’s Turner syndrome, they decide against taking Eden in because of the known long-term medical issues
• Social services doesn’t have another family lined up and is asking for more time, but Morgan says no – she knows the perfect person to foster Eden: Morgan herself
• Morgan takes Eden home that night, and Alex swings by to check in and to surprise them with a mobile with jungle animals for Eden to enjoy
• When he mentions to Morgan that Eden is the perfect practice run for when her own child comes along, Morgan has already decided she won’t continue with the IVF – she wants to raise Eden as her daughter

Asher’s Journey

• Their patient Eddie with the striking skin deformations on face, hands and feet embodies all the things that are majorly triggering to Asher
• Eddie talks about how much believing in God has changed his life and how blessed he feels that he’s been given gifts to thrive personally and professionally despite his disfiguration
• At home when Asher and Jerome are cooking dinner, Asher goes on this long and impassioned tirade about how he thinks it’s stupid rather than inspiring that Eddie chooses not to have surgery on his skin growths
• He starts quoting Marx (religion being the opiate of the masses and all that) and rants about how religion has been wrongly used as a motivator or rationale to commit crimes or atrocities against humanity, and you’d have to be a complete moron not to see that that’s wrong
• Jerome tries to interject at first, then asks to change the subject, because clearly there is no reasoning here and Asher will automatically shut down any attempt at having an actual conversation about the topic
• After their patient Eddie dies, Jerome finds Asher in the surgeon’s lounge, and the latter thinks it’s sweet that Jerome wants to check on Asher, but Jerome actually wants to tell Asher that he’s meeting with friends that night and will go home to his own apartment afterwards
• Asher picks up on the underlying accusation, so he probes what’s wrong
• Jerome admits that he doesn’t want to be around Asher right now because Asher tends to become too vehemently judgmental about certain topics and then radically shuts down any attempt at a conversation about it, not even willing to hear other opinions
• As Jerome is hanging out with his three friends at a bar, Asher goes in guns blazing – he approaches their table and admits that Jerome was right, that he tends to go scorched earth in a debate because he wants to win
• Eddie’s unexpected death has shown Asher that he shouldn’t take anything for granted, that he values Jerome and his love and companionship, that he feels blessed to be in Jerome’s life and have a place where he feels he belongs
• Asher makes a quick exit before Jerome can say anything, and one of Jerome’s friends asks if Asher is really that passionate or a little insane – Jerome’s answer to that is: both

Andrews’ Journey

• After Andrews’ clash with Lim in the previous episode, he seems to suddenly be invested to… hm, spy on Lim through the residents by trying to innocently ask Asher and Jordan about how things are going in their department
• Good thing that the residents catch on and don’t indulge him
• While they treat their patient with the skin disease, Eddie, Andrews walks in on Dalisay showing photos of her watercolour paintings to Eddie, when Andrews probably didn’t even know that she had painting as a hobby
• After Eddie passes away unexpectedly, Andrews realises that life and short and he needs to try harder, so he runs after Dalisay and shares with her that he has trouble opening up to people and that he’s grown up with a mindset of seeing contentment as a sign of complacency
• He apologises (of sorts) for not respecting Dalisay, for not empathising enough with her point of view
• He wants to change, he wants to show that he values the people he cares about, so he asks her to give him another chance
• Dalisay accepts the offer and asks him to take her out to dinner on Saturday at the Filipino place

Jordan and Danny’s Journey

• While they are looking at imaging scans together, Jared asks Danny if he wants to help him and his cute friend Samira coaching troubled kids playing football (er… soccer)
• Danny isn’t interested in Jared’s friend, he says that he’s trying to get a year in recovery before he starts dating
• Danny runs into Jordan in the hospital’s chapel and apologises for the other night (their karaoke outing) and he shouldn’t have tried to give her relationship advice
• He admires her for being a strong, independent woman and tells her, “You’re everything.”
• In the locker room, Jared checks in with Danny again, and Danny has said yes to the soccer coaching
• Danny also learns that Jordan talked to Jared about him, that she made sure that Jared knew what Danny was dealing with, that she was looking out for Danny
• After Eddie passes away, Danny comes to speak with Jordan in the locker room, tells her that he’s sorry and that he’s here for Jordan if she wants to talk or wants some company
• Jordan says she’s fine, but Danny has her back if she changes her mind
• Jordan is really touched and conveys that she feels like Danny really sees her for who she is and that they could be gifts to each other
• They embrace in a comforting hug, both admitting that they want to be open to moving forward with whatever this is, but they don’t know what that might look like

Things to Further Dissect

Glassman’s Fate

Okay, finally! Finally we know what’s going on. And boy, am I glad it’s not dementia or Parkinson’s. I mean, sure, the TIA still sucks. As does the fact that he’ll likely have to give up surgery. But that doesn’t mean he’ll have to stop practicing medicine. Kinda feels like we’ve been here before, when Glassman returned to work at the clinic after his cancer treatments, but of course it’s a different matter if you voluntarily abstain from going back into the OR or if you’re forced to do so against your will.

What I’m a little puzzled about, though, is why Shaun didn’t go to Glassman with the diagnosis first and ran straight to Lim. Especially after Glassman cautioned Shaun that he would be super pissed if Shaun did that. We can only assume that this is some kind of setup to create friction between Shaun and Glassman.

As usual, there’s already wild speculations running rampant in the fandom as to what all this means. This ranges from people still being convinced that Glassman is going to die in the season finale (such as having another stroke right after having held his grandson, or in a car accident) to saying Shaun and Glassman will have a huge falling out over this, creating a rift that will last well into season 7 and several other more or less wild theories in between. I can buy into the falling out theory, it sounds like something the show might use as a quarter season arc or something, although it feels kinda repetitive, cause haven’t we just done that?

Some voices were popping up, saying that Glassman has a tendency to run away from his problems (his ex-wife called it “pulling a geographical”), so maybe he’s going to up and leave again. Although we already had this in season 5, so I don’t know. He also has a grandson who’s about to be born into this world that he’s excited about, so would he really pack his things and bail?

I think the extended Shaun & Glassman friction theory is likely, but I wouldn’t want to speculate too much on how exactly that’s gonna play out. I hope that anyone saying Glassman will die in the finale is a 100% wrong. I don’t really have any good predictions here, but I can maybe say a few words about the TIA.

A TIA (transient ischaemic attack or mini-stroke) happens when blood flow to the brain is temporarily disrupted and brain cells and tissue gets damaged or dies as a result. This can happen with or without noticeable symptoms (the latter is called a silent stroke), and symptoms can include a variety of things such as loss of vision, facial droop, muscle weakness, balance issues, dizziness or speech impairment. Interestingly, memory loss and cognitive impairment only occur in 2 to 12% of TIA cases.

What’s actually contradictory is that Wikipedia says that TIAs are transient, self-resolving, and do not cause permanent impairment. Shaun said the damage to Glassman’s brain was permanent, so to me that sounds like what he had was an actual stroke and not a TIA or a mini-stroke.

I don’t know how Glassman’s previous cancer surgery and cancer treatment plays into this and whether that might promote permanent brain damage after a TIA, but everything I’ve seen online states that a mini-stroke is the same as a TIA, and a TIA is, by definition of the word “transient”, not permanent and resolves on its own. So maybe the writers or medical consultants screwed up here, I don’t know.

But potential medical blunders aside, the concerning thing is that a TIA increases the risk of a full-blown stroke manyfold. Many patients develop a major stroke within 48 hours of the TIA. Mayo Clinic states that about 1 in 3 people who have a TIA will eventually have a stroke, with about half occurring within a year after the TIA.

If Glassman now has permanent damage, as the word already states, it is lasting and will persist. Obviously Glassman is now also at risk for developing a major stroke and should probably take some precautions. There’s a wide range of things that fall into this category, including blood coagulation and hypertension treatments and surgery. So really, if the show wanted to kill Glassy off eventually (I hope not!), then stroke would be a likely and realistic candidate. Crossing my fingers that’s still a long way off in the future.

Parenting 101

Actually, I think we should upgrade this to Parenting 201, because Shaun has evolved and grown so much in this area. Maybe we’re even at 301, or at least approaching it.

It’s amazing when we compare the Shaun from five to six years ago – a frazzled, somewhat unstable fledgling yelling at Glassman that he wants to make his own decisions, that he doesn’t need or want guidance, that he doesn’t want a father – to this much more mellow, mature Shaun who openly calls Glassman his father and who gives him an absolutely beautiful speech about how grateful he is that Glassman made a conscious choice to always watch out of for him, even when Shaun didn’t want him to.

What’s even more amazing is that Shaun is now flipping the dynamic on its head by acknowledging that it’s time he stepped up as a son and by telling Glassman he can relinquish the responsibility of looking out for Shaun, that Shaun will now take care of him. That’s an incredibly grown up and mature thing to do, and I’m pretty sure that Glassman has questioned in the past if Shaun would ever grow up emotionally enough to be able to do that.

And the fact that Shaun is here, that he’s all-in on being Glassman’s safety net, that’s a huge leap from where Shaun’s journey on this show started. I’m vicariously proud because I think this is kind of a big deal when you think about it.

That said, there’s an important caveat to this that Melissa Reiner spoke to in her episode insights, which is that Shaun’s motivation here isn’t completely altruistic, that there’s still the underlying motivation that he needs to find out what’s wrong with Glassman’s brain, and so he’s going to pursue his conquest of the “the truth”—no matter what. In other words, there’s an inherently selfish aspect to Shaun wanting to push for answers and it’s not primarily driven by Shaun wanting to be protective of Glassman.

And then of course, when he had his answer, he went to Lim rather than Glassman himself, which was not super mature, and possibly an error in judgement, but that’s also Shaun. Maybe another lesson to be learnt, even though the road to that learning will be paved with more fallout.

Morgan, the Mum

Honestly? Not very surprising that Morgan was going to foster to adopt. Most of us saw that coming from a mile away after the last episode. I think it’s beautiful, though. Morgan is stepping up to help a sweet, innocent little girl in need, and she absolutely knows what she’s in for from the medical side. I would agree with her when she says that there’s no one more perfect to adopt Eden than Morgan herself.

I hope we’ll see a little more of Morgan’s experiences and struggles as a single mother, and that last scene there with Alex also gives us hope that there may be a path for them to get back together. And hopefully we’ll see this paired up or juxtaposed against Shaun and Lea raising their first child.

Asher, the Earth Scorcher

We already know Asher has a tendency to be somewhat judgmental and a little close-minded at times. And it’s great that Jerome is calling him out on it. His sheltered Hasidic upbringing surely contributed to this, and I also found it interesting that one of Jerome’s almost off-hand comments about Marx gives us more insights into Asher’s family history.

“Ash, I didn’t grow up discussing religion or quoting Marx at the dinner table.”

Of course we don’t know if Asher’s family actually had regular discussions around the dinner table that quoted communist leaders or other world-famous literature, but it illustrates very well that Asher’s dinner table situations were very different to what you’d see in John Q. Public family homes.

And now I actually kinda wanna know how Jerome grew up. Is he a typical city boy? Does he come from the suburbs? Is he a rural kid? Tell us more!

Truly Blessed

No big surprise that the episode title relates most to our skin disease patient Eddie and his trust in god that guided him through life. He mentions multiple times to multiple people how blessed he feels, and that his faith has taught him to accept his bodily affliction and be grateful for what he has rather than bemoan his troubles. The word “blessed” is used verbatim four times throughout the episode, and not just by Eddie.

Morgan even comments on it, calling it the “Eddie Effect”: Our patient radiates positivity. It’s oddly contagious. What I found noteworthy is that the Eddie Effect rippled across the episode and affected everyone that he spoke to, and suddenly everyone was taking a step back and trying to be more grateful for the things you have in life.

Jordan speaks to how blessed Eddie is that the surgery went so well, and later, when Danny checks on her in the locker room, I also get the feeling that she says she’s okay because Eddie was such a positive person and that he basically believed that if God meant for this to be, then it was his fate he should be accepting. And likely it prompted Jordan to talk about how she and Danny can be gifts to each other.

Asher actually quoted the word “blessed” in his little speech to Jerome at the end of the episode when he said how blessed he feels to be in Jerome’s life. Interestingly, Asher also uses an analogy of an island (“ You showed me what it truly means to belong, to not be an island.”), when Glassman’s patient Ricky had also used an island reference before, “You can’t walk off the island.”

Granted, however, that that saying has a totally different meaning. I know absolutely nothing about baseball, so I won’t even try to explain the “walk off the island” reference. Apparently it has something to do with Dominican baseball players and how to make a career outside of the Dominican Republic and a specific move in baseball called a “walk”. I’m sure others can explain that way better than me.

But to bring this back around, despite his aversion to having a strong belief in religion or a higher being, Asher was also greatly affected by his patient Eddie, in a way that he came to see and express how grateful he is to have Jerome in his life.

Andrews was also impacted by Eddie’s faith in that it made him realise that life shouldn’t be a constant endeavour to aim higher, that it can be beautiful and rewarding to enjoy what you have and live in the moment, which prompted him to ask Dalisay to give him a second chance.

Despite the bad outcome for Eddie in the end, he had a profound effect on several people whose lives he touched, and that’s a beautiful notion, too.

Random Bits and Pieces

Not sure if we can already talk about Jared’s redemption, but after last week’s unanimous Jared bashing, things are strangely amicable between the residents. Danny even gives Jared a playful arm bump in the locker room, and they bond over soccer coaching. Not that I’m averse to the peace and quiet, but it seems oddly abrupt.

The Danny and Jordan thing – the super slow-burn continues. It seems we may be in for an eventual happy ending on this one, and possibly something that’ll play out in season 7, hopefully along with a just as slow-burn rekindling of the Park and Morgan romance.

A word about inconsistencies again: The other week they wanted to make us believe that Shaun actually drinks filter coffee. I think now they want to make us believe that he likes sauteed artichokes. I mean, artichokes? Really? Shaun has the palate of a 6-year-old. I can’t see him actually liking artichokes. Unless that line was meant to say that Lea would love to have them, but then why mention those when she was had this massive craving for meatballs?

Favourite Scenes and Lines

Danny: “Dr. Murphy, do you mind if I ask, why are you observing us?”
Shaun: “I don’t mind.”
Danny: “… Why are you observing us?”

Shaun: “Dr. Glassman is not only highly experienced, he has above average intelligence.”
Lea: “I don’t know. He’s an A’s fan…”

The scene with Shaun and Glassman washing hands was definitely my favourite from the episode. Hit me right in the feels.

Sorely Missing

Not that stood out this week as sorely missing.

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!

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