New Amsterdam (2018) s02e16 Episode Script

I can't believe they're still sleeping.
I know.
I think they actually sleep better with company.
Me too.
This okay? Mm-hmm.
You? Yeah.
Wait, wait I haven't done - Not since - Me either.
Really? Really? Wait, wait, wait.
Do I take this off? No, you don't have to.
I don't think I'm ready.
You don't have to be.
I'm not.
Do you still Yes.
Oh, you must want to kill her.
I knew Castro was up to something, but making her patients tumors look worse than they actually are so that when they get better it makes her trial look more effective? So her trial's a sham.
I don't know the extent of it.
I only know that she's falsifying her data.
- You have to take this to Max.
- I can't.
Max made it policy to go public with our mistakes.
To own them.
If this gets out, New Amsterdam will lose our NIH funding, and that is millions of dollars.
What about Brantley? She'd just sweep it under the rug to avoid a PR nightmare.
Well, then what are you gonna do? Blow up her trial.
I'd read about pituitary veinous sampling.
I've never actually seen it done.
Many less experienced neurologists fear this procedure because it requires a precise localization and sturdy hands, which in my case is not Give me a moment, please.
Ella, I don't think you should touch that.
Oh, that is a she, and her name is Calliope.
We'll call her Callie for short.
I didn't think I'd ever be ready for another pet after Gertie died.
Pet? - To live with us? - Yeah.
Well, Dr.
Frome thought it might be a good idea if I had an emotional support animal to help manage my OCD.
And she's pretty much the cutest, isn't she? Yes, she's cute.
Very cute.
I should be going.
Oh, okay.
Well, we'll see you at home.
Hmm.
- Cancel the veinous sampling.
- Wait what? Will you do that, Agnes, please? I can't.
Mr.
Bagey's is already being prepped! Okay, you are more than welcome to sit down if you want.
Anywhere you like.
So, you are aware of why your parents sent you here to see me, right? Uh, it's for refusing to go to school.
And, uh, your parents say you came back about two weeks ago a different kid.
Won't come out of your room, easily upset.
I can't be in my room? Well, not if it means skipping school, no.
Danica, why do you keep looking at the door? Do you do you feel unsafe right now? Do you feel that way a lot? Did something happen at school? Danica, why are you afraid to go to school? Because I can't stop seeing Megan lying on the floor with a hole in her head.
That's why.
I think you guys seriously buried the lede.
How could you not tell me Danica was in a school shooting? - What what school shooting? - I think we'd know if there was a shooting at our daughter's school.
There wasn't.
- How was dinner with mom? - Oh, it was great.
After 20 years, I finally told her what a nightmare it was being raised by such a raging alcoholic.
But instead of apologizing and accepting responsibility, she said she didn't remember it.
Wow.
She tried to gaslight you? That's messed up.
Guess I'll add that to her list of irredeemable qualities.
- Dr.
Lauren Bloom? - Yes? You've been served.
Why did you tell your mother that our wedding might not be in San Francisco when you know it definitely will be? It's called "stepping out the truth.
" - Mmm, it's called "lying.
" - I just heard.
And my one question is: how big a going away party do you want? Oh, no, no, no, no.
No thank you.
Um, I'm trying to keep this all low key.
- Not gonna happen.
- Of course.
You were saying? Well, look, my sisters and I learned early that with Mama, you gotta roll the truth out gradually - so she has time to acclimate.
- Mmm.
Dr.
Reynolds? Oh, no going away cards, please.
You've been served.
You have an administrative meeting at 2:00.
- Great.
- And dermatology wants to know if you could touch base about new exam lights.
Sounds like a plan.
Have you been replaced by a pod person? I don't think so.
You hate meetings, and these are the worst.
Well, I'm just in a very good mood, and nothing gonna change that.
- Hospital's being sued.
- Okay, that didn't last long.
High profile case we're talking community backlash, media circus, and a ridiculous amount of money on the table.
HCC and the mayor's office have already called to make sure we don't screw it up.
- Who is it? - George Whitney's family's accusing us of malpractice and wrongful death.
Every doctor involved in his care is being sued, including - Dr.
Max Goodwin? - Yes? You've been served.
Okay, why are you stressed? You're out of here, aren't you? Really? A patient died, and we're being blamed for it.
We didn't do anything wrong.
So all we can do now is tell the truth, and we're gonna be fine.
Deposition prep isn't about the truth.
It's about finding weak spots in our stories.
So we see how strong the opposition's case is against us.
- Thank you, Dr.
Optimism.
- He's right.
Hospitals go down because of cases like this.
Lauren? I'm ready for you.
To gain access to the tumor, we first locate the internal jugular vein.
BP normative, respiration spontaneous.
I'm not getting flash-back.
Abscess in the airway.
The needle broke.
How did it break? Needles don't just break.
Well, this one just did.
There's ectopy on the monitor.
The needle may be lodged in his right ventricle.
If we don't get it out, he will get a heart attack.
Page cardiothoracic.
- You get him to an O.
R.
- Where are you going? Dr.
Kapoor, what's happening? This is all happening because of that cat.
What? Nurse supervisor to main floor.
Nurse supervisor to main floor.
B.
Ready to go.
I'll check back in a couple minutes.
May.
Morning.
Uh, would you be able to get a couple of extra blankets for the chairs in there, please? - It's freezing.
- Sure.
Thank you.
- Here you go, Dr.
Sharpe.
- Thank you so much.
Uh, everyone will appreciate this.
We were in Mr.
Marks' history class when there was this bang.
Mr.
Marks started screaming.
Telling us to get down.
I looked out into the hall and there was this man there with a gun.
He was shooting into the class across from us over and over again.
Then I saw Megan coming back from the bathroom.
And my brain was like, "Go help her!" But I couldn't move.
And then he shot her.
Mr.
Marks was shoving a table against the door.
Everyone was crying.
And I was just standing there, staring at Megan on the ground.
Then the bell rang, and the man stopped shooting, and Megan got up.
And they told us it was just a drill.
A stupid drill.
Megan was part of it? So was the man firing blanks.
But it all felt real.
Her school didn't tell us that there would be anything like this.
No one knew.
Not even the teachers.
I know it wasn't real.
I But I feel scared all the time.
I can't go back there.
Four weeks ago, a patient named George Whitney entered the ED.
Do you remember this patient? Of course I remember him.
He was, uh Lauren, don't give more information than was asked.
Right.
Okay.
Do you remember George Whitney? Yes.
Can you describe Mr.
Whitney's condition when he entered your care? George Whitney, 30-year-old man, collapsed at a street fair with blurred vision, shortness of breath, and hemiparesis.
Tachy, hypotensive, and tachypneic in the field.
Any allergies, Mr.
Whitney? - You taking any medications? - No.
Okay, let's get him to trauma one, and hook him up to a monitor on O-2.
What do we got here? How many patients were admitted that day to the best of your recollection? Eight patients, all presenting with the same symptoms.
And what did the police say happened to these people? Some sort of smoke device went off at a Middle Eastern Street Fair.
They were exposed to more than just smoke.
People complain of a weird smell at the scene.
Double vision, descending paralysis, diaphoresis.
- Botulism toxin.
- This was a terror attack? Casey, dilute one vile of anti-toxin in 100 cc's normal saline and infuse as slow IV drip with close hemodynamic monitoring.
Copy that.
But that's not what the patient received.
Well, that's what I told Casey to give them.
Casey wasn't working that day.
Of course he was.
Nurse's schedule.
Casey's not on it.
But I thought I don't Would you care to revise your statement, Dr.
Bloom? All right, you're up.
All right, let's see what we got.
Hey, doc.
Tell me I'm crazy.
Did you sabotage my trial? You didn't give me a choice.
What the hell were you thinking? Switching my patient's meds? Everyone got their chemo.
Everyone's safe.
- That's all that matters.
- Oh, that's all that matters? There's no control group anymore.
Everyone's been dosed with the trial additive.
I guess you'll just have to start your trial over again.
Are you really that jealous that you have to kill it? I know what you did with your patients' baselines.
I only did that because the preliminary data showed the drug was not working well enough on this protocol.
Then you report that.
If the drug doesn't work, it doesn't work.
It will work, when I have more time to get the parameters of the trial right, and I will once it gets to phase three.
You have to shut this down now.
The entire trial has been compromised.
The trial, yes, but not the drug.
I am bringing it to phase three.
Then I am taking this to Max.
If you were willing to do that, you would have done so already.
That's what I thought.
These are the best active shooter drills available.
These drills could save our students' lives.
Okay, if I showed you an MRI from a kid that was in your drill, or an MRI from a kid that was in an actual shooting, do you know what you'd see? - They would be similar? - They would be identical.
Right down to the long-term problems, from the fear, the depression, the anger, the anxiety.
The full PTSD buffet.
Trauma doesn't happen because you're in danger, - it's because you think you are.
- So what would you have me do? - Pretend school shootings don't exist? - No.
- Ignore the law? - No.
God forbid a real shooting happens here.
I'll be damned if my kids aren't prepared.
Okay, look, I recognize that you are in an impossible situation here, but there are alternatives.
There are desktop training programs.
One where the kids don't have to act out traumatizing events.
Because all that does is make them believe that they've already been through one, like Danica.
Well, I'm sorry about Danica, but I haven't heard any other complaints.
Well, how many students have checked in with the school's counselors? With all the budget cuts, we don't have any.
Well, you do now.
I'm not seeing patients today.
Um, I just Okay, how much can substance abuse affect someone's memory? Depends on substance and the degree to which it was abused.
Genetics can also be a factor.
Why are you asking? Um, I abused Adderall for a while.
Now I'm forgetting things.
What kind of things? Details about a day that I should've remembered everything about.
And my alcoholic mother says she can't remember the last 15 years, so, I don't know, given my stellar gene pool and my own issues, maybe I'm just Lauren, there's a significant difference between the type of memory loss associated with a lifetime of substance abuse and your situation.
Are you sure? I see you every day.
I work with you every day.
There is nothing that concerns me.
Okay.
Your mother's condition, on the other hand, is much more serious.
And very real.
She may never remember.
Dr.
Goodwin, isn't it unusual for you to dedicate your entire day to the ED given the scope of your duties? Uh, yes, but because this was such a high profile case, the mayor asked me to monitor the victims personally.
So you were there in your capacity as medical director? That's right.
Double vision, descending paralysis, diaphoresis.
Botulism toxin.
- This was a terror attack? - Brunstetter.
Dilute one vial of anti-toxin in 100 cc's normal saline and infuse as a slow IV drip with close hemodynamic monitoring.
Copy that.
Technician to X-ray one.
Lab technician to X-ray one.
Forget the dilution.
Push anti-toxin in a a single IV injection.
I have to clear that with Dr.
Bloom.
No, there isn't enough time, okay? Patients could die unless you push the full dose of anti-toxin now.
So you countermanded Dr.
Bloom's order? Yes.
Then she wasn't at fault for giving an order that was never carried out? I don't know if we should be assigning blame, I think Did all eight patients respond to your treatment, Dr.
Goodwin? All but one.
Okay, I got it.
It's weak, but it's there.
- What do you got? - V-fib arrest.
A tachy hypotensive.
We're in the middle of an echo when he arrested.
Global left ventricular hypokinesis.
We gotta to get him to the O.
R.
now.
Would you say the decision to treat with a full dose of anti-toxin was made in haste? During an emergency, doctors have to make a lot of decisions in haste.
But you weren't there as a doctor.
To your own admission, you were there as medical director.
I have to wear multiple hats every day.
Which hat were you wearing when you countermanded Dr.
Bloom's order to follow the dilution protocol? My doctor hat.
But obviously, Nurse Brunstetter saw you - as the medical director.
- While that may be true, I don't know what affected their decision Which may have meant Nurse Brunstetter may have felt unable to contradict your directive I have no idea what Nurse Brunstetter may or may not have felt A directive that may have led to George Whitney's cardiac arrest.
From where I sit, because you wear multiple hats, one of your patients died.
Okay, um, hi, everybody.
My name is Dr.
Iggy Frome.
You can just call me Iggy.
Um, first of all, I'd like to thank Principal Colvin for allowing me to speak to you all today.
Bet you're all pretty pumped to be missing some class, huh? Yhoo! They're missing gym.
Yikes.
Uh, okay.
So I promise you that I'm here for a good reason, guys.
I'm here to talk to you about the shooting drill that happened a couple weeks ago.
I want to talk to you about how that made you feel.
Yeah, okay, all right.
Yeah, fair enough.
I hear you loud and clear.
Talking about our feelings is not your favorite subject.
I don't blame you.
Why don't we try something a little different.
Try something easier.
You guys like easy? - Yeah.
- Yeah, good, me too.
Um, I'm gonna say something, and if you agree, you clap your hands twice.
That's it.
Can you handle it? - Yes.
- Of course you can.
All right, this assembly seems crazy boring.
Whoa.
Wow, all of you.
Okay, step two.
I'm gonna say something, and again, if you agree, uh, this time just come walk down onto the court with me.
Okay? Ready? I sometimes feel scared about guns.
I do.
I'm scared about guns.
Really? I'm the only one? I find that a little hard to believe, but okay.
I have had a dream about the shooting drill since it happened.
It doesn't need to be a nightmare necessarily.
Just a dream.
Any kind of dream.
Yeah.
Good, thank you.
Come on down here.
Yeah, come on down.
Take a spot.
Anywhere on the floor with me, okay, guys? Thank you.
Okay! Here's another.
I avoid going to where I was when the shooting drill happened.
Yeah, I would too.
I sometimes have a hard time concentrating in class because I'm thinking about someone charging in with a gun.
Yeah, that would make it hard to concentrate, wouldn't it? All right, one last one.
When I have felt scared since the drill, I thought that I was the only one.
Find somewhere around me.
Make sure you can all hear me.
Make room for everybody.
Okay.
We're all here.
Take a look around.
Look at your classmates.
Your feelings are not weird or wrong because we've all got them.
You've all got them, okay? But those feelings, they're not They're not gonna just go away.
They are going to find somewhere inside of you and make a home, all right? The only way to avoid that is by talking.
We have to talk to each other.
You have to talk to your parents.
Talk to your counselors.
So let's start talking.
You look how I feel.
You first.
So, I'm gonna tell you something, and I need you to not react like "Max the Revolutionary.
" - Which Max do you need? - The sane medical director.
Really want me to pick a lane today.
Did something happen at deposition prep? I don't know.
I Starting to wonder if maybe I'm doing this wrong.
Doing what wrong? I wear these scrubs so I can actually help people, but what if I'm not helping? What if I'm just making things Worse.
I mean, maybe I should just wear a suit.
You know? And actually sit at my desk like a sane medical director.
Maybe it's time I stopped trying to be all things to all people.
The Max who is all things to all people is the Max that we all need.
I need.
How can I help? Actually, I don't need you to.
I have to handle this one.
Dr.
Flores was able to remove the needle from Mr.
Bagey's heart with no damage.
- He should make a full recovery.
- Good.
Then I'm staying right here for the rest of the day to avoid doing more harm.
Is there something going on with you today? There is nothing wrong with me.
Good.
The problem is the cat.
Why do you keep bringing up this cat? Ella's cat.
The harbinger of bad luck.
From the time it has showed up, my entire day has been disastrous.
And now it's going to live with me to destroy my life.
No, no, no, no, no.
I have to get rid of this cat.
Hey, did you reorder any of those Kapoor says it's probably true.
Did I miss part of this conversation? He said those 15 years are probably gone.
From my mom.
- Completely? - Could be.
It just pisses me off, you know? I mean, if I have to remember every brutal detail about my childhood then she should have to remember it too.
Look.
I know you're hurt, I know you've been carrying around these feelings for a lot of years, but maybe it's time to stop looking backward.
You know, start looking forward.
- I don't see Max with you.
- You were right.
- I do need Max.
- Hmm.
This entire hospital needs Max.
And six months ago he was dying, and I couldn't save him.
But you did.
You knew that precision oncology was the future long before anyone else.
But if I could figure out that you falsified your data, then NIH will too, and that kind of scandal You expect me to believe you're worried about me? Not you.
Your work.
It's the only reason that Max is alive.
Then, what are you gonna do? I'm gonna help you get away with it.
Dr.
Floyd Reynolds, can you describe for me in detail what happened in your O.
R.
during George Whitney's LVAD operation? - Bypass is ready when you are.
- Ah, rib spreader.
Why were you placing the left ventricular assist device? Mr.
Whitney suffered from Acute Coronary Syndrome from a blockage in his left main coronary artery.
Did this have anything to do with Dr.
Goodwin's administration of anti-toxin? No, no.
Max had nothing to do with it.
It was a pre-existing condition, most likely exacerbated by the events of the day.
Once you decided an LVAD was necessary, you made a second choice.
To install it via a full median sternotomy rather than the less invasive catheter introduced LVAD.
Why? Well, he was unstable and needed immediate help stabilizing his blood pressure.
And a sternotomy was the fastest way.
So why weren't you able to stabilize Mr.
Whitney? - TF on one.
- He's stoking out.
The embolism in the MCA is not responding to TPA.
Then we need to go with plan B: embolectomy.
We need to go in there and suck it out.
Advancing through the internal carotid and through and into the middle cerebral artery.
You're right there.
Performing embolectomy.
The brain should be re-perfusing now.
D-fib arrest! Intrathorvacic paddles.
Clear.
He died on the table.
What was the cause of death? Embolic stroke.
And what caused the embolism to his brain? Sometimes they just happen.
You don't think it was because you just performed an incredibly invasive procedure on Mr.
Whitney? No.
Uh, sometimes embolisms just happen.
You know, they're a risk for any surgery.
Did you make the decision to go more invasive, before or after you learned George Whitney was a white nationalist.
Did you make the decision to go more invasive before or after you learned George Whitney was the one who released the botulism toxin at the Middle Eastern Street Fair? Next question.
Dr.
Nottingham, thanks for coming in.
Please take a seat.
I'm not recording this.
No one's gonna get in trouble, I just need you to tell me the truth.
The truth? I need you to tell me exactly what happened in the O.
R.
during George Whitney's LVAD surgery.
Chest is open.
- Lab results are back.
- And? White count 5.
2.
Hematocrit 39.
Botulism anti-toxin 276 micrograms Wait.
Whoa, whoa, whoa.
- 276? - Correct.
That's twice the expected level.
Did he get a double dose? Maybe he predosed himself assuming he'd be exposed.
Why would he do that? Maintain paralysis through a sternotomy.
Because he's a white supremacist.
This racist son of a He almost killed seven people and now we have to save his life.
Dr.
Nottingham, we do not judge the people on this table, we just treat them.
So you realized George Whitney was the perpetrator after you made the decision to perform the more invasive LVAD procedure? Yes.
Dr.
Reynolds had already cracked the chest when I saw the tattoo.
Thank you, Dr.
Nottingham.
Uh, you can go.
Evie, I'm impressed.
You're even interviewing the residents.
So, what's the hospital's liability? Dr.
Goodwin, Dr.
Bloom, and Dr.
Reynolds None of them caused George Whitney's death.
That's good to hear.
But if I put any of them on the stand, the plaintiff's attorney will rip them to shreds.
Why? They all made choices that would appear suspect to a jury.
I know this will be a big pay out, but to avoid an ever bigger one, we need to settle.
Oh, he's coming in hot.
Forgive me, Ella, but your cat cannot enter our home.
- Why? - You know me.
I'm I'm educated, and reasonable, and modern, but to a point.
But black cats wherever they go, bad luck follows.
So you're superstitious.
Yes, and I'm ashamed to admit it.
Because for you it may be a silly superstition, but for me it's real.
The stress this cat has caused me is unbearable.
I understand completely.
You do? Unbearable stress over irrational fears? That's pretty much how my OCD makes me feel every single day.
Like, sometimes I think I'm losing it, and I would never want you to feel that way too.
Does this cat really help your OCD? Yeah, uh, so, um.
Like, if I'm obsessing over something, and I can't stop.
Like my pregnancy or what kind of mom I'm gonna be.
Callie does this little thing where she flips belly up and then she tucks her head under my hand.
It just gives me something else to focus on.
It she brings me back to Earth.
Then you must keep this cat.
Really? Are you sure? Yes.
That's my final decision.
But there's one thing you must do.
Change its name.
What's wrong with Callie? Kali is a sacred Hindu goddess.
Often associated with the bloody death of demons.
- I didn't help Megan.
- I didn't help Megan.
- I was scared like a baby.
- I was scared like a baby.
Got it? Okay, now you mirror me.
I wanted to run to Megan.
I wanted to run to Megan.
But I was doing what the teacher said.
But I was doing what the teacher said.
I did the best that I could.
It's okay.
You can say it.
I did the best I could.
Yeah, you did.
You see? The story itself is less powerful than the way we tell it, isn't it? I'm just I'm really sorry.
For what? For all us adults making you kids deal with this problem rather than fixing it ourselves.
- That's not fair.
- Yeah.
We've received your thoughts and prayers, thanks.
But you know what gives me hope? - What? - You.
You and your whole generation.
You've blown me away.
You're already taking on the big issues way better than us.
No pressure.
Yeah, no pressure.
So for now, your only job is to do the exercises, and I promise you, the fear will subside.
You will feel safe again.
We all will.
I didn't think I'd ever hear from you again.
I didn't think you would either.
So why did you wanna meet here? I thought maybe we could try and make some new memories.
I'm here to tender my resignation.
Why why would you resign? My study's been compromised.
How? It's entirely my fault, but my duties as chair compromised my focus.
Things fell through the cracks.
What? No.
Listen, we can work something out, okay? You can start your trial over.
Here.
No.
Thank you.
I need to be centered on my research right now, and I cannot do that here.
Castro needs to go somewhere where she can be more vigilant about her process.
It's an important trial.
People will be watching.
With more scrutiny than ever.
She's right.
Okay.
Then, um, I guess I accept your resignation, - effective - Immediately.
I'll help her get her things.
After you.
Be well, Max.
Why didn't you just tell me the truth about George Whitney? Well, I thought You thought you could just step out the truth? Didn't you? Whatever you think you know, you don't.
TF on one.
He's the terrorist? You're just now figuring that out? Pre-dosed himself with the anti-toxin, in the event that he'd be exposed.
It doesn't look like it worked too well.
Nope.
Racist son of a Tried to kill seven people, now we have to save his life.
Sorry, I I don't know why, uh Just do what we do, and do it well.
Why didn't you just tell me that? You didn't do anything wrong.
But I did.
As a role model, as a leader, I never should have said those words.
Not in my O.
R.
You know, I remember the first time knowing I wanted to be a doctor.
I was learning about Bessie Smith.
- Empress of Blues.
- Yep.
Died after being refused service in an all-white hospital.
Buried in an unmarked grave.
I knew right then that I wanted to become a doctor, without prejudice.
And I hate that you or anyone had to see that I couldn't do that.
But you are that.
You live that every day.
That's one of the many reasons why I'm marrying you.
But let me tell you one thing, Dr.
Reynolds.
If you ever step out the truth with me I will seriously mess you up.
Okay, what was that? Exactly what you saw.
What I saw was pure theatrics.
Max, I handled the situation.
I can see that, but what exactly is the situation? Well, let's just say that Castro hasn't changed since I fired her the last time.
She is a very talented doctor, but she's always gonna let ambition get in her way.
Then why did you bring her back? Why did you give her half your department? You have a good night, Max.
- I wanna know.
- I think you already do.
Then just tell me.
For God's sake, Max.
I did it for you.
Everything I have done, I have done for you.
You okay? I don't know.
You? Um I don't know.
Well, at least we're both messed up.
Hmm.