It seems Joan’s time at Westside Hospital is coming to an end. Doc season 2, episode 17, “Good Hands," sees the walls closing in around Joan as she’s forced to face the secret she’s been keeping regarding her MDS diagnosis.
As the episode opens, Joan is waiting for a patient outside the elevators as a man is rushed in. We learn that the man’s name is Havi, and he worked with Joan on a number of medical missions back in the day.
Amy arrives to assist with the case, and Joan quickly notes that Havi is aware she has MDS, as she assures Amy she only just recently found out about the diagnosis as she assures her she plans on telling Michael. Amy questions whether Havi is aware that Joan has shaky hands, and Joan notes that her hands are just fine.
Joan heads off to prepare for surgery as Jake pulls Amy aside to question whether Joan should be practicing with her diagnosis. We flashback to Joan working on a mission trip with Havi when a call comes through from her son, Ethan. It seems something is wrong back home, as Joan tells him to get to Westside and ask for Amy.
Back in the present day, Amy scrubs in with Joan, and she asks her to tell Michael today. Amy is understanding of Joan’s hesitancy, as she admits they both know the disease will take things from her, and Joan’s legacy shouldn’t be one of them. As Joan heads into the operating room, Amy gets a flashback of Joan telling her she can’t do dinner as she’s too tired – suggesting perhaps Joan confided in Amy about her diagnosis before Amy’s accident.
While performing the surgery, Havi’s stats begin to fall as they find a bleeder that requires a blind repair. Joan quickly gets to work and makes the repair look easy, but directly after, she races to the bathroom and spits up in the sink.
We return to the past, where Joan’s son Ethan has brought his son, Robbie, to the hospital for emergency treatment. As Ethan and Amy talk, he notes that he wishes his mom were there. At first, Amy thinks he’s meaning to treat Robbie, but he notes that he was talking about her being there for him during this difficult time. Amy defends her, saying that she’s doing her best, but Ethan is not having it.
In the present, Joan gives herself a shot in the arm in the bathroom as Amy comes to check on her. She says she needed to splash some water in her face as she disposed of the needle.
Amy comes to check on Havi and things seem to be going well post-op as Amy gets another memory, this time of Joan telling her, “That’s a hell of a bedside manner you have." Amy wants to try to recover the memory, knowing that her brain has given her glimpses when it’s trying to tell her something, and her doctor agrees. Amy begins a treatment and gets a flash of the memory as Joan tells her to stay quiet about her MDS diagnosis, which could turn into leukemia. At the time, Amy told her she couldn't perform surgery anymore.
After recovering the memory, Amy goes to see Joan and bumps into her as she’s walking down the hall as Havi is having complications. Amy admits that she remembered Joan was diagnosed months ago and that she took the job knowing she couldn’t handle it, as she points out a bruise on her hand from injections.
Joan sidelines Amy as Sonya steps in, noting that the scans show Havi has tuberculosis and needs surgery. Joan brings her in to assist as we flash back to Joan at the camp speaking with Havi over dinner. Joan admits she tried to stay put when she was first married, but she wasn’t cut out for it. Joan gets a call from Amy informing her that her grandson is stabilized but has an intense recovery ahead, as she urges her to come home.
In the present day, Amy confronts Joan, and we learn that Ethan no longer speaks to her after Joan failed to come home to be there when his son was sick. Joan heads to meet with Sonya, and the scans find things are worse than expected. Joan assembles a massive team for a complicated surgery. That’s when Jake returns and suggests to Amy that Joan isn’t leaving them with many options. Amy asks him to give her the day, as she shoots a Hail Mary shot by calling Ethan.
It’s then that we flashback to Joan showing up at Ethan’s door to check on Robbie. Ethan questions why she didn't come home sooner and says that he needed her; he’s mad at himself that he actually let himself believe she’d be there. She tries to explain that the patients needed her as he quips that it’s always something. He says he’s done as she comments about him not being the man she raised if he thinks her being there wasn’t important, and he remarks that she barely raised him at all as he closes the door.
In the present, the surgery went well, and Havi should make a full recovery. After getting Amy’s call, Ethan shows up at the hospital and embraces his mom as Amy watches on from afar. Shortly after, Amy goes to speak with Joan. Joan admits she and Ethan have a lot to clean up, but he’s here, which is a huge step. Amy reminds her they need to figure out what to do, as Joan says she knows exactly what she’s going to do.
Joan gathers everyone for an all-hands meeting where she admits this is not a conversation she wanted to have, as she notes she knows there have been concerns about her health, which she appreciates. She reveals to the doctors gathered that she has advanced MDS and notes that it’s time for her to accept it’s not something she can outrun. After careful consideration, she’s stepping back from surgery and leaving as chief.
Given that Joan mentions sticking around for another week to assist with the transition as she steps back, this isn't likely the last we've seen of Joan this season. However, it seems that Felicity Huffman's time on the show is coming to an end and that we likely will not see her back in a series regular role in season 3.
Elsewhere in the episode….
Richard and TJ team up to treat a billionaire patient named Zander, who has come after discovering a suspicious mass in his lung. After running tests, the biopsy shows Zander has an aggressive form of lung cancer that has already spread through his body. When Richard informs him he likely only has 4-6 months to live, TJ suggests that they could try CAR-T (Chimeric Antigen Receptor T-cell therapy), a personalized immunotherapy that reprograms a patient's own T cells to detect and destroy cancer cells.
Zander immediately wants to learn more despite Richard’s concerns with the course of treatment, which is not typically used to treat this particular type of cancer.
TJ presents his plan to use CAR-T to Zander’s medical team as they inform Zander that the only other option is an experimental treatment only tested on mice. With no other choices, Zander wants to push ahead with the CAR-T treatment. Richard makes it clear that this treatment plan is very risky and wouldn’t even be in consideration if not for his deep pockets as he excuses himself from the case.
TJ preps Zander and notes that this treatment is out of the box as Zander admits he’s never been a lab rat before. An hour after the injection, Zander's BP drops and he begins seizing. He’s put on a ventilator as a priest is called in to give last rites. Michael arrives and immediately grills Richard on how this happened as Richard notes it was out of his hands. TJ admits Richard has been right all along and they should follow his lead in trying a course of treatment to reverse the CAR-T effects.
They’re able to get Zander back, but they’re back to square one as Richard assures him they’ll do all they can to help him make the most of his last months. Rather than accepting his diagnosis, Zander says he’s going to be frozen before it’s too late, hoping that when the time comes, his body can be thawed in the future when a cure has been found.
After leaving the room, TJ admits to Richard that he got carried away as Richard notes what happened was unethical. He reminds TJ that he’s not a rookie anymore and needs to start acting like it, as he won’t always have a senior physician on hand to help in situations such as this.