New Amsterdam Episode 4
Max turns off his alarm and rises from the couch to look in on Georgia. He smiles to himself and proceeds to make her breakfast in bed. When he brings the food to Georgia, he finds her in the floor looking at crib parts. It seems Dr. Goodwin isn’t the only member of the family who likes to challenge the rules. After a heartfelt discussion, Max assures Georgia that he “has all the time in the world”. On his run to work, Max encounters a homeless woman with an infected foot. True to form, he stops to try and help but she rebuffs his effort.
How do you laddu?
We catch up with our favorite brain docs strolling through the hallways. Iggy is crowing about having finally received funding for a community garden to implement as part of his therapies. Dr. Kapoor is carrying a small container of laddu. Dr. Frome tries to steal one. but discovers that these treats are for Ella in the coffee shop as a token of gratitude for her kindness. Throughout the episode, nearly everyone will take their turn offering an opinion to Dr. Kapoor on whether he should or should not give them to Ella.
After all his crowing about the community garden, Dr. Frome finds that the community garden has been funded by Volt cola. This leads Dr. Frome to a crisis of conscience. He wants the garden and knows it will help but feels the money from Volt cola to be somewhat tainted. After all, colas are part of the sugary diet that leads to childhood obesity and we know one thing about Dr. Frome, he is passionate about healthy eating. When the pressures of an overcrowded ward start to get to Frome and the patients, he takes them on the roof for a walk and some fresh air. His commitment is true helps Jemma through questioning again whether she would ever find a real home. When he discovers a weed pushing through a dirt-filled crack in the concrete, he has an idea for the garden.
This is a bad idea
The cardiothoracic surgeons from across the country are away at a conference save one at each location. The surgeon from Baptist, Dr. Fernandez has come to the Dam via ambulance with a dissecting aortic aneurysm. On any given day, assuming medical treatment of a peer is tricky, on this day it brings tricky situations to the whole team.
Without a cardiothoracic surgeon, Baptist can no longer serve as a Level 1 Trauma center. In typical Max fashion, Dr. Goodwin springs into action to take on the entire ambulance load for Baptist in addition to the regular load of the Dam. He looks to each department head for buy-in “Guys this is what we do, we help”, and while met with skepticism receives it from nearly everyone. Dr. Sharpe does not approve. “Why do we choose the hardest road at every opportunity?” Max replies, “Better views?”
Speaking of the harder road, Max sets out to help the homeless woman with the infected foot. She leads him to her ailing brother who is in desperate need of a hospital but refuses to go. The family lost their house trying to pay medical bills for their mother. They feel alienated by the system and have no money to pay for treatment. Max explains that New Amsterdam is a public hospital and the treatment is free, but to no avail. The man has a treatable fungal infection, but it does require quick treatment. After Max returns to the hospital and has a second pep talk/falling on the sword talk with his staff, the brother arrives by ambulance and treatment begins. During this talk, the Dean who is unimpressed by Max’s decision, is asked to jump in the trenches and help as well.
Under Pressure
Max may be the medical director, but on this day, the success of the Dam will depend on Dr. Bloom. We already know she has a headache for which she has medicated herself. Dr. Bloom is upfront with her additional staff for the day. She is going to point and yell, don’t take it personally, just get the job done. The first round of ambulances arrives, and she directs the placement of patients. So far, so good, except she is already searching for her ibuprofen, and is very agitated about her missing bottle. There is no time to dwell, the next round of patients is arriving to the ED.
Dr. Bloom, facing a backup of cardiothoracic surgeons pushes Dr. Richards in the OR to allow his resident to help. Unwilling to hang that level of responsibility on his resident, Dr. Bloom concedes for another hour.
Despite Max’s request, Dr. Kapoor has a patient (Mrs. Monaghan) in the ED for an extended period. She claims she is dizzy but refuses to describe it for Dr. Kapoor. He returns later to ask again. She claims dizziness again and challenges whether he is a doctor. When Dr. Kapoor returns, he finds Dean Fulton at her bedside. Ultimately, she admits to feeling like she might fall over because she can’t feel her feet. Dr. Kapoor can diagnose Mrs. Monaghan with Gullain-Barre Syndrome. Even Dr. Fulton seems a little impressed. At what point will the Dam stop under-estimating Dr. Kapoor?
Dr. Bloom is growing increasing agitated and very focused on her bottle of ibuprofen. Meanwhile, her nurse, is outpacing everyone despite the long day he is also having. We learn that the ibuprofen is really Adderall and that Dr. Bloom has dealt with ADHD all her life. Proper treatment (including stimulants) were the only way she could survive medical school. The question is, is she overmedicating herself to deal with the pressures of being a department head?
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Finding Leadership
At no point have we doubted that Floyd Richards is an excellent physician. Max has pushed him into a leadership role as a department head with no attendings. We have seen glimpses of his work in rebuilding the department, but on this day, he has only himself and his residents. One man cannot run a full cardiothoracic case load. Throughout the day, we see Dr. Richards struggle with trusting his resident and needing to use the extra hands to cover the department.
At the end of the day, he chooses to lean on his resident and use the help since he cannot be in two places at once. He reveals the struggle that most mentors have, the desire to take their mentees through the same path they followed and simultaneously carve out their own style of leadership. This is a universal struggle for mentors.
A Sharpe Turn Toward the Harder Road
Dr. Sharpe treats a young girl from the ED who has arrived in excruciating pain. She patiently lies on the table, tablet in front of her, as Dr. Sharpe prepares and completes a lumbar puncture. The biopsy will reveal if Tianna’s cancer has returned. During the procedure, Tianna asks questions about dying and her parents are not prepared to discuss the subject with their young daughter. Dr. Sharpe tells them the cancer has returned, a particularly aggressive form, and suggests setting up palliative care for Tianna. Dr. Sharpe encourages the parents to answer her questions. The parents, with heartbreaking authenticity reveal that they can’t tell their daughter she is going to die. Dr. Sharpe decides to take the hard road and to explain to Tianna that her cancer is back and answer her questions about death. The talented Dr. Sharpe grows a little softer with each visit to the Dam.
Building the Dam Community Garden
After a long and very difficult day, the doctors assemble on the roof. They each take a turn at planting something for Dr. Frome’s garden as they unwind with a little therapy of their own. Remember Dr. Frome said the soil can help serotonin production? The beer helps them a little bit too. Dr. Sharpe admits to max that the hard road does have better views. Ultimately, Dr. Kapoor shares his laddu with his colleagues.
In the closing scene, Max returns to the house, builds a crib and sleeps in the next morning. When questioned by Georgia he tells her he is taking the day off to spend with her. It appears the only place Max is willing to abide the rules and slow down is at home.
My Thoughts
New Amsterdam is doing a great job of layering character development of the doctors around the central theme of helping. They help the patients, they help each other, and we are starting to catch glimpses of them being willing to help themselves. I love the interweaving of real information for viewers regarding laws, health information amidst deep stories and a fast pace.
They can be overlooked for the few inaccuracies, it is difficult to make a completely realistic medical show in Hollywood. Nevertheless, I’ll be back next week for another all new episode.
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