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S04.E04: Not the Same

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Dr. Morgan Reznick and Dr. Shaun Murphy's pregnant patient with twins is having pain and they are forced to grapple with a decision no one wants to make. Meanwhile, Shaun asks Lea to move back in despite her reservations.

Original airdate: 11/23/20

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The two female newbies are terrific.  The small newbie reminds me of glasses/ contacts from Grey’s but better.

I always felt Resnick and cop doc would get together from the beginning. Glad they had it build.

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13 minutes ago, Diana Berry said:

I always felt Resnick and cop doc would get together from the beginning. Glad they had it build.

Yeah, I'm really curious to see how that pans out. They have an interesting dynamic. 

I like Olivia and Jordan, too. I liked how this episode explored the struggles both in trying to teach and learn when it comes to training new people at a job. I'm all for more instances of them working with Shaun, and I'd love to see them work on a patient with Claire, too. I could see those three making a pretty formidable trio in their own right. 

I also liked the bit with trying to calm the pregnant woman by having her imagine her future children. That was a good move. What a crazy case. And yay for Claire's patient pulling through okay, too. 

I can't help wondering how long this whole living together thing will last between Shaun and Lea-on the one hand, the fact she can't see herself with anyone else other than him in a year is a good sign, on the other hand, her hesitation at moving in and her talk about commitment has me going, "Hm". But the bit where she pulled out that baseball and put it on the shelf was a nice little touch :). 

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38 minutes ago, Annber03 said:

I can't help wondering how long this whole living together thing will last between Shaun and Lea-on the one hand, the fact she can't see herself with anyone else other than him in a year is a good sign, on the other hand, her hesitation at moving in and her talk about commitment has me going, "Hm". But the bit where she pulled out that baseball and put it on the shelf was a nice little touch :). 

It seems like after everything we went through with Shaun and Lea, they have to be endgame. But there was the hesitation, and last week when Shaun said he loved her, she said "thank you." 

I like how all the new doctors are fitting in, and I like seeing Shaun in the new dynamic as teacher. It felt like a lot of the same last year.

It seems pretty sketchy for Andrews not to tell anyone he is the one doctor's uncle. Are we supposed to think he pulled strings to get her matched at the hospital?

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1 hour ago, KaveDweller said:

It seems like after everything we went through with Shaun and Lea, they have to be endgame. But there was the hesitation, and last week when Shaun said he loved her, she said "thank you." 

I like how all the new doctors are fitting in, and I like seeing Shaun in the new dynamic as teacher. It felt like a lot of the same last year.

It seems pretty sketchy for Andrews not to tell anyone he is the one doctor's uncle. Are we supposed to think he pulled strings to get her matched at the hospital?

I have to imagine he disclosed it to Lim and she sent it up, and the writers just wanted to save that reveal for this episode.

I liked this episode outside of Glassman doing the annoying inspiration porn-y "I have learned every day since I met you" blah blah blah bullshit

Also, yeah, Leah and Shaun aren't going to last long in the apartment. I have autism, and my brain was going "no Shaun, tell her that since she said she isn't ready/nothing has changed, she should wait until she feels ready"

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I truly thought Andrews was trying to teach Shaun how to teach, that he was mentoring SHAUN. It struck me as unexpected, but I bought it. Didn't have a clue that he was actually intervening for his niece. Actually, it was a good and valid thing to do to check in with the residents about how the interns are doing, but of course he didn't do that with Claire, so that should have been a red flag.

Claire and Lim socializing outside work is like Claire and Melendez repeat. Isn't it wrong to socialize with a subordinate?

Asher sure seems to be eiher very lucky or a total genius with his shocking diagnoses. And the happy patient... if this was HOUSE, they'd have discovered his happy attitude was actually a symptom of the disease causing his cancer and they would cure his infection and is cancer but he'd be miserable because they also got rid of whatever condition caused his happiness. This show can be a bummer, but at least it's not THAT.

They haven't been killing as many patients so far this season. Maybe they feel like with eht pandemic people have enough grief already. Plus, they killed off Cllaire's mom and then also Melendez; after that, maybe they decided to do penance by not killing anyone else for a while.

 

 

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57 minutes ago, possibilities said:

Claire and Lim socializing outside work is like Claire and Melendez repeat. Isn't it wrong to socialize with a subordinate?

It is. And it’s gonna be come off as favouritism when Claire continues to get picked for stuff etc the same way it did with Melendez.

I called Park/Morgan early in the either three second or third season. I never understood why they put him back with the ex wife.

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Andrews being Olivia's uncle put any problem with Lim and Claire socializing in the shade. She never should have asked to match in his hospital and he's already shown that he can't be objective around her.

Everyone was working on one case except for Morgan who even though she is no longer in surgery, got to be in on both. That's going to get old really fast if they continue to push her to the front like that.

I still have no interest in either Shaun's or Glassman's relationship difficulties because they as well as their SO's have problems. At least the latter couple was kept off this episode.

7 hours ago, possibilities said:

And the happy patient... if this was HOUSE, they'd have discovered his happy attitude was actually a symptom of the disease causing his cancer and they would cure his infection and is cancer but he'd be miserable because they also got rid of whatever condition caused his happiness.

Another of the reasons I stopped watching House. No one one that show could be happy or emotionally healthy.

I'm glad that the patient didn't die because Adam Beach has been killed off too many times but they pushed the idea of "you can find meaning in your life after a loved one dies by helping others" too hard.  I did like the repetition of the tires at Costco story though; the first time you think that his wife is alive and the second time you realize that she's dead.

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I still can’t stand Morgan and hope Park told her he will pay rent but no she can’t treat him like crap because she gave him a place to stay.

I like Sean’s growth as a doctor and as a boyfriend. 

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I have wondered about Park/Morgan for awhile, they have chemistry and an interesting dynamic, so this could be something to explore, certainly more interesting than him holding onto his marriage with his ex wife. I am not sure if their mutual hard ass tendencies will make them work perfectly together or end with a spat that will make the baseball bat incident look tame by comparison, but its a decent looking plot for them. 

I get why Lim and Claire are hanging out, they are still bonding over their grief for Melendez, but them hanging out so much after work, could lead to some problems, considering Lim is Claire's boss. I guess just playing some video games to relieve stress is fine, but its something that they should probably try and cut back on. 

Speaking of Melendez, it seems really weird how little him dying has been brought up by anyone besides Claire and Lim, its like they are the only ones who even notice that he died. I know that its been awhile without the story because they flew through several months for the pandemic stuff and everyone got busy with the pandemic, but its so really strange how no one else seems to have brought up how their friend/co-worker just died in a freak accident not too long ago. Its not like this is Grey Anatomy where doctors are always dropping like flies in random violent deaths, this should be a big deal. Why kill him if you aren't even going to do anything with it besides have Claire be sad for two episodes? Just to keep Claire from being too happy and add some cheap melodrama for short term rewards? 

Glad that both patients made it, they generally seem to be saving a lot of people this season, which makes me think we are building up to a big and heartbreaking loss of some patients later on. The speech the super positive patient gave about why he didn't kill himself after his wife died was really great. 

Seeing everyone mentoring the newbies is fun, its certainly a learning process, especially for Shaun. It adds a new dynamic in the show and gives Shaun more room for growth, while all feeling natural, unlike how contrived and unpleasant the romance stuff ended up being last season. The newbies in general seem to be working out, and the little twist about Olivia being Andrews niece could add to more conflicts. Its probably why they had the whole plot with Shaun wondering if it was fair that he dot the job over someone else because Glassman really fought for him and him worrying that he was prioritizing one newbie over the other, does this create a conflict of interest with Andrews? Is that fair? He has already shown he isn't objective about her, so this definitely going to be an issue.

Shaun and Leah moving in together is obviously going to be a mess, but I guess not too much of a mess as the show is super committed to this Shaun/Lea romance, despite their lack of romantic chemistry. 

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Lucky that the twins survived as if I were the patient I’d be suing the hospital for the ridiculously unprofessional conversations happening during her labour.

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Always happy to see Adam Beach and I thought he did great work as the cancer patient.  I know he can be hit or miss at times, but I think he can truly shine in the right role, and it's just seems to be a case of him and the industry figuring out what kind of role that is.

Not surprised that Shaun struggled with leading the newbies, but at least it didn't go quite as badly as it could have been, and it does seem like he is starting to understand it better (and, of course, writing out actual lists of what one did right and what one did was wrong was totally a Shaun move!)  Out of the newbies so far, I do think Jordan is the one who seems to be the most reliable outside of her issues with authority, but I'm glad she has the awareness to realize she still needs to make sure someone is watching her back in case she messes up.  Olivia continues to be intelligent but lack confidence, and her "secretly" being Andrews' niece probably plays a part in that and I can see being an issue going forward.  But I hope both of them stick with it.

As for the other two, Asher definitely has the smarts and was on fire today, but I do think Claire has a point that he was letting his emotions dictate a lot of his decision-making, and I can see that going the completely wrong way if he isn't careful.  As for Enrique, he seems to be a bit of an enigma so far.  I mean, he's seems smart enough, but it feels like he's more concern with psychoanalyzing his fellow doctors than the actual case itself.

So, Park is now divorced and moving in with Reznick?  Not sure what to make of this, if it ends up being romantic (which, knowing this show, will probably happen.)  Will Yun Lee and Fiona Gubelmann are certainly a great duo and the banter between the characters is always a delight, but I worry about there being another romance on this show, since it tends to devolve into soapiness and eye-rolling dramatics.

Speaking of which, Shaun and Lea moving in together is totally going to backfire, right?  Despite her smiles, it seems like Lea still isn't comfortable with it and I really can't understand why she caved like she did, since it didn't seem like Shaun was being too pushy about it (at least by his standards...)

Hey, this was directed by Sarah Wayne Callies!  Didn't know she was getting into directing.  Good for her!

Glad both of the patients (and the twins!) were saved, but as usual, that just makes me worry that some major heartache will be counterbalancing that all out at some point in the season!

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I thought this was a pretty good episode, I can't really make any complaints other than Shaun and Lea being annoying.  

Thought it was nifty the way the two newbies needed the exact opposite things from Shaun.

Apparently several people here saw Park and Reznick getting together, but it caught me completely by surprise.  I'm one of the few posters here who actually likes Morgan, but living with her or being in a relationship with her?  No frigging way.

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2 hours ago, thuganomics85 said:

Speaking of which, Shaun and Lea moving in together is totally going to backfire, right?  Despite her smiles, it seems like Lea still isn't comfortable with it and I really can't understand why she caved like she did, since it didn't seem like Shaun was being too pushy about it (at least by his standards...)

I think Lea caved because she knew Shaun wouldn't stop asking and figured she wouldn't be able to hold out forever. That is a terrible reason to move in with your boyfriend. It is actually a reason to run far away from him.

1 hour ago, rmontro said:

Apparently several people here saw Park and Reznick getting together, but it caught me completely by surprise.  I'm one of the few posters here who actually likes Morgan, but living with her or being in a relationship with her?  No frigging way.

I like Morgan as a character. I would not want to be around her much in real life. I was also surprised at her and Park, but it could actually work. He is as insulted by her attitude and pushes back. Except they work together and that will lead to drama.

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8 hours ago, Avabelle said:

Lucky that the twins survived as if I were the patient I’d be suing the hospital for the ridiculously unprofessional conversations happening during her labour.

Did I miss something or did we just see an extremely rare and complicated twin pregnancy/delivery with no highly experienced OBGYN present?  I'd be suing about that too.

Edited by Brookside
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11 hours ago, Avabelle said:

Lucky that the twins survived as if I were the patient I’d be suing the hospital for the ridiculously unprofessional conversations happening during her labour.

I mean doctors talking about irrelevant things isn't something you could sue over, however....

2 hours ago, Brookside said:

Did I miss something or did we just see an extremely rare and complicated twin pregnancy/delivery with no highly experienced OBGYN present?  I'd be suing about that too.

You could sue over this - especially if anything went wrong - which it could, leaving a third year resident in charge. Maybe, just maybe, the OB was out of the room for a minute due to eating some bad burritos, but yeaaaah - they should've at least had Lim or Andrews there if they didn't want to hire someone to guest as the OB due to COVID concerns.

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1 hour ago, bros402 said:
12 hours ago, Avabelle said:

 

I mean doctors talking about irrelevant things isn't something you could sue over, however....

Irrelevant things Is gone but they were talking about how inexperienced they were/how they could screw up and how they wermt confident in Sean as a teacher. How would that not add stress to the already poor stressed woman. 

 

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This seemed like a solid episode.  I do like the new residents, but it’s too bad they sacrificed Melendez to make room for more characters, and it does bug a little that Olivia is Andrews’ niece, but I suppose that is so they can set up conflict for future episodes.

I also like Morgan.  I didn’t initially but she has grown on me, and even when I didn’t care for her, I always found her interesting as a character.  She does have a hard exterior and is definitely ultra competitive, but I think deep down she is somewhat of softie.  She did, after all, try to be there for Claire when her mother passed, and I’m sure there are other examples, but Claire is the one that initially comes to mind.  Her and Park as roomies might be fun, but I’m not sure I’d want to see them get romantic. 

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I try NOT to nitpick medical shows, but they absolutely should have said something about no one in OB/GYN being available. That is what they did on ER on the famous baby delivery episode "Love's Labor Lost". ER also had an OB/GYN who would come down on occasion.

This particular pregnancy situation was also done on PBS's "Call the Midwife". Sometimes my husband is in the room when I watch that (currently watching on Netflix), but I didn't think he was paying attention at all. He is the one who said to me, "This is the same situation as on Call the Midwife!"

Can someone medical explain it? Something happens to the mom after the 1st pregnancy (antibodies develop?) ... and then what? Does it only apply for fraternal twins?

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Director: Sure, the hospital has OBs, but for this scene we are focusing on the surgical residents.

Patient: So turn off the ***** camera and call the OB!

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3 hours ago, MoreCoffeePlease said:

Can someone medical explain it? Something happens to the mom after the 1st pregnancy (antibodies develop?) ... and then what? Does it only apply for fraternal twins?

It has to do with the Rh factor (named after Rhesus monkeys) which is a protein on the outside of blood cells. You can be either Rh negative or positive. Lots more about it here but basically for an Rh negative mother

Quote

Rh antibodies are harmless until the mother's second or later pregnancies. If she is ever carrying another Rh-positive child, her Rh antibodies will recognize the Rh proteins on the surface of the baby's blood cells as foreign. Her antibodies will pass into the baby's bloodstream and attack those cells.  This can make the baby's red blood cells swell and rupture. This is known as hemolytic or Rh disease of the newborn. It can make a baby's blood count get very low.

If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin shots during her first pregnancy. She'll get the first shot around the 28th week of pregnancy and the second shot within 72 hours of giving birth. Rh immune-globulin acts like a vaccine. It prevents the mother's body from making any Rh antibodies that could cause serious health problems in the newborn or affect a future pregnancy.

A woman also might get a dose of Rh immune-globulin if she has a miscarriage, an amniocentesis, or any bleeding during pregnancy.

One of the fraternal twins was Rh negative and fine, the other was Rh positive. Because she had had an abortion when she was 15, she had developed the antibodies from that.

She should get the shots in case of a future Rh positive pregnancy.

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3 hours ago, Driad said:

Director: Sure, the hospital has OBs, but for this scene we are focusing on the surgical residents.

Patient: So turn off the ***** camera and call the OB!

If I was a patient on a show created by David Shore, I would be doubly concerned.

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On 11/24/2020 at 3:07 AM, possibilities said:

I truly thought Andrews was trying to teach Shaun how to teach, that he was mentoring SHAUN. It struck me as unexpected, but I bought it. Didn't have a clue that he was actually intervening for his niece. Actually, it was a good and valid thing to do to check in with the residents about how the interns are doing, but of course he didn't do that with Claire, so that should have been a red flag.

Claire and Lim socializing outside work is like Claire and Melendez repeat. Isn't it wrong to socialize with a subordinate?

Asher sure seems to be eiher very lucky or a total genius with his shocking diagnoses. And the happy patient... if this was HOUSE, they'd have discovered his happy attitude was actually a symptom of the disease causing his cancer and they would cure his infection and is cancer but he'd be miserable because they also got rid of whatever condition caused his happiness. This show can be a bummer, but at least it's not THAT.

They haven't been killing as many patients so far this season. Maybe they feel like with eht pandemic people have enough grief already. Plus, they killed off Cllaire's mom and then also Melendez; after that, maybe they decided to do penance by not killing anyone else for a while.

 

 

I kept waiting for them to reveal his always happy as some side effect or symptom of whatever his diagnosis was! Clearly, I've watched too much House. 

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1 hour ago, Court said:

I kept waiting for them to reveal his always happy as some side effect or symptom of whatever his diagnosis was! Clearly, I've watched too much House. 

I struggled with his explanation, honestly.  It's great that he liked helping people, but I'm not sure why that would make you immune to bad news.  I would think the potential end of his life would mean the end of his helping people, and that would cause him some distress.  I guess knowing he was serving some purpose gave him some sort of serenity, but it still seems a little shaky to me.

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21 hours ago, bros402 said:

I mean doctors talking about irrelevant things isn't something you could sue over, however....

Not by itself, if it was all hospital show doctors would be in danger of massive lawsuits.

But if something had gone wrong you could use it as evidence of them being negligent.

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2 hours ago, rmontro said:

I struggled with his explanation, honestly.  It's great that he liked helping people, but I'm not sure why that would make you immune to bad news.  I would think the potential end of his life would mean the end of his helping people, and that would cause him some distress.  I guess knowing he was serving some purpose gave him some sort of serenity, but it still seems a little shaky to me.

Everyone takes news differently. I have cancer - an incurable chronic leukemia (It won't kill me). I never went into a depressive funk about it - I laughed when I got the diagnosis (I have a very... odd medical history, full of rare crap) and I kept being the same person I am, just with a new medical condition to deal with and some medications with shitty side effects

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If I understand correctly, it was not the fact that she had had an abortion that caused the Rh factor. It was that she had been pregnant. The abortion wasn't really the issue. Same thing could have happened if she'd had a miscarriage or carried the pregnancy to term.

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10 hours ago, possibilities said:

If I understand correctly, it was not the fact that she had had an abortion that caused the Rh factor. It was that she had been pregnant. The abortion wasn't really the issue. Same thing could have happened if she'd had a miscarriage or carried the pregnancy to term.

Yes. It was because she had had a previous pregnancy with an Rh positive fetus and developed antibodies.

In real life, this wouldn't have been a surprise to anyone. Her family doctor or OB would have asked about any previous pregnancies (assuming that she had prenatal care) and since she was Rh negative they would have tested her fetuses. But TV.

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20 hours ago, Court said:

I kept waiting for them to reveal his always happy as some side effect or symptom of whatever his diagnosis was! Clearly, I've watched too much House. 

I’ve never watched House, but that would be so awful. I’m glad that didn’t happen.

It’s a good sign that Lea can’t see herself with anyone but Shaun in the next year, but she seemed unsure about moving back in because she knew things wouldn’t be the same as when they lived together as friends. I wouldn’t have pushed her about it as much and would have given her space to figure that out. I hope the next time Shaun has a major event happen that affects him negatively, she will support him.

Speaking of living with Shaun, I’m guessing the reason Park took Morgan’s offer to live together Is because he had to leave Shaun’s due to Lea moving in. The episode didn’t really provide context on that. I get that Morgan doing spiteful stuff is who she can be, but hiding the gloves was taking it too far. What if someone else needed those and couldn’t find them because of her games? Hopefully for her sake she doesn’t find herself in the unemployment line; Lim warned her last season and Glassman already warned her this season.

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On 11/25/2020 at 10:48 AM, MoreCoffeePlease said:

I try NOT to nitpick medical shows, but they absolutely should have said something about no one in OB/GYN being available. That is what they did on ER on the famous baby delivery episode "Love's Labor Lost". ER also had an OB/GYN who would come down on occasion.

This particular pregnancy situation was also done on PBS's "Call the Midwife". Sometimes my husband is in the room when I watch that (currently watching on Netflix), but I didn't think he was paying attention at all. He is the one who said to me, "This is the same situation as on Call the Midwife!"

Can someone medical explain it? Something happens to the mom after the 1st pregnancy (antibodies develop?) ... and then what? Does it only apply for fraternal twins?

It's a blood type thing, RH Factor.  If a mother has negative blood (I have 0-) and the baby has positive blood (my daughter was B+) then the mother's body's antibodies will attack the fetus causing miscarriage or fetal death in subsequent pregnancies (which is why they asked if she'd been pregnant before.).  However, it's easily fixed with a Rogham shot which they give ALL mothers with negative blood midway through the pregnancy (it is not something that could be missed) and another after birth if the baby has positive blood.  This sometimes irritates new moms because they refuse to believe that the mother knows 100% that her baby will be negative because the father is.

It would be serious malpractice for a situation like that to get as far as it did without anyone figuring out that the mother needed the rogham vaccination.  It's a simple blood typing of the mother.

https://www.parents.com/pregnancy/complications/health-and-safety-issues/what-happens-when-you-get-a-rhogam-shot/

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I can't help wondering how long this whole living together thing will last between Shaun and Lea-on the one hand, the fact she can't see herself with anyone else other than him in a year is a good sign, on the other hand, her hesitation at moving in and her talk about commitment has me going, "Hm". But the bit where she pulled out that baseball and put it on the shelf was a nice little touch :). 

I'm thinking this will go on and on. Just as one or both of them decides to split, Lea will turn up pregnant, because, as we know, TV doctors know very little about birth control. 

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On 11/26/2020 at 8:56 PM, meatball77 said:

It's a blood type thing, RH Factor.  If a mother has negative blood (I have 0-) and the baby has positive blood (my daughter was B+) then the mother's body's antibodies will attack the fetus causing miscarriage or fetal death in subsequent pregnancies (which is why they asked if she'd been pregnant before.).  However, it's easily fixed with a Rogham shot which they give ALL mothers with negative blood midway through the pregnancy (it is not something that could be missed) and another after birth if the baby has positive blood.

I don't think that it's an across the board thing. I'm also Rh negative, and they just kept taking blood from me multiple times during the pregnancy to check my blood.

When my children were born, they tested the umbilical cords to see what their blood types were. Both my kids wound up being negative despite my husband being positive, so I never had a Rhogam shot.

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A lot of the medical stuff goes over my head, but did Claire’s cancer patient have the same issue after surgery that ended up killing Melendez, the perforated bowel? Where they basically had to wait for the infection to kill him, or the antibiotics to work? If so, I’m surprised Claire handled it so well. 

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I'm trying to become interested in the newbies.  I didn't care about any of them when the interview process began, all six (?) of them, the two they rejected or the four they hired.  All during this episode my mind kept wandering despite my trying to stay interested.  I didn't even bother with the last half hour.  Hopefully that will change because I don't want to stop watching this show.

I also couldn't stand Morgan at first but she did grow on me.  I think she's wonderful with Shaun, and that was unexpected.  She's blunt (so is he, so maybe he appreciates that) while always being patient with him, and kind to him without being condescending at all.  

I'm not sure how I feel about Morgan and Park (if that's where they're headed).  I don't think there's chemistry between them, but that could be because I didn't see it coming.  What I do see coming however, which I think could be THE romantic relationship of the season and beyond is between two other main characters.  While it could have people wondering why there can't just be a strong female friendship between two women, I'm getting a vibe that they're possibly going there with Claire and Lim.  

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I realize this is fiction, and they need to get some 'personal' information out there to keep it interesting.  But I found it wildly inappropriate that they kept bringing up Asher's former Hasidic life (which he left).  I thought that was way out of line in the workplace, and had no bearing on his work as a doctor.

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