New Amsterdam Episode 3
Every Last Minute
Welcome back to the Dam. The Dam is busy as ever and as we join the staff on this day, Dora is once again chasing down Dr. Max Goodwin noting 31,252 steps in her daily quest to find and keep up with Max. Despite his penchant for avoiding the unpleasant parts of life, Max must finally meet with the Dean who waits in his office.
The Dean of Medicine
The Dean, seated in Max’s chair offers two words by way of greeting, “You’re fired.” Max politely says “Okay”. As we all expected, the Dean isn’t thrilled with the changes that Dr. Goodwin made in his first five days on the job. Dr. Goodwin was hired to make changes, which he is doing, but the Dean isn’t pleased because he hired Max to make his changes, not Max’s. If the Dean was looking for a yes man, he made the wrong hire with Dr. Goodwin. Ultimately, this is a can’t lose situation for Max. As he explains: if he is fired it will save his marriage and he will be eternally grateful. If he stays, he can save the hospital and the Dean gets the credit. The Dean gives Max six months. Dr. Goodwin, thriving on pressure and conflict avoidance, responds “Give me three.”
Treating a prisoner
Dr. Bloom is busy securing the ED in preparation of receiving a patient from Riker’s Island. We see the preparations at the prison and hospital to transport a prisoner safely to the hospital for treatment. As the patient arrives, we meet Janelle, a young pregnant woman in an orange jumpsuit. Clearly, this wasn’t what Dr. Bloom (or I) was expecting.
Janelle presents with high blood pressure which may be the first signs of preeclampsia, a fairly common condition during pregnancy. As it turns out, Janelle has the more serious HELLP Syndrome, which impacts blood pressure, liver function and platelets. With such sever hypertension, Janelle also experiences maternal seizures and treatment (delivering the baby) becomes emergent. Janelle refuses to consent for delivery.
Dr. Bloom finds Dr. Goodwin to help intervene with Janelle. Janelle is refusing to deliver because she doesn’t want her baby to end up in the foster care system like she was. With only six weeks left of her sentence, Janelle wants to try to hold on and deliver after she is released. She has no family to help and is willing to wait or die trying. The doctors know they can get the court order to save her life, but Max prefers patient consent. While he doesn’t utter the words this time, he brings his “How can I help” attitude. He promises to find Janelle a solution for her and the baby. There is always a way.
Janelle delivers her baby by c-section. Without an answer from Max, Janelle says she must give the baby up and refuses to hold her. Janelle is a scared Mom who feels let down by Dr. Goodwin’s inability to find a solution before her baby was delivered.
The invisible man
When we meet Ray DeMarco, he is nude and digging up a grave by hand apparently trying to see his fiancee’ Maddy again. When he arrives at the Dam, Dr. Bloom orders a toxicology screen based on the tracks on his arm and refers him to Psych. Enter Iggy who begins his assessment in his typical disarming manner. Ray is distressed over the loss of his fiancée’ and signs suggest that this case is a fairly clear psychotic break. The case gets more complicated when Dr. Frome discovers that Ray has no feeling in his arms and believes himself to be invisible.
Dr. Frome teams up with Dr. Kapoor (#Kapiggy) for further neurological assessment, but finds Ray’s room empty, which offers Dr. Kapoor the opportunity to exercise his dry sense of humor. Dr. Frome alerts security to his missing patient without tipping off the entire hospital. After all, Max is busy trying to woo Mrs. Ryland for $10 M. After several sightings of Ray throughout the hospital without him being returned for treatment, Iggy becomes frustrated. He meets a distraught woman named Maddy, Ray DeMarco’s fiancée’.
As the doctors check in on Ray’s labs they unlock the mystery. Ray has been injecting himself with embalming fluid because he thinks he is dead, and those puzzle pieces help Dr. Frome with locating Ray. He finds Ray in the Morgue and tries to explain Cotard’s syndrome to Maddy. As Dr. Frome speaks with Maddy, Dr. Kapoor looks for underlying neurological pathology to cause the physical symptoms not explained by the Cotard’s diagnosis. The MRI reveals a brain tumor that can explain all of Ray’s symptoms: delusions, numbness, out of body feeling. Dr. Kapoor begins treatment with steroids. Maddy tells Ray that the Drs. will bring him back to life tomorrow (when the steroids should begin working).
Physician Heal Thyself
We catch glimpses of Max coming to terms with his cancer but also not aggressively treating it. Dora catches up with Dr. Goodwin speeding down the halls with some administrative paperwork for him to sign. As skilled as Dora is at tracking Max down, Dr. Sharpe is equally talented. Dr. Sharpe falls in step with Max as he heads off to visit Georgia while discussing his treatment plan. Chagrined by Helen discussing his condition in the hallway he tries desperately to wave her off. He reminds her that he is also a doctor while embodying the stereotype that physicians make the worst patients. They discuss the steps necessary to begin treatment: molar removal, PEG insertion, IV ports. All these things would dramatically slow down Max’s pace before adding the chemotherapy. One thing we know about Dr. Max Goodwin: he is a clock racer. He is currently racing several: the clock to save his marriage, the hospital, his own life and change the system. What we don’t know? Which will win.
Max is still ignoring Dr. Sharpe’s directive to share his diagnosis with Georgia when he walks in to visit her. He is surprised to hear that she is being discharged today. Her plan is to go to her parents’ house in Connecticut while Max is desperate for her to stay. Georgia grants him another reprieve to attend to his job and says she won’t leave before he returns.
At the end of the day, Max chooses to jump all in on the fight for his life. He asks Dr. Sharpe to be his physician and with both setting their claims, she agrees. The clock to the start of his chemotherapy and radiation treatment is set at 3 weeks. It’s a good thing Max likes a fast pace, he has a lot to do before that treatment begins.
The New Cardiac Surgical Department
During the tour with Mrs. Ryland, Dr. Goodwin crosses paths with Dr. Richards and his three new attending physicians. All women of color. An awkward moment ensues but Max is saved by Dr. Bloom’s need for his help on her case.
In the elevator, Dr. Bloom and Dr. Richards discuss the new hires. She assumes she knows his motives in making these hires and asks if there is a future wife in the mix. Dr. Richards explains that 19% of surgical positions are held by women and that not enough women of color hold such positions to even create a statistic. He continues by assuring Dr. Bloom he plans to hire staff of all ethnicities and genders, but he started with these three women. He also notes that all three of them have better qualifications than either Dr. Bloom or Richards.