New Amsterdam (2018) s01e04 Episode Script

1 Good morning s A cruel person wrote these.
A cruel person is going to put you back in bed.
Do you remember how much I loved this bed when we got it? - I do.
- Hmm.
Now I want to set it on fire and laugh while it burns.
That sounds dangerous, and bed rest is important.
- It prevents the cervix from - From having a life.
Max, my cervix is so bored.
Thank you for doing this.
All of it.
How's the couch? - Really good.
- Hmm? Yeah, it's a little bit better than the bed, to be honest.
I want to be ready, Max.
I want to want you back.
I'm just I'm not I got all the time in the world.
Do you mind if I ask how long your foot's been hurting? It's nothing.
I'm fine.
I'm a doctor at New Amsterdam - right across the street.
- No.
Maybe you could take a walk with me.
I could have a look at that.
Maybe you could leave me alone.
Your foot is badly infected.
If you don't do something about it, it's going to get - a lot worse.
- Can you get away from me? I love soil.
Do you want to know why? I am at the edge of my metaphorical seat.
Because it contains mycobacterium vaccae, which has been proven to promote serotonin production, which acts as a natural antidepressant.
So does that hat.
Can't bring me down, my friend.
Not today.
The HCC has funded my proposal.
After two years, they funded it! - For the community garden? - Yes, exactly.
You know, horticultural therapy dates back to ancient Mesopotamia, and uh, oh, my gosh, are those your little homemade Indian donuts? They are not donuts.
They are laddus.
Well, I don't mind if I "laddu.
" They are not for you.
They are for someone else.
Not the girl from the coffee shop, though.
Her name is Ella.
It's my gesture of gratitude for someone who showed me kindness.
Okay, let me see if I got this straight: you're gonna give pastries to someone who works - in a pastry shop.
- Laddus are not pastries.
- They are sweets.
- Oh.
Well, that doesn't make it any less weird.
Gladys? Gladys, what is this? Volt cola swag.
A gift from the new sponsor.
What new sponsor? For your community garden.
Bloom? What's the urgent page? Got an EMS notification asking to have thoracic standing by.
- You okay? - Headache.
45-year-old man, acute onset tearing chest pain.
Heart rate 110; 140 over 56, right arm; 100 over palp, left.
Respiration's 18.
- Gave him nitro - Dissecting aortic aneurysm.
Mateo? Hope you're on your game today, Floyd.
- Who's - Mateo Fernandez.
The cardiothoracic from Baptist? - Yeah.
- Isn't this week Yeah.
Hey, get Max down here now.
Oh.
Okay, as I fit you for the radiation mask, remember you have to keep absolutely still.
I always found stillness to be a highly overrated - human ability.
- Consider it practice for when we aim high energy external beam radiation at the cancer in your throat.
If you move then, you die.
Has anyone ever told you you would make a great James Bond villain? Uh, Max, you cannot move.
Right.
So, uh, come here often? That includes your mouth.
- All of it? Because - Do I have to remind you that you need a throat to make jokes? Relax.
You can close your eyes if you'd like.
Stay still, Max.
Done.
I think it's fair to say that was torture for both of us.
If my cancer gets anyone else killed besides me, then I'm really going to be upset.
I got the 911.
This week's the annual conference of Cardiothoracic Surgeons in San Diego.
Everyone goes.
All of my attendings are there.
One unlucky surgeon stays behind at each hospital to cover.
It's me here, It's Fernandez at Baptist, but only one of us has a dissecting aortic aneurysm.
And since he's here, I'm guessing no one's covering Baptist.
They still have general surgeons, transplant surgeons.
Yeah, they can't cover for Fernandez.
You want a gynecologist tagging in on your heart surgery? How can Baptist run their hospital without a cardiothoracic surgeon? They can't.
Which means they're no longer a level-one trauma center.
Without cardiothoracic backup, they can't treat myocardial infarctions, car accidents, GSWs they can't accept ambulances.
Guys, we're gonna have to pick up Baptist's full ambulance load.
I knew you were gonna say that.
- They'd do it for us.
- Would they? We're short-staffed too.
What about the network hospitals? They'll pick up the elective admits, but emergency patients will die waiting in cross-town traffic.
We're the closest.
- It's on us.
- You really think we can shoulder their full ED plus all the cardiothoracic surgeries? Just the ones that need to be done today.
- Yeah, just those.
- Guys, this is what we do.
We help everyone.
Floyd, I trust you and I believe in you, so I am only going to do this if you tell me you can handle it.
- I can handle it.
- Okay, good, because if something goes wrong, we are both on the hook.
But nothing will go wrong, all right? I'll make sure of it.
upstairs, all right? Okay.
Bloom, we're going to live or die today based on our ED load.
So, any doc or nurse standing still in any part of this hospital needs to go down and pitch in.
- I'll take it.
- I already hear sirens, so unfortunately, you're going to have to miss the rest - of my big pep talk.
- Aw, so sad.
Iggy, psych wait times are the longest, so make sure you get your patients up to your ward early and often.
All right.
Good thing psych patients are so compliant.
Kapoor, neurology wait times are second, so I need you to move double time today.
- This is my double time.
- Noted.
- Sharpe.
- This is a bad idea.
So is sending every cardiothoracic surgeon in America to San Diego at the same time, but they do it every year.
- Last year was Barcelona.
- I do love sangria.
- This is a bad idea.
- So, are you telling me that you wouldn't have taken the extra patients? No, I wouldn't have.
I try to make things simple, easy.
- You know, like a normal person.
- Ah.
Why do you keep choosing the hardest road at every opportunity? Better views? Tall person, how long have you been with Reynolds? Three years.
And it's Nottingham.
- I'm a PGY-6, so - Okay, today is not the day where I'm gonna be polite and remember your names.
When patients come in, I'm going to point and yell.
Don't take it personally.
You move on my orders only.
- What'd you bring us? - Adaline Simon.
53-year-old female, had a pleurodesis - on the books at Baptist.
- Tall person, take Mrs.
Simon to any empty bed and get her prepped for surgery.
This is Mr.
Gold, 47-year-old male in need of a VATS procedure.
Casey and brown-haired woman.
Any open bay.
Name is Sherry Fletcher.
68-year-old female.
She requires a mediastinoscopy.
Stay with me.
Okay, let's get her inside.
Okay, put Mrs.
Fletcher in bay 23.
Has anybody seen my ibuprofen? Tell a nurse to grab you a bottle from the What I need is for people to stop taking my stuff.
Incoming! - Rib spreader.
- Rib spreader.
Fair warning: this is being recorded so that Dr.
Fernandez can see my technique when he's awake.
Um, Dr.
Reynolds? Uh, Dr.
Bloom asked me to, um Start with the subject, then the verb, and see where the sentence goes from there.
The cases from Baptist are crowding the ED.
There's a pleurodesis.
With your permission, I was thinking I could grab a general attending to supervise and handle it myself.
Appreciate the enthusiasm, but prep the patient and wait for me.
It's just the ED's awfully full, and I really think I can help out You have a very promising future.
I don't want you in over your head when I'm too busy to bail you out.
A mistake like that can derail your entire career, so go ahead and prep the patient, and I'll get there when I'm done.
Yes, sir.
Thank you.
Baptist's surgeons are on a flight back from San Diego.
It lands in five hours.
You got this, right? Do I have a choice? I could warp the space-time continuum.
Hey, what patient is that for? A homeless woman outside.
You couldn't find a patient inside to help? If I don't help her, she's going to lose her foot.
- Send an intern.
- She's skeptical of doctors and so am I, so we have an understanding.
- I'll be back in five minutes.
- What? Sorry, Doc! You and Ella have an asymmetric power structure.
Giving her a gift can be misinterpreted as a deliberate extraction of reciprocal favors, sexual or otherwise.
I see you talked to Dr.
Frome.
Mrs.
Monaghan, I am Dr.
Vijay Kapoor - and this is Dr.
, uh - Kao.
Dr.
Kao.
- I'm dizzy.
- I'm so sorry to hear that.
Dizzy can be awful.
Can you explain to me what do you mean by dizzy? You don't know "dizzy"? I do, I do, but I also know that it means different things - to different people.
- Well, at Baptist, - they understand dizzy.
- That may be true, but here at New Amsterdam, I want you to think about what exactly dizzy means to you.
It means dizzy.
The good news is that your CT scans are negative and preliminary lab tests all look fine.
- She's a good doctor.
- Yes, she is.
So, while I examine my other patients, I want you to think about your kind of dizzy.
Tell me you're admitting "dizzy chick.
" I cannot admit anyone without a proper diagnosis.
And I don't have any yet.
Maybe we should make it a multiple choice question? We cannot give her choices.
It will influence her answers.
We just need to know what dizzy means to her, and we will get our diagnosis.
So then I call HCC, and they say I take the money from Volt Cola or I can kiss my garden goodbye.
More than half of the sugar kids consume - comes directly from soda.
- I know.
Volt Cola spends millions each year to defeat public health legislation that could actually help.
- I know.
- So, unless you want to hurry along the epidemic of childhood obesity, then there is no way you can take their money.
- I know.
- Great.
Now you can focus on the epidemic of overcrowding in my ED.
Your psych patients are in bays 2, 8; rooms 12, 22, and 28.
Get them out of here.
Okeydoke, Doc.
Okay, I'm just gonna check if the numbing medication has worked, Tianna.
Can you feel this? - No.
- How about this? Mm-mm.
She was in pain, so we called 911.
We didn't want to take any chances.
Should we have just driven her to Baptist? No, no.
You did the right thing.
I've read Tianna's file.
I'm all caught up.
- Mommy, you're not watching.
- I am, sweetheart.
Oh, don't move, Tianna.
I'm just gathering the cells I need for the biopsy right now.
Those are gonna tell you if my cancer's back? That's right.
What's it like when you die? Baby, you don't need to know that.
That's not going to happen for a long, long time.
All right, baby girl? Right, Dr.
Sharpe? Do you want the elephant or the tiger Band-Aid? Nobody tells me anything.
- Miss me? - Nope, nope, nope, nope.
- I can't afford your help! - My help is free.
Not taking it is gonna cost you your foot, so either way, you're gonna have to deal with me.
You're relentless.
I'm Max.
- I'm Faye.
- It's nice to meet you, Faye.
Okay, take one of these a day until the bottle is gone.
I have to go, but, uh, I'll come back to check on you.
I have a brother who's very sick.
He won't go to the hospital.
Can you help him too? I have a hospital full of patients who need me.
How can I help? - Faye, I really can't go far.
- We're close.
I promise.
You have to see him.
This way.
Hey, how much longer? I'm backing up downstairs.
I'm holding this man's aorta together with string and Scotch tape.
I'm doing everything I can.
Well, your seven surgeries waiting in my ED - would disagree.
- Take it up with Max.
- I would if I could find him.
- I'm going as fast as I can.
I'm the only cardiothoracic here.
Well, what about one of your residents? I mean, the tall one looked semi-competent.
Nottingham and, look, for all these patients, this is the scariest day of their lives.
They woke up needing major surgery, then they were thrown into an ambulance and dragged across town so that a doctor they don't know can cut open their hearts.
They're trusting me, just like Max is trusting me.
And I'm not putting that kind of pressure on a first-year resident straight out of med school.
Oh, we got a bleeder.
Are the patients downstairs stable? - Yeah.
- Then they can wait.
I am giving you one hour and then I am sending them somewhere else.
All right, here we go.
Suction.
Mrs.
Monaghan, can you describe your symptoms now? Dizzy! Are you even a real doctor? Yes, and I'm trying to help you.
Good, then give me something for dizzy so I can go home.
I would love to do that, but I want to give you the right something.
- I'll give you more time.
- You She's gonna be here all day.
Maybe, but fast and wrong is not a service to her or to anyone else.
Dr.
Bloom? What are you looking for? Are you getting her out of my ED? Not as yet.
Can you get some other patients out of here? Something's gotta give.
Oh, and you should totally give Ella your pastry.
So, you do understand it was a harmless gesture.
Oh, I think it's a huge mistake, but I want to see you suffer.
Oh! Laddus are not pastries! It's like my college sit-in days.
Every chair occupied, so people just lie on the floor.
Almost done.
Tilt and four hours to go.
Go steal the chemo chairs from onc'.
Oh, a grab and go.
Also like my college days.
On it.
Jemma.
Jemma, wait.
Hey, whoa, whoa.
Are you okay? No, I'm not okay.
None of this is okay.
Jemma, hang on.
We're trying our best here.
Okay? It's an uphill battle.
I just what? What's this? What's happening here? - Transfers from the ED.
- No, no.
Uh-uh, no.
No vacancies.
- We're all full up.
- So is the ED.
I'm not their safety valve.
- All right, let's go.
- I just Yeah, come in.
This is exactly why we needed the community garden.
- What happened to the garden? - I have to kill it.
You have been wanting that garden for years.
Yeah, just not with Volt Cola attached.
In India, Volt Cola builds playgrounds, football fields, cricket pitches for kids to play on.
Which means land, which takes money.
Would a garden make a difference to these kids too? Yeah.
Yeah, it would.
Tianna's cancer's back.
Ewing's Sarcoma.
It's extremely aggressive.
I'm very sorry.
What about something experimental? Unfortunately, there are no clinical trials for kids her age.
There has to be more out there um other countries, um there has to be something else.
I think that we should discuss palliative care options.
- How do we tell her? - We don't.
We can't.
Tianna is smart.
She is asking questions.
She is looking for answers.
- The best course of act - I can't tell her.
Can you? Who are you? What'd you bring this guy here for? He's a doctor and his name is Max.
You brought a doctor to our house? Hey, hey, hey.
He can help.
We don't need his kind of help.
Give him a chance, Paul.
Just it's okay.
Where are you from? Are you from the Midwest? Hamilton, Ohio.
Born and raised.
Why? Vance, you may have a fungal infection, and if it's the kind that I think it is, we need to get you into New Amsterdam right now.
No, man.
No hospital.
All right, what you got to do now is just get the hell out of here.
I don't know what you have against hospitals, but if we don't take your brother to New Amsterdam right now, - he is going to die.
- Oh, that's exactly what the other doctors said when Mom was sick.
Except rather than help, they just kept bringing bills.
We lost our apartment.
The debt collectors took the rest.
I promise you will never see a single bill from New Amsterdam.
What do you say, Vance? I took a gamble on you coming here, leaving my own hospital.
You want to take a gamble on me? Go away, man.
You heard him.
Get out of here.
The graft's pulling taut.
It's too damn small.
What? Everyone is prepped, so I thought I'd scrub in.
No.
I've watched you do this surgery four times.
I know to ligate the internal mammary before transecting the intercostal, I know I don't need you in here.
I need you out there.
Go! Suture.
Excuse me.
Excuse me! That is my chair! Wha I said I ain't moving.
You're not the only dumb-ass that needs space! Fight, fight, fight! Thanks.
Over there.
Not now.
Goodwin! Where the hell have you been? It's like a damn MASH unit in here.
- Dean, I had to take - What were you thinking? Bloom, get all of the department heads down here.
Now.
Here you go, Doctor.
Okay, I'll make this quick and clear.
I screwed up.
All this chaos, it's on me.
I overcommitted us and then went out looking for more.
I thought I could help everyone and ended up helping no one.
I'm not asking for understanding or forgiveness, but I am asking you to help me fix this.
So, here's the plan.
Reynolds, I am sorry that I put so much pressure on you.
How can I take some of it off? Are any of the surgeries waiting in the ED stable enough - to go to Mount Zion? - Two.
I'll send them.
Bloom, anywhere there's an open bed, admit a patient to it.
Admit everyone you can.
And if we don't get reimbursed for the beds? I'll send Baptist the bill.
Iggy.
- Captain? - Take your patients to the cafeteria, to the roof, for a walk anywhere to keep them busy and out of the ward.
- Aye-aye.
- Sharpe.
- I know what I have to do.
- Great.
Any questions? Any questions not about Kapoor's laddu situation? - No.
- Go.
Max, I don't know how you're gonna pull this off.
We're all gonna work together.
Including you.
I could really use your help, Dr.
Fulton.
The flat metal part goes on the patient's chest.
How're you holding up? I thought getting the news would be the hard part, but telling Tianna's a million times harder.
You shouldn't have to.
You be her mum.
I'll be her doctor.
I'll tell her.
In for a little treat here.
Come on.
Come on out.
Okay.
So, it's not a garden, but, you know, it's outside.
It's fresh-air therapy.
We got a wonderful view of the city, so, you know, spread out, feel the space.
Find your own spot, all right? Jemma, hi.
What's going on? Talk to me.
There's nothing to say.
Well, I heard that Blanca's background check came through clean.
That's good news, right? Yeah.
But, like, the site visit keeps getting pushed back.
It isn't for months.
And there's, like, 100 other things that could go wrong before I get out of here.
Hey.
Are those facts or those feelings? - It's feelings.
- Right, they're feelings, so why don't we try sticking to the facts? Okay, I'll make some phone calls.
We're going to get you the home you deserve.
I promise.
All right.
Dr.
Frome? Don't we have wheelchairs for that? They're all taken, but don't need one.
This is how we did it in Afghanistan.
My man right here's on his way to X-ray.
Got a lateral malleolus fracture playing indoor soccer, but he's going to be fine.
Right, Camden? Did you take my ibuprofen? Yeah.
Thanks - Ah, Dr.
Kapoor.
- Oh, Dean.
Mrs.
Monaghan has been telling me a very interesting story.
How you don't seem to understand the word "dizzy.
" I do understand.
Do you? Do you see what I mean? I should have walked out of here an hour ago.
- Why didn't you? - Because when I tried to stand up, I feel like I'm going to fall over.
Like my feet aren't even there.
Mrs.
Monaghan, you have Guillain-Barré syndrome.
Excuse me? The anti-bodies your system made to fight your cold are attacking the nerves in your feet.
That's why you can't feel them.
Uh I can now officially admit you and get you taken care of.
Help! We we need help! Max Max Max said he would help him.
Max? Max? We've got an arterial bleed.
Ready an intubation tray and page Max to Trauma One, now! - Max! - Come on, stay with us.
Come on.
Class-one airway.
Get 20 milligrams of Etomidate and 100 milligrams Succinylcholine and let's start a propofol drip.
Gonna be a 7.
5 on the hockey stick.
7.
5 on the hockey stick.
I'm in.
Now we find the bleeder.
There it is.
The bleeding is coming from that bronchiole.
Don't say it.
We need Reynolds.
Uh, elbow deep in a tricky closure.
A man's bleeding out in the ED.
Is this your idea of relieving pressure? I know, Floyd.
I'm sorry.
I don't know what else to do.
- I don't know who else to ask.
- Well, I can't be - in two places at once.
- Well, I hope you can figure out how, or someone is going to die.
- Blood pressure's dropping.
- Push more fluid.
- Got two liters wide open.
- It's not enough.
Grab a bag of O-negative out of the trauma fridge.
There's too much blood.
I can't see anything.
There's a pumper in there somewhere.
I just can't find it.
Suction.
Will you get the Richardson and lift up the middle lobe, please? There it is.
I got that bad boy.
Hey Max, can you give me a little light over here? - There we go.
- It's ready.
Bleeding stopped.
Heart rate's steady.
Oxygenation stabilizing.
Nice work, boys.
So, what, you just let Dr.
Fernandez just bleed out in the OR? I left him in the hands of a top-notch surgeon.
One more running suture.
Respiration is spontaneous.
That should hold.
All right! Surgeons landed at JFK an hour ago.
Baptist is up and running.
You did it, Max.
It was fun, being back in the trenches.
And Max don't ever do that again.
Good news: Vance will be in the ICU a few days, then a course of pills, then he should make a full recovery.
What was wrong with him? Histoplasmosis.
It's a fungal infection we see in the soil around Ohio.
It must have been dormant in Vance his whole life, and I'm sure living on the streets weakened his immune system.
The fungus reemerged, and attacked his lungs and his liver.
I would like to test you both as well.
We can't possibly pay for all this.
You don't have to.
This is why public hospitals exist.
This is why I work here.
This is why all these doctors work here.
We don't say no to anyone.
We don't know how.
Thank you.
- Casey, hydrate.
- Why? Because water plays a vital role in nearly every bodily function.
Mm.
Ah, I needed that.
My ibuprofen wasn't ibuprofen.
It was Adderall.
That explains why I thought I was covered in lice.
And my headache never went away.
- I have ADHD.
- Listen, you don't have to I had it my whole life.
Adderall got me through med school, through my residency.
I mean, I couldn't do this job without it.
So, why do you keep it in an ibuprofen bottle? You're killing yourself for this job.
Everyone here is.
Everyone looks sad.
Sweetheart your cancer is back.
Tianna.
You asked what it's like when you die.
I think that it's like this.
Come.
So, when it happens, you won't be able to see your mum and dad, and they won't be able to see you.
But they will always be there.
And I'll always be here? Yes.
You'll never stop thinking of each other.
You'll never stop talking to each other.
You'll just be on a different side of the room.
Mommy, can you hear me? - Yes, baby doll.
- We can hear you, little one.
I can hear you too.
You okay? I took the hard road.
And? Better views.
You know, my attending wouldn't even let me look in the OR the first three months of my residency? I can still hear him in my head.
"Reynolds, you're more likely to cut yourself than the patient.
" I don't know.
Old habits die hard, I guess.
Well, the difference is you trained these residents.
Yeah, well, but you know, if something had gone wrong Okay, do you know what feels even better than being in control? Letting go of it.
Don't start what you can't finish.
Well, on the bright side, I can finally take up fencing.
In a few weeks, we'll start chemo in the morning and radiation at night.
- By few weeks, you mean - Two.
'Cause sometimes a few can mean - Two.
- Right.
There's so much to do.
You're going to have to prioritize.
You mean start saying no? I mean start saying yes.
To you.
What do you need, Max? Max.
It's 9:30.
You're going to be late.
No, I'm not.
Oh, my God.
Did you get fired? That was fast, even for you.
I'm taking the day off.
Thought I'd spend the day here with you.