The Good Doctor (TV Series)
Point Three Percent (2017)
Nicholas Gonzalez: Dr. Neil Melendez
Photos
Quotes
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Dr. Shaun Murphy : Good morning, everyone!
Dr. Neil Melendez : Right on time. What, did you sleep here or use a teleporation device?
Dr. Shaun Murphy : I used a teleportation device.
[Claire snickers]
Dr. Shaun Murphy : Nonsensical questions usually imply sarcasm, which I've found people often answer sarcastically.
Dr. Jared Kalu : Good one.
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Dr. Neil Melendez : You're giving a fractured arm a head CT?
Dr. Shaun Murphy : Yes.
Dr. Neil Melendez : Get back to the pancreas.
Dr. Shaun Murphy : He's not clumsy. He has a brain tumor behind the inner ear.
Dr. Neil Melendez : Forget the pancreas.
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Dr. Neil Melendez : Trauma wants a consult on a 66 year old male who collapsed from anaphylaxis, complicated by respiratory arrest. Now, his son just got back from Thailand. Almost immediately, the father had his allergic reaction.
[loud groans of pain from nearby]
Dr. Neil Melendez : Patient has a few allergies; pollen, mold, shellfish, but no corresponding allergens were in evidence.
Dr. Claire Browne : Well, why are we doing a surgical consult on an allergy?
Dr. Neil Melendez : Well, we're not. We're doing a consult on the excruciating abnominal pain he now has.
[more groans of pain]
Dr. Neil Melendez : As you may have heard.
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Dr. Jared Kalu : The guy was in some serious pain. Ten milligrams of morphine worth.
Dr. Claire Browne : Test results show elevated lipase, amylase, pancreatic enzymes.
Dr. Jared Kalu : Pancreas is enlarged. Could be pancreatitis, maybe alcohol-induced.
Dr. Claire Browne : The son said he smelled alcohol on his father at 6:00 in the morning.
Dr. Jared Kalu : And anaphylaxis has been known to precipitate attacks of pancreatitis.
Dr. Neil Melendez : Guess that's it, then.
Dr. Claire Browne : Meaning you totally disagree.
Dr. Neil Melendez : Not everyone who starts their day off with a mimosa fries their pancreas. Your eyesight must be a hell of a lot better than mine, because I can't see the entire pancreas due to the overlying bowel gas.
Dr. Jared Kalu : We'll order an abdominal CT and take a better look.
Dr. Neil Melendez : There you go. Where the hell is Murphy?
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Dr. Neil Melendez : Instead of a death sentence, he could have something that could easily be treated with prednisone?
Dr. Shaun Murphy : Next, we need to do a bone marrow aspiration to confirm.
Dr. Neil Melendez : I assume you've looked at his file.
Dr. Shaun Murphy : For a very long time.
Dr. Neil Melendez : Well, there must have been a biopsy. What did the pathology report say?
Dr. Shaun Murphy : Yes. There were two biopsies. Both were positive for osteosarcoma.
Dr. Neil Melendez : Murphy...
Dr. Shaun Murphy : They could false positives.
Dr. Neil Melendez : Do you have any idea how unlikely it is to have two false positives?
Dr. Shaun Murphy : .03%.
Dr. Shaun Murphy : Which we can comfortably round off to "not likely".
Dr. Shaun Murphy : It is possible...
Dr. Neil Melendez : Yes, but it means telling the parents of a dying child that there's hope, when really there isn't. Grab a shower and get ready for rounds.
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Dr. Shaun Murphy : It might not be cancer.
Dr. Neil Melendez : Fractured arm?
Dr. Shaun Murphy : Yes.
Dr. Neil Melendez : You said he'd been diagnosed with stage four osteosarcoma.
Dr. Shaun Murphy : Evan was diagnosed with the flu eight months ago, but his symptoms are actually a better fit with Epstein-Barr virus, which is linked to Langerhans cell histiocytosis, which causes osteolytic lesions in the long bones of the upper limbs.
Dr. Neil Melendez : And those lesions could be misdiagnosed as signs of osteosarcoma.
Dr. Shaun Murphy : Yes.
Dr. Neil Melendez : What about his brain tumor?
Dr. Shaun Murphy : Langerhans can also manifest in the skull.
