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Paul told him that he wanted the surgery… even if that’s not exactly what was said in the chapel.
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He assures them that Paul’s death isn’t their fault. Paul’s kids turn on each other after receiving the news, causing Shaun to intervene. Shaun wants to tell the family, but Melendez insists it’s Claire’s turn. An artery ruptures, and ultimately proves fatal. Paul, meanwhile, eventually experiences complications from the surgery.
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He’s unable to articulate what he’s feeling, and says he doesn’t know how to be honest with Lea. Claire senses that Shaun’s upset, and follows to ask what’s wrong. She’s hoping to get lunch, but Shaun walks away, claiming he’s too busy. Shortly thereafter, Lea turns up at the hospital and surprises Shaun. And so, they proceed with the whipple surgery, which is initially deemed a success. Shaun and Claire then deliver Paul’s family the good news. He’s going through with the surgery, not because he wants it, but because he made a promise to always be there for his family. Shaun then asks if he thinks praying will help him come to a decision, but Paul has already made one. Shaun walks in and apologizes for how he relayed the earth-shattering news, but Paul isn’t upset and understands that Shaun did the best he could. Later, Paul visits the hospital chapel to pray. “Having the surgery could kill you,” Paul’s daughter points out, “but not having the surgery will kill you.” Paul’s wife and adult children come in to discuss the potentially life-saving procedure, which Shaun and Claire emphasize is high-risk. Shaun approaches Paul and asks to speak privately, but when Paul hesitates, Shaun comes right out and tells the janitor that he has less than a year to live. Melendez tells Shaun that he, not Claire, should be the one to break the news to his patient. Without a procedure known as whipple surgery, Paul will not survive.