ABC’s The Good Doctor might want to change its name to The Woke Doctor. After previous episodes this season supported Black Lives Matter and abortion, Monday night’s episode, “Irresponsible Salad Bar Practices,” offered the double whammy of a pregnant trans man and systemic racism in medicine.
The episode began with trans man Rio Gutierrez (played by trans actor Emmett Preciado) at the hospital to receive treatment for a pituitary tumor. Rio tells the doctors about being engaged to a man, while the doctors bemoan the “messed-up software” that correctly records Rio’s gender as female.
Dr. Reznick: Your primary care doctor was right. The mass is on the smaller side. We'll confirm with the new images, but it should be manageable with medication. No surgery needed.
Rio: Well, my fiancé will be so relieved. He's been worried I'll look like Frankenstein in all our photos. Also that I might die.
Dr. Allen: When's the big day?
Rio: June.
Dr. Allen: You've been dealing with wedding planning on top of a pituitary tumor? You deserve a medal.
Dr. Reznick: Our medical record system, on the other hand -- it has you listed as female.
Rio: Probably because of the Pap smears.
Dr. Allen: Software clearly needs a trans update. Deep breath.
Dr. Reznick: I'll fix it so everything is correct going forward. Please confirm your gender and pronouns.
Rio: Male, he/him/his. Thanks for asking.
Dr. Reznick: We're the ones with the messed-up software. Your scans from this morning were just uploaded. In less than two weeks, the tumor's doubled in size.
Turns out Rio is pregnant and pregnancy hormones are causing the tumor to grow exponentially. After first saying, “I'd like to terminate the pregnancy,” Rio then decides to keep the child and must have a risky brain surgery to remove the tumor.
The surgery is a success and the couple celebrates, “We're gonna be dads!” When Rio is asked, “Are you ready?” Rio responds, “I've never been a pregnant man before.” With the fiancé chiming in, “You'll always be the best man that I've ever known.”
During all this, Dr. Shaun Murphy (Freddie Highmore), the autistic savant who says what all logical people are thinking and had trouble wrapping his brain around transgenderism before, ponders Rio, a biological female engaged to a male, and asks the fiancé if he considers himself gay, reasonably pointing out, “You have vaginal intercourse with your fiancé” before being cut off by the other doctors.
In another scene, Dr. Murphy says, “He is very confusing to me, too. Rio has worked so hard -- he had a bilateral subcutaneous mastectomy and takes hormone replacement therapy, but now he is choosing the most female act [giving birth].” To which the fiancé claims, “It's not female if Rio's doing it.”
Preciado, the trans actor who played Rio, loved that scene, saying:
“I understand that I was born in a female body, but my brain and my soul is masculine; It is male… I loved how it was written, because it shows that just because this person is deciding to carry a baby, because they can, because their body was built for that, why does that have to be a feminine thing? Why can’t it also be a masculine thing or why does it have to be either/or?”
That's nice. A cis male (the fiancé) and a trans man (Preciado) trying to redefine femininity and take away what's special about being a woman from us.
A second woke storyline involved the racist treatment of a black patient. The twist is that the “racist” doctor identifies as a black woman.
Zara Norton (X Mayo) enters the ER delirious suffering from what Dr. Claire Browne (Antonia Thomas) thinks is untreated chronic hypertension. Dr. Browne doesn’t believe Zara when she says she takes her medication for hypertension and gives her ACE inhibitors, which end up being a bad call because Zara was telling the truth about taking her meds and the ACE inhibitors sent her into cardiogenic shock.
When explaining why she didn’t believe Zara, Dr. Browne says, “I made a medical diagnosis based on pattern processing that we're taught in med school, which involves considering, you know, race, education, occupation, BMI.” Another doctor replies, “Always sounded like profiling to me.”
At first, Zara is pleased with her doctors: “My lucky day. Three doctors of color taking care of me. Doctors who won't talk down to me. Not exactly what I'm used to. You guys know what I mean.” She is able to spout off statistics like “doctors are 22% less likely to give pain meds to Black patients than to white patients with the same symptoms.” But then she figures out Dr. Browne’s mistake and demands to be transferred to a different hospital, “One where she won't be ‘racially profiled into heart failure.’” Hmm, maybe racism isn't so black and white.
The president of the hospital, Dr. Aaron Glassman (Richard Schiff), goes in to meet with Zara.
Dr. Glassman: Dr. Glassman, president of the hospital.
Zara: Unless you're here to drive me to S.F. Regional, you can head right back on out.
Dr. Glassman: I apologize for your experience in the emergency room.
Zara: That's mighty white of you.
Dr. Glassman: I don't recommend that you transfer to S.F. Regional, or any other hospital, for that matter.
Zara: I'm sure they got the same fancy equipment, same shiny sets of diplomas y'all got here, and maybe a few less racist doctors.
Dr. Glassman: Well, apparently, that doesn't seem to be the case. I pulled data on comparable hospitals within 100 miles, did numbers on surgical outcomes and patient satisfaction aggregated by race. Apparently, we're doing well, comparatively.
Zara: Your argument is that your hospital may be racially biased, but it's less racially biased than these other hospitals?
Dr. Glassman: Yeah. Pretty much. Stay at St. Bonaventure, the president of the hospital will monitor your care every step of the way. For whatever it's worth, I don't think you can do better than that… She's gonna stay, on one condition. That you're off the team.
Despite not being able to participate in the surgery, Dr. Browne is able to verbally help save Zara during a complication via the observation deck. Afterwards, she speaks to Zara and confesses her own racial insecurities:
Zara: Dr. Andrews told me you was the one who figured out how to save me. Still don't change what went down earlier, though.
Dr. Browne: When I got to med school, people took one look at me and they thought they knew exactly who I was. Black girl on financial aid. She must not be that smart. She must have gotten a lot of breaks. She'll probably need a lot more. And I worked -- I worked so hard to prove them wrong, that I wasn't who they thought I was, that I deserved to be there, that I -- that I fit in. When you came into the ER -- loud and messy... I saw... I saw everything I have tried hard not to be. And I think it made me angry. And I'm ashamed of that. And I'm really sorry.
Zara: I used to be that way. But I got tired of working that hard to make white people comfortable.
After, Dr. Browne tells another doctor: “I apologized to Zara. She pointed out I spent med school trying to make white people comfortable. I mean, she's right. It wasn't just med school.” The other doctor replies, “Exhausting, isn't it?”
This inspires Dr. Browne to confirm Zara’s statistics and report to the Chief of Surgery, “I asked Lea to run some numbers on various metrics by race, and the results are not great, especially when it comes to pain management. We are under-treating African-American and Latinx patients by a considerable margin.”
Can't wait to see what leftist social justice issue The Woke Doctor cures next.
