Early 60s, found prone on the sidewalk, appears to have chest pain, maybe broken ribs, - possible heart att*ck.
- Did you fall?
She's very disoriented, hasn't said a thing.
Coley?
No, I'm Dr.
Shaun Murphy.
Will you help me, Coley?
I have to it's my job.
She has stridor.
Checking her pulse.
Radial pulse is normal.
But much weaker in her leg.
She has a descending thoracic aneurysm.
Page Dr.
Melendez to the O. R. !
I just woke up on the front campus lawn covered in blood, with a skateboard next to me.
But I can't skateboard.
Obviously.
Were you drinking, Aiden?
Or smoking something?
No to both.
There are actually college students who abstain.
You are incredibly lucky half an inch in any direction, and you would've bled out.
Aortic wall's tearing.
Can't expect pristine in a 60-year-old possibly homeless woman.
Drop to a 5-0 suture.
Not great, but better.
Let's see if it holds.
Remove proximal clamp.
No leakage.
Let's finish the repair.
Carly broke up with me.
I'm sorry, Shaun.
What happened?
I thought you two were doing great.
We were.
Then I guess we weren't.
Cross-clamping.
You must really be hurting?
N-No.
I'm fine.
We've all been through it.
And, trust me, it helps when you own that you're in pain.
There's nothing for me to own.
She's having epistaxis.
Carotid aneurysm rupture two French Foley catheters.
Give protamine stat.
68/44.
Holding pressure on both carotids at the neck.
Inflate.
41/28.
She's still bleeding internally.
Okay, four units of PRBCs and start TXA.
Loading 700 milligrams TXA.
No distal perfusion.
We have to clamp her carotids.
Ten blades.
Suction, clamps, let's go!
I can't see a thing.
Her blood volume's on the floor.
Time of death, 10:22 a. m.
Jane shouldn't have d*ed not then, not like that.
Her carotids blew out.
What am I missing?
Patients die, Dr.
Murphy.
That's something else we have to own.
Your next patient's waiting in the E. R.
How are you feeling, Aiden?
Awesome considering whatever you did to me.
Mm.
Surgery went well.
Hey, I'm alive, doped up, talking to two very attractive doctors.
I guess this is what happens when you mix weed with my skateboarding skills.
You said you didn't do dr*gs.
Or skateboard.
When did I say that?
When we met you in the E. R.
I've never seen you guys before in my life.
Trust me, I'd remember.
I'd like to order an autopsy on Jane.
We went over this there was nothing suspicious about her death.
Oh, I was asking the Chief of Surgery.
I know the case, and I agree with Dr.
Melendez.
I'm not authorizing an autopsy.
Jane's vascular walls It's hard to lose a patient.
Almost as hard as losing a girlfriend.
I'm okay, and I don't know why no one believes me isn't it okay to be okay?
Not when something bad happens.
We should feel hurt.
If you won't approve the autopsy, I'll get it from Jane's family.
Good luck with that.
According to the files, Jane's last name was Doe.
Y-You're saying I'm having some kind of blackouts?
Which could be caused by head trauma or drug use.
I'm definitely aware of telling you that I don't take dr*gs.
I live like a monk sleep, class, study, repeat.
That's it.
You've also told us the exact opposite.
I need to find Jane's family to get their permission to perform an autopsy.
Dr. Lim wished me luck, but Jane has no I. D. , no purse, no phone.
We know absolutely nothing about her.
Mm.
This should be interesting to you.
You used to be a detective.
And now I'm a doctor, and so are you, and we both have a new case.
A boring case.
He has gallstones.
So, you and Melendez sneaking around again?
I hear he's back to being a good mentor.
Apparently, my complaint changed nothing.
You?
Park said he did it.
Park was lying.
Because he wanted to get you to focus on work.
Good motive, bad judge of character.
And you don't like that Melendez has gone back to being a good mentor?
I don't like that he likes you.
I don't like that, because he likes you, Shaun, Park, and I are second-class residents.
For someone as cynical as you are, you are shockingly naive.
I'll tell you what you did.
You threw a b*mb because you felt slighted.
You made Melendez doubt himself, doubt his judgment.
You made him resent you, Park, Shaun, and me.
I like to think it's that easy to change the status quo.
But I am pretty naive.
I am with Dr.
B on this.
Sorry.
Office politics.
Thought you were asleep.
Watching brain waves can't be too thrilling.
Not when they're as normal as yours.
Hmm.
Except these delta waves.
They mean you're still asleep.
Not planning on doing any cutting, I hope.
Jane had a knee replacement using an LCS system, which means it's at least 30 years old.
She also had an abnormal number of cavities, crowns, and implants.
These are clues, right?
I don't think this is about you losing a patient.
I think you're distracting yourself.
You don't want to let Jane go because you don't want to let Carly go.
Hmm.
What?
You're a doctor now.
You won't find it interesting.
Hmm.
A hummingbird.
Am I right?
The police keep a database of all distinguishing marks.
Jane Doe, homeless there's no way she was never in the system How's Mr.
Ginley?
Your gallbladder case you should be working on?
Uh, we confirmed the presence of gallstones and have scheduled a cholecystectomy.
It's a very simple case and requires no work.
With that attitude, you could end up sending another patient to the morgue.
Focus on the living.
He's right.
We need to bail on this.
Hey, Shaun.
You and Carly shared a lot of firsts.
That must make it harder to move on.
I had a lot of firsts with Lea, too.
Yeah, you did.
And you moved on.
Didn't you?
How do you move on?
Hmm.
Hey, Kenny, I need a name.
We need to keep this on the DL.
We're going undercover.
Causes of sleepwalking run the gamut from the serious, like MS, encephalitis, and brain tumors, to the mundane, like alcohol and drug use, poor sleep hygiene, and stress.
Problem is, to rule some of those out, we need a full patient history, but AsleepAiden and AwakeAiden each have their own story.
So interview them both.
Take a medical history from a patient when they're asleep?
I've never heard of a lying sleepwalker.
I got to go.
Hey!
Stress?
I have to maintain a 4. 2 GPA.
W-What do you think?
You have to care about something to be stressed, don't you?
And since I'm getting a 4. 2 without trying Maybe a glass of wine at a party.
I just microdose you know, whenever I'm not macrodosing.
Do you nap, exercise before bedtime?
I never nap, I work out five days a week never too close to bedtime, which is midnight, 12:30 at the latest.
I am surrounded by 5,000 women.
Yes, right before bedtime.
That explains the headaches I've been waking up with.
I never thought that they were hangovers.
He's a Cro-Magnon.
He's not me.
He can't be.
Maribel Ventane.
"Sharing the Spirit.
Marco, Maribel, and their 5-year-old son, Jules, open their doors to host the fourth annual fundraiser 'Friends in Need.
'" "Maribel Ventane, 33, was one jump away from a first-place ribbon.
" Blah, blah, blah.
"She suffered severe orthopedic injuries.
" "After two years in family court, Maribel Ventane, 36, and ex-husband Marco Ventane, 43" Blah, blah, blah.
"Mr.
Ventane was given full custody of their 11-year-old son, Jules.
" "Marco Ventane, 63, passed away in his home.
He is survived by his son, Jules Ventane, 32.
" I found him.
Are you Jules Ventane?
Yes.
I'm Dr.
Shaun Murphy, and I recently treated your mother, Maribel.
She d*ed on the operating table.
I would like your permission to do an autopsy.
We're very sorry for your loss.
She came in with a ruptured aortic aneurysm, and there wasn't much we could do.
But we would like to be absolutely certain about her cause of death.
I don't care how she d*ed.
Remember we talked about moving on?
This is the time to do that.
Where do we stand with the Aidens?
Between the two alters, they engage in just about every single behavior.
So, we go back to Dr.
Lim's list.
Maybe we should be looking at paraneoplastic syndromes.
May want to consider psychiatric issues could be having psychotic or dissociative episodes.
I have a fair amount of personal experience with people with psychiatric issues.
If he had psychosis, I'd have picked up on it.
How about thyrotoxicosis?
No irritability, agitation.
Paraneoplastic syndromes trigger a loss of coordination, which could have caused Actually, our personal experiences make us less effective in spotting symptoms.
You know I always make an effort to be as objective as possible.
Well, you're not this time.
The vast majority of cases of paraneoplastic syndromes present with antibodies.
His labs show a normal serum panel.
The "vast majority" of all diseases don't present with competing entities day and night.
- I'm just giving an idea.
- No, you're undermining mine.
Fine.
Your idea's brilliant.
Go waste your time on it.
Thank you both.
Get an MRI to rule out brain tumors and MS, an LP for encephalitis, and a CSF panel to check for paraneoplastic syndromes.
And a psych consult.
No.
Hi.
I'm Dr. Lim.
And you are?
Trinity.
Where are your parents?
My mother's in the maternity ward.
She's having a baby?
Already did.
A girl.
Wonderful.
So, why the wandering?
My mom sent me to the cafeteria to get a snack, but I got lost.
Three times?
Hey, Lucy.
We're looking for, um Trinity!
Please call security.
Stop the car.
No.
Yes.
Shaun!
Shaun!
I need your permission!
Don't do this, Shaun!
No!
- I need your permission!
- Let it go, Shaun!
It can't be over!
- It can't be over!
- It's over!
You have to let Carly go!
- No!
No!
- You have to let Carly go!
- No!
- You have to let Carly go!
It's not about Carly!
Well, it's not about this, either!
- It is not about Carly!
- He's calling the police!
- No!
Open the door!
- You'll get arrested!
Open the door!
Shaun, he's calling the police!
Come here!
- No!
- Shaun!
Open the Oh, my God.
Shaun, are you okay?
It was bad.
I missed my surgery.
Well, don't worry about that.
Park's there.
Everything there is fine.
Will I have to go back to jail?
No.
No.
It's a good thing you were with an ex-cop.
The guy's not gonna press any charges, but you're not allowed to be anywhere near him ever again.
Here.
Let's get out of here, huh?
Park says that you are upset about Carly.
Everyone keeps telling me that, but I am not upset about Carly, and they need to stop.
Okay, so, this isn't about Carly.
I wish Carly didn't break up with me.
But she did.
And now I have to do what she said.
What do you mean you have to do what she said?
She doesn't get to dictate to you.
She told me to tell Lea I love her.
Oh.
O-Oh.
And you're afraid of what might happen if you told Lea the truth?
If I tell her I love her and she tells me she doesn't, then I can't be her boyfriend.
And even worse, I I don't think I can be her friend, either.
And what if Lea were to say "You know what, Shaun?
I love you, too"?
Hmm.
Pretty disturbing, having this weird personality creeping out of me.
Does he represent something I'm suppressing and need to express or something I need to bury forever?
If it's any consolation, I kind of like him.
I think he's just trying to enjoy himself.
Except he's sabotaging all the hard work of his waking self.
It's not sabotage.
It's just a part of who he is.
Some parts of who we are suck.
I'm sorry.
I shouldn't have ratted on you and Melendez.
I screwed things up.
But this guy needs a drink every now and again.
You see that?
Yeah.
You have an arachnoid cyst compressing your hypothalamus, Aiden.
We basically just need to drain it.
W-Will it k*ll me if you don't?
He knows the risks?
He knows it won't k*ll him, which is enough for Jekyll to decide to keep Hyde alive.
What if we ask Hyde?
I'm pretty sure consent needs to be informed, voluntary, and conscious.
It also doesn't matter.
AsleepAiden's a hedonist.
He's not gonna make a decision against his interest just to help his alter.
Maybe he cares more than you think.
Okay.
Dr. Lim?
Thank you.
Trinity, have a seat.
There's no one in our maternity ward with a daughter named Trinity.
So, I'm gonna need some information, and it will be much more efficient if it's the truth.
First and last name.
Trinity.
Mm-hmm.
Last name?
Okay.
Will you at least tell me what you're doing in this hospital?
I just wanted to meet you again.
Someone left a baby girl at the E. R. about eight years ago, on Trinity Sunday.
You were so tiny, so sick, and so helpless.
k*lled me not to take you home.
But look at you now, so strong and healthy.
And fast.
You know we need to call your mother and let her know where you are.
That you're okay.
You know her number?
Yes, but But?
Can you adopt me?
Shaunie.
You poor thing.
I'm so sorry about you and Carly.
I want to tell you how I feel.
I know you're hurting.
Carly made a huge mistake.
You're a wonderful man, Shaun.
Maybe the most wonderful man I've ever met.
Lea?
Yeah, Shaun?
I found that in my mother's drawer.
Does she know you're here?
She's been in Campbell Memorial for the last two days.
She thinks I've been in school and at a friend's.
As long as I'm home by 6:00, no one knows the difference.
Mm, well, it's past that.
I'm sure she's worried.
She has a new daughter.
It's hard to share your mom, isn't it?
If she loves your sister with all her heart, it doesn't feel like it'd leave much room for you.
Do you love your mom with all your heart?
How about your dad?
You love him with all your heart, too?
But that doesn't seem possible, does it?
Hearts are amazing things.
I've held one in my hands many times.
You'd never know it by looking at them, but somehow they have all the room we need.
Dr. B.
Please tell me you're single.
You have a cyst in your brain.
If we leave it as is, it could expose you to considerable neurological complications potential visual loss, endocrine abnormalities, depression.
But if we drain and treat the cyst, there should be no complications.
Including sleepwalking.
The Professor already rejected treatment?
So you're asking the Frat Boy to fall on his sword for him?
I think the Frat Boy is more than just a Frat Boy.
We're all complicated.
We're all sometimes superficial, selfish jerks.
But we're also capable of sacrifice.
I think you live in him the same way he lives in you.
And that won't change, no matter what decision you make.
Shaun.
Maribel d*ed.
I think she had polycystic kidney disease, which is associated with dilation of the arteries, which results in weakened vascular walls, which in turn contributes to the formation of aneurysms.
I need to do an autopsy.
Dr. Melendez Didn't approve.
Dr. Lim didn't approve.
- The family said no.
- So, what can I You're the head of pathology.
Shaun, I'm not going to I can't do what you told me I should do.
Until I solve this distraction.
No sign of polycystic kidney disease.
I know that this break-up has been hard on you.
It's been hard on me, too.
But I know what I saw between you and Lea.
I did see something, didn't I?
I love you, Carly.
But you were right.
I love Lea more.
Okay.
So you know you have to tell her, right?
I'm scared.
I know.
But look at how far you've come with me how scared you were.
How brave you were.
I have to go.
Thank you, Carly.
If you're watching this, it means I'm dead.
And you're waking up from a surgery you think you didn't consent to, but I hereby proffer my full and informed consent to said surgical procedure.
Signed Aiden Michael Porter.
The second.
Uh, just one one more thing.
My advice is to try to chillax a little.
Neither of us is perfect.
But we're okay.
We are gonna be Okay.
And that girl who sits in front of you in Advanced Calculus, her name is Staci with an "I," and she likes you.
Way more than she likes me.
Peace out Professor.
You're kidding me, right?
I know why your mother d*ed.
And I said I didn't care.
When I examined her liver, I found three aneurysms in her hepatic artery, which is very unusual and made me realize she has Vascular Ehlers-Danlos syndrome.
It's a very rare disease that often goes undiagnosed and can be fatal.
Are you really gonna make me call the police again?
It's hereditary.
No, I don't want to get arrested again, but do you have an excess of cavities?
You might have inherited Vascular Ehlers-Danlos syndrome from your mother, and your life could be in danger.
But its symptoms can be treated.
Okay, goodbye.
So, that's all I got from my mother?
A potentially deadly disease?
Did your mother ever call you "Coley"?
Yeah.
Short for "colibri," the French word for hummingbird.
She said I would flit around the house, always going from one thing to another.
She had a hummingbird tattooed on her body.
And "Coley" was the last word she said.
She loved you.
M-Maybe she was just afraid to tell you.
Morgan buy the fight?
Is it weird how hard we have to work to hide a platonic friendship?
Very.
But it's worth it.
Hi, Mom.
Shaun?
What's up, Shaunie?
Shaun.
Please.
Talk to me.
I love you, Lea.
I want to be your boyfriend.
I love you, too.
But Y-you know me.
I am selfish, and I am so, so needy.
I-I'm I mean, listen to me right now.
I can't even put a complete sentence together.
I am a I'm a total mess.
How?
How am I supposed to, you know, just lay all of that on you?
Why do you think I can't handle your selfishness, neediness, and messiness?
I think I can.
It's just I'm a challenge for anyone and you're you.
And I just know it would be too hard for you.
You need things a certain way.
You work in a certain way and Because I have autism?
You don't want to be my girlfriend because I have autism?
Mm.