[Editor’s Note: The following contains spoilers from “The Good Doctor” Season 3, Episode 2, “Middle Ground.”]
“The Good Doctor” excels at two types of storylines: those that highlight underrepresented groups — such as the transgender community, or people with autism — and those that place the San Jose St. Bonaventure Hospital surgeons in ethical quandaries that don’t always have satisfactory conclusions. On Monday’s episode, the medical case of teenage patient Asha (Camille Hyde), who was tied down and “circumcised” at age two by family members, ticks both boxes. Here we see the hospital condemn the brutal practice, but “The Good Doctor” also shows the organization undermining its own authority by crossing ethical boundaries.
Female genital mutilation (FGM) — also known as female genital cutting or female circumcision — is the ritual cutting or removal of some or all of the external female genitalia. It affects 200 million worldwide; it also fuels a complicated conversation about culture and health that surrounds it. In the episode, Asha comes in for Dr. Audrey Lim (Christina Chang) to perform a vaginal reconstruction to fix the damage that she believes makes her hideous in the eyes of her American peers and future romantic partners. Complications set in after she wakes from surgery and experiences extreme pain, which means that despite the extensive damage done to her as a toddler, some nerve endings still work.
It also turns out that she used a fake ID at the hospital. Her real name is Mara, and she’s underage. When her parents arrive, debates rage over the options to alleviate Mara’s pain: undoing Lim’s work and killing the peripheral nerves completely, or additional reconstructive surgery. Dr. Lim believes the latter option could protect Mara’s newly awakened nerve endings, which would also give her hope of someday feeling sexual pleasure. Although Mara states that she will follow her parents’ preferences, Dr. Lim deceives them all and does the reconstruction. Mara wakes with pain in her cheek, realizing that tissue was taken from there for the reconstruction, but happily stays mum.
FGM can take place from infancy through adulthood, and can involve different degrees of cutting. Both the World Health Organization and United Nations condemn the procedure as a human rights violation. They see it as unnecessary and harmful to a person’s health without any physical benefits, and possibly fatal. It is also deemed to be used as a way to control women’s sexuality and sexual pleasure, while maintaining gender inequality in these groups. In addition, it’s believed that no child too young to give consent should be harmed, even if it’s done with the parents’ approval.
“The Good Doctor” only lightly touches on why some cultures may find the practice desirable. It can be viewed as a rite of passage that identifies womanhood and belonging in some communities, with some groups treating it as a joyous initiation that a young woman will celebrate. Understanding that gulf in perceptions isn’t a politically correct nicety: Merely informing these communities of the health risks isn’t enough to deter them, since those risks can even give extra significance to the cultural value of FGM. Without fully appreciating its value to these communities, it’s difficult to find an argument against it that will resonate.
Mara’s parents are portrayed as loving and proud of her achievements. Mara’s mother mentions how cutting is a tradition that all women of the family have endured, and how it makes Mara desirable for marriage to men in their community. They want what’s best for their daughter, but this definition of what’s best is still rooted in the standards of their old community, not the new one that Mara must grow up in.
Having Dr. Lim defy the parents’ decision — and even Mara’s stated wish — is a bold choice for the show because it’s not solely rooted in concern for Mara’s physical health. Instead, Lim makes a decision based on what she thinks will help the girl’s emotional and social well-being. While it’s possible that Mara changed her mind and told Lim she wanted the reconstruction offscreen, it’s implied that she did not and that even Dr. Alex Park (Will Yun Lee) understands that Lim is operating without express consent.
Mara’s case is framed in the context of her experiencing psychological stress about assimilating into American society because of what was done to her as a child. Her description of the procedure — how her aunt and grandmother “tied me down” — also sounds incredibly traumatic. For viewers, there’s no doubt that FGM was a negative event in her life, and a doctor choosing to go rogue is positioned as a happy ending for all.
“The Good Doctor” often portrays its medical professionals not only as flawed human beings dealing with romance or addictions on top of their stressful jobs, but as people struggling with the weightier issues of the human condition. However, Lim’s decision should be questioned for its shaky ethics. Her character is an example of how, in its second season, the show has strengthened and expanded its storylines beyond exploring what it’s like to think like the titular good doctor, Shaun Murphy (Freddie Highmore), who has autism and savant syndrome.
This episode’s story slightly dovetails with Murphy’s: He struggles with the nuances of straight-out lying, white lies, and lying by omission. He eventually settles on how intent — to help or harm — will guide the need for and degree of deception. When Dr. Lim decides to leave the parents out of the loop and claim that Mara gave her verbal consent, she did so with the intent to help her patient more holistically.
While Lim’s decision-making is questionable, it aligns with the show’s aim of understanding ourselves and others’ motivations, and how achieving that goal still doesn’t lead to a clear-cut outcomes. The show’s thoughtful and more nuanced exploration of complicated and often controversial topics informs just enough to inspire more research and discussion, playing with ideas as much as with medical oddities. This is one reason that, despite its unabashed sentimentality, the show avoids becoming inspiration porn.
”The Good Doctor” airs Mondays at 10 p.m. ET on ABC.