I really wish I knew what they were trying to accomplish with the romance between Shaun and Carly. AS it is playing out on screen it is just uncomfortable to watch on all sides.
On his side, Shaun just plain looks/acts like he is not ready for a full on grown-up romance despite what he says.
On her side, Carly just feels like someone who is putting a yeoman's effort into a relationship where the return is very small and is having her feelings battered because of it.
If the idea, as I presume it is supposed to be, is for the show to let us in Shaun's world as he navigates all the 'typical' things of life but from a neurodivergent perspective, then I wish we'd get some wins instead of a litany of frustrations to let us hang in there with them. It would be nice if we could see a clear and visible progression in the relationship, even if it is only 3 steps forward and 1 step back. We'd be actually moving forward. As it is, it currently it feels like they are either standing in place or going 1/2 step forward and 3 steps back. So no progression at all. And I am not sure if it is direction or an acting choice but I am just not feeling Shaun's need for this.
Re; The knee surgery woman. I am wondering if she refuses any drugs that could even be considered half-way addictive? Addiction is physical, yes, but there is also a powerful mental component. She struck me as someone who was determined to stay clean but was very aware of the lure of her addiction. So maybe even the thought of having had something, even something that put you under, could be a trigger to backsliding. Even if it is not truly addictive, coming out from under anathesia or something could mimic the feelings of well-being that one has when one is under the influence of their drug of choice. So she uses the pain as a way to stop her from using the drugs. Kinda like that one case in Season 1 were the fiancee and the parents were arguing over whether to amputate a ex- addict climber's leg. He substituted his 'adrenaline junkie' rushes for his drug and if he couldn't climb/run anymore it might have been the trigger that caused him to slide back into his addiction.