Review: The Good Doctor – Season 1, Episode 11, “Islands Pt. 1”

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After having a meltdown of epic proportions and slapping Glassman, Shaun goes on an unscheduled road trip with his neighbour Leah in this two-part season opener. Glassman covers for Shaun with Melendez and Andrews (yeah, let’s see that not back-firing). Meanwhile, in the part of the show where medicine is being practised, Melendez, Andrews and Claire are scheduled to complete a kidney transplant on conjoined twins, Katie and Jenny. The situation becomes more complicated (as it usually does on this show) when Jenny’s begins to experience heart failure and the team have to speed up the separation surgery that was meant to take place six months after the transplant. A surgery that the twins aren’t even certain they both really want. Alongside all of this, Claire continues to deal with the after-effects of Jared’s single-minded and selfish decision to attack Doctor Coyle.


Main Review

While the medicine side of this show may be pushing the truth/outright unrealistic, I have to say I infinitely prefer it to the road trip story that takes over a lot of this episode. I don’t particularly like Leah’s character, and I think that’s part of why I was so “Eh” about this episode, but I also think there’s some weird greyness about Shaun’s autonomy and the power dynamics between him and Leah. This won’t be the only episode these thoughts come up. In some ways, I think Leah isn’t all that different from Glassman in pushing Shaun to be the version of him that they want him to be.

Anyway, there’s a lot at the beginning of the episode centered around Shaun learning to drive (which I think Shaun wants to do but I can’t actually remember) and Leah pushing him to go outside of his comfort zone (the theme of the episode actually). This leads to an exchange which has in a few seconds one of the most amusing lines in the episode, followed by casual ableism:

Leah: What’s the worst that could happen?

Shaun: I could run someone over and kill them.

Leah: You have autism, you’re not blind.

There’s so much about Leah’s comment that is just infuriating in the casual ableism that is prevalent in the way we speak (myself included, I get annoyed at myself too at times). It also doesn’t make sense from a factual perspective because I would think that the vast, vast percentage of pedestrian fatalities which occur are not caused by a driver who is legally blind. There are many reasons why someone could crash a car, and in the situation Shaun’s autism could very well complicate his learning to drive.

This isn’t to say that being Autistic always complicates learning to drive, just that for Shaun and the way his autism presents, it could make his learning to drive difficult. Shaun is shown to have these suspicions himself and they are brushed aside by Leah. Eventually Shaun has a minor incident on the road which occurs as a result of information overload and emotional dysregulation and he crashes. It’s a minor crash and no-one is hurt but Leah does downplay Shaun’s distress over the issue.

Later, Leah gets Shaun drunk. This part gets really squiffy for me. Shaun doesn’t want to get drunk, but the whole thing is positioned as Leah “helping” Shaun experience new things and have fun. After getting drunk, they sing karaoke and then Leah springs it on Shaun that they were on a date. Or at least role-playing one. Then she role-plays further and tells Shaun he has to kiss her. This whole thing is at best a dubious grey area in my mind because there’s some definite power imbalance when you consider Shaun’s social differences and the fact he has a huge crush on Leah so would do almost anything she asked him. I’ve seen comments on forums saying that Shaun could have said no, which yes he could have but that’s only if you (ironically) look at it from a very black and white perspective without considering the wider context and implications of what is happening in Shaun’s life and think that by going along with it, Shaun is giving full and enthusiastic consent.

Then, after all that, Leah reveals to Shaun that she is going to quit her job and move away to Hershey, Pennsylvania. Shaun gets up and walks out of the café, not sure how to cope. It’s another example of a sudden transition and Shaun not knowing how to respond. Which is what this episode has been for Shaun. Repeated sudden transitions that he is uncertain how to respond to.

Wow, so that’s that rant out of my brain (it’s been there for a while, getting rantier). What else was there in this episode then?

The medicine part of this episode was much more interesting and engaging than all of the above. Conjoined twins Jenny and Katie have been preparing for multiple surgeries – first a kidney transplant, then a later separation transplant – and throughout the course of the episode, complications arise that mean timelines need to be sped up. Even the surgical options which will save their lives are complicated and the twins have to all of a sudden deal with emotions and uncertainties that they would otherwise have had six months to process and talk through. It makes sense that this case takes place over two episodes because the emotions, considerations and complexities behind a decision (even without complications) are immense.

This episode is also where we start to learn more about Claire’s background and the impact it has had on her as a person and as a doctor, including being – as Melendez says – the best communicator on his team. Claire will frequently go to talk to patients, even during their most difficult moments, from this episode onward, and there’s some interesting considerations for later on down the line as to how fair this is.

“No, it’s okay, Water under the bridge. That nearly drowned me”

-Claire Browne

There’s also some follow-up to Jared getting fired. Jared first goes to Doctor Coyle himself and asks for his help getting his job back. This whole thing is weird in that he kind of blames Claire in a subtle way for his reaction? That he felt bad because she had told him and then he hadn’t believed her. It’s weird. Then Claire goes and threatens Coyle to get Jared his job back and Melendez also asks Doctor Andrews to reconsider. Jared has a lot of people trying to get him his job back basically but Andrews refuses to reinstate him, though he does agree to recommend him to other hospitals.


Autistic Rep Review

You know what, even with my rant above, I’ve still got more to add. I think this episode does demonstrate how, under the right circumstances, Shaun can be essentially manipulated into doing something he either doesn’t want to do or isn’t sure if he wants to do. This comes back more blatantly in a later episode under different circumstances but I argue that you can first see it here.

A while back there was a lot going on on Twitter with some people arguing (often with quite offensive methods) that Greta Thunberg was being manipulated by her parents and was essentially a puppet. In an effort to push back on that, a well-meaning trend rose where Autistic people and families of Autistic people claimed that it was impossible to coax, manipulate or otherwise maneuver Autistic people into doing something they don’t want to do. This got widespread until another Autistic advocate pointed out that this simply wasn’t true in all cases and inadvertently minimized the mate crime and exploitation that some Autistic people were victims of.

In this episode, I think that Shaun’s particular vulnerability to pressure, coaxing and, arguably, manipulation was demonstrated throughout. Shaun often has his “No” ignored. It was repeatedly ignored by Glassman and it’s ignored again by Leah in this episode. The whole episode is meant to be framed as though Shaun does actually want what ends up happening throughout, in some ways that makes it worse. Shaun is surrounded by people who want to change him (including ones the fandom often claim accept him as he is…) and this episode does a good job of showing the complications that arise from this.


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