Let me start off by saying hello, and thank you. This will be the second to last review of the Good Doctor, before we enter the winter break. I have had so much fun writing these reviews, and I hope you have enjoyed reading them. Over break, I will not be quietly waiting, I plan on writing reviews for the Korean The Good Doctor, which has inspired this series. I hope you will continue this journey with me, and for the many more seasons I am sure to come from this series. Let’s go ahead and get to the reason your here, the review.
I won’t lie, this episode didn’t hurt my heart like every other episode tried to do. Ironic, since we dealt with the young Gabriel’s heart. The characters just didn’t draw me into their cases like other patients did. Still, the doctors were quite fun to watch, and we see Melendez giving Shaun more and more responsibilities, and start understanding him more. Young Gabriel has many issues with his heart, and Doctor Aoki expects Doctor Melendez to repair something which seems unfixable. I actually have a friend who has a heart condition, in which the walls of her heart keep growing to the point the pressure inside the chambers try sucking the blood, instead of forcing it out. She had a pacemaker added at the age of 14, and I believe she has had 3 open heart surgeries. She is under 25, and the toughest woman I know. One thing she told me, though, is if she ever gets a heart transplant, she will no longer have the issue. Her heart walls will never grow again, and she can run for the first time. I wonder why they didn’t just replace Gabriel’s heart. Might have made things simpler.
Claire gets a podcast star who has a nodule, which is is a small swelling of cells, or lump, that formed in her voicebox. They are concerned about the lump, as it might be cancerous. Of course, everyone reassures her it is most likely benign. Dr. Andrews does the surgery, it’s been a while since we saw him in the building. And he has a wife. Shocker. She seems quite cool, though. And cute how they try to make time in passing as one is going and the other is coming. As a wife with a 50+ hour work week, married to a man who works the same amount of hours, just different times, I understand. It sucks, you miss spending time with them the way it was before careers and bills and life took over. But, I love those moments. Even now, he is snuggled up to me, asleep as I write this. Love, it’s not something you need to make time for, it will always happen organically.
Eh, sorry. My heart ran away with my hands. So, Melendez is trying to figure out how to repair a child’s heart, but luckily, Shaun has an idea. A bit reflective of the first episode, when Shaun begins to speak, Melendez cuts him off. Instead, he tells him to follow, and goes to meet Aoki, and explains his idea of how to fix Gabriel’s heart. Melendez thinks it is a horrible idea, but decides to go for it. We actually get to see a really cool effect as the two use VR technology and replicate the surgery, figuring the best course needed. It seems like 14 millimeters is the ideal size needed to be shaved down. Too much or too little would make the heart unrepairable.
Back with Claire, it seems the nodule has gone missing. The hospital is worried they will get sued, and Claire just wants to help her patient, as they were going to biopsy the cells and check to see if it was benign. Otherwise, she must choose to remove her voicebox since it might be cancerous, or leave it and it might develop cancer. Every path leads them to a dead end, and they finally opt for the surgery. Just before Andrews cuts in, Claire realizes it might be a labelling issue. They find the nodule and test it, and the podcaster still can podcast. But, in the end, she does sue the hospital, and Claire realizes even best intentions have bad side effects. Melendez and Shaun get into the surgery with little Gabriel, and Melendez realizes he needs to drop down to 13, even though the valve needs to be attached and in the projections, at 13 the spectrum cannot hold the valve. Luckily, they realize there is another point to attach the valve. Melendez does a miracle surgery, and the episode ends well.
Overall, a good episode. We got to see a few secondary characters come to light, including Carly the technician, and Lea starting to flirt with Shaun. We see Claire trying to explain flirting, and watching it blow up in her face, and we see Shaun fighting with Dr. Glassman, implying that he wants Shaun to have a life coach, and Shaun is taking it as Glassman is giving up on him. In previews for the next episode, we see Shaun flipping out. I wonder if it was set up this episode. I am glad the episode tried to keep with the flow, but it still felt unexciting, not like the previous episodes. Still, every series has to have episodes we do not love.
See you all next week, and as always, stay shiny!
Hey, hey, hey! Let’s talk about the medical side of the show! Today, we are focusing on Gabriel, who has pcongenital heart anomalies. Melendez orders an transesophageal echocardiogram, which is like an ultrasound, but more detailed. It’s a bit rougher on the patient, as it involves a tube put down the esophagus to get closest to the heart.
They find out he has hypertrophic obstructive cardiomyopathy, which is actually the disorder my friend has, which thickens the heart walls, atrial septal defect, a birth defect that causes a hole in the wall between the heart’s upper chambers (atria), and abnormal insertion of the mitral valve leaflet, which means as the heart pumps blood, it’s not sealing correctly, and blood can leak back into the chamber. Again, I stand by the fact heart replacement would have been way less stressful. But his heart has a hole, connecting the atrias, a valve issue, so blood flows between the atria and the ventricles, and the walls are thickening, making the blood flow harder, and might actually suck blood instead of pushing it into the veins.
The biggest issue is the septum. They can repair the hole between the two atrias, but the valve needs to be replaced, and the septum has to be thinned so his heart works normally. It measures at 25 millimeters, when a normal kid has 8. Sadly, they need to have more to support the artificial valve, so most likely, he will need another surgery when he is older, to thin the walls again. It’s kinda weird, watching a show portray something I actually know about. My lovely friend had blood pressure 65 over 40 and was walking around right before her surgery. The walls need to be thinner to push the blood throughout the body. Thickened walls means less blood being pushed out.
Luckily, the surgery works out perfectly. And the boy lives a decent life for a while, until the walls thicken again. He probably will not be able to run around, as even though his heart is picking up speed, the walls cannot push the oxygenated blood fast enough through his body, especially his brain, and might make him light-headed and pass out.
I love doing these, and I got to research a disease I really am curious about. Till next week, stay shiny!