New Amsterdam (2018) s03e02 Episode Script

Previously on "New Amsterdam"
Somebody reported that you
have a problem with Adderall.
You're asking me if I've
ever risked a patient's life
because I'm stoned.
Yeah, and you haven't
answered the question.
What do you think would happen
if you stopped helping people?
Who would they see?
They would see a corny, nerdy,
fat, worthless nothing.
All right, since you all
prescribe 79% of our opioids,
I am giving you one year
to prescribe 79% less,
and anyone who doesn't will be fired.
I think they're clean.
The damage to his heart was extensive.
The virus also ravaged
the surrounding heart muscle.
How bad?
Even if you found the best
heart surgeon in the world,
I'm not sure it'd be enough.
- Hey.
- Yeah?
Dr. Reynolds.
I used to work here.
Hospital ID?
No, but I should be in the system.
Oh, thank you.
So?
I can't operate.
Here's Vijay's cardiac echo.
- What do you mean "can't operate"?
- His mitral valve,
- it's greater than 60% regurgitation.
- Floyd,
- I didn't fly you out here
- That's secondary
- to a ruptured papillary muscle.
- to not operate.
Listen, his EF is under 20%.
These numbers aren't even
compatible with life.
Right, which is exactly why
you need to fix the valve.
I can't fix it
because the virus has damaged
the heart muscle around the valve.
There's nothing to sew a new valve into.
Doing nothing isn't an option.
I didn't say I was doing nothing.
- Look, I'm gonna use a catheter.
- TAVR?
- All right, I'm gonna place a clip
- A clip?
Into the mitral's weakened
area that should fix it.
He's dying, Floyd. He needs surgery.
Okay, look, you brought me
here because of my expertise,
and because you trust me.
Right now my expertise is saying this.
I gotta go.
What happened to "How can I help?"
The virus hit us hard.
Nothing's the same.
My hospital had three.
Three what?
Only three deaths.
I feel guilty just saying it.
Don't. You were spared.
I wish we were.
Especially Lauren.
It hit her the worst.
- Candelario's on!
- Dr. Bloom, it's Gladys.
- Get Candelario!
- It's about Iggy.
I'm on my way out.
He's sweaty, wobbly on his feet.
Did he take a COVID test?
PCR came back negative,
but he can hardly stand.
Ig?
- Hey.
- Hey.
What brings you down to the Ooh.
Aw, God, Gladys was right.
You gotta go home.
No, I just I stood up too fast.
- I got a head rush.
- Your valor is noted,
but if you've got the flu, you gotta go.
I don't have the flu,
I'm just I'm tired.
Your color's not great.
Lauren, if I feel
anything flu-y, I'll, uh
Hey.
- I'll page you.
- Hey, hey, hey, hey, hey.
Hey, come on, come on. Sit down.
- Sit down.
- No, no, I'm fine.
I just I haven't eaten.
Since when?
Hey. How many meals?
How many days?
Two.
Maybe three.
Hi.
I thought you might enjoy
a full-bodied Ethiopian roast,
carefully wrapped
for contactless delivery,
- as an apology.
- None needed.
I'll take the coffee,
but keep the apology.
Um, look, all of this, um,
being close to bodies
and trusting, normal,
it's kinda like I don't remember
how to do any of it anymore.
I get it, if that's what it is.
What do you mean?
I mean, there's no reason
to force something
that's not there anymore.
No, it's not that's not it.
Are you sure?
It's okay, Helen.
COVID took away a lot of things.
We focus here on the lives lost,
but there were other casualties.
See you around.
It's all I know right now. I'm sorry.
I know, but Dr. Kapoor
was supposed to be in the OR hours ago.
So that can't be good, right?
I know it's hard to wait.
As soon as I have an update,
I will let you know.
Hi, Ella, I'm Dr. Sharpe,
one of Vijay's colleagues.
Of course, Double French
Roast with a splash of agave.
Yep.
I'm sorry I'm not standing.
I just I'm worried that
if I get out of this chair,
Vijay's gonna die during surgery.
I have OCD,
and my irrational thoughts
won this round.
It happens.
Ah, I wish it hadn't
because sitting is making
my leg cramps worse.
I stretch, but they just
keep coming back.
How long has that been going on?
Um, an hour or two?
I woke up breathing better
for the first time in months,
but my back gets hot and now this.
Although my pregnancy podcast
said I was going to start
feeling confident and sexy.
Ella, it sounds like you're in labor.
I got your page.
We caught the guy
who's been pinching Oxy
- from the dispensary.
- An orderly?
- My name is Paul.
- Paul Argento.
Been working here for 13 months
and stealing from you just as long.
You mind telling me why?
Look, if we're using,
we can get you tre
They're not for me.
Well, if you're selling them
The they're for my mom.
She got diagnosed
with osteosarcoma a year ago.
She used to be happy,
but now the pain's killing her.
She can't even walk her dog.
The Oxy was helping,
but that idiot doctor of hers
He's been giving me
less and less for my pain.
Told me I had to be weaned off.
And what is he giving you
as an alternative?
Nothing.
That's awful.
Whoever was treating you stops today.
You're a patient at New Amsterdam now.
But my doctor is at New Amsterdam.
Brenna Argento.
- I know her well.
- Stage three bone cancer.
She can barely walk, and
yet you pulled her Oxy. Why?
Because I received a letter
from a Dr. Max Goodwin
saying that if I didn't, I'd be fired.
No, for overprescribing,
needlessly, recklessly,
- but Brenna
- Who wasn't the type
of patient you pictured
when you wrote it.
This is what happens when
you needlessly and recklessly
make a blanket policy without a
regard to individual patients.
She is suffering.
Of course she's suffering,
but not because of me.
Because of you.
Don't hang up!
Because I want whoever that is to know
that I'm person who killed you
for reversing this hospital's policy
on limiting opiate prescriptions.
I am unmoved.
Wow, okay, I gotta go.
Yeah, Daddy's in trouble.
Love you. Bye.
Opioid prescriptions
at New Amsterdam are down 38%.
We've won awards.
We're a national model.
The Nyler family's rightfully drowning
in class-action lawsuits.
And yet, deaths from narcotic overdoses
are skyrocketing. Know by how much?
240%. So mission accomplished?
You instituted that policy.
Yeah, to save lives, but that
policy was a blunt instrument
that put paper over people.
So you're denouncing your own
hugely successful policy?
Well, that's just it.
It wasn't successful.
Our books were clean, but
at the cost of hurting people
who needed our help.
We have to do better.
By returning to the halcyon days
when doled out highly addictive
drugs like Halloween candy?
Karen, do you know what it
feels like to have bone cancer?
- Oh, Max.
- It's like being stabbed
over and over again
all day long with a serrated knife,
and the only thing, the only thing,
that is gonna ease
that excruciating pain
is opioids.
Those aren't my words.
They're Brenna Argento's,
a patient that we
that I let down.
You don't have to
convince me opioids work.
That was never the issue.
This was always about abuse.
About ensuring the drugs
we send into the world
aren't getting our patients
hooked or being sold
or ending up in the wrong hands.
You're absolutely right.
I don't like it when we're fighting,
- and you agree with me.
- No, you're right.
We can get opioids
to the people who need them
and in quantities that are in safe
Karen, yes!
Sorry, forgot this was my office.
Uh, would you excuse me?
Contractions are organized
and four minutes apart.
It's official.
What's official?
Ella, you're gonna have a baby today.
Oh, no, that's impossible
'cause my due date's in three weeks.
On a Friday. And today's Tuesday.
And Dr. Richardson was gonna
delivery my baby.
Well, looks like someone
wants to crash this party early.
I'll be covering for
Dr. Richardson all day,
so I think we'll be seeing
a lot of each other.
I'll be back in a bit
to check on your progress.
Thank you.
This is not OCD.
This is a relaxation exercise.
Good, you know, good. Relaxing is good.
How is this happening?
I am not ready for this.
Is there someone that you
would like me to call?
- Family, friends?
- No, there's only Vijay,
and he promised he'd be here for this.
Um, okay, uh
Who uh. You could try my doula,
but I think she's in Portland
this weekend
for her great-aunt's birthday,
so that feels like a dead end.
I know a great doula here
at New Amsterdam.
Has she been working with me
for the last 26 weeks
on ways to manage my OCD
for this specific moment?
Uh, no.
I had a plan. I had such a perfect plan.
Oh.
Surgical suite prep to OR seven.
Uh, Leela, hi.
Can you clear my afternoon please?
No pagers, no patients. Nothing.
What are you doing?
I'm kicking off a new plan.
Okay.
Well, your concern is duly noted,
but I don't need your help.
But thank you.
You know your staff's noticed?
I mean, even I can tell
you're weak on your feet,
and you just admitted
to caloric restrictions
spanning over 72 hours.
It's a cleanse, Lauren.
Really, I'm fine.
You know you sound like
every first-timer
who's just been dragged to rehab.
Whatever it is that you think this is,
it isn't, and I don't
appreciate the accusation.
Do you hide food?
Lauren
Sometimes people starve
themselves after a binge,
and not for health reasons,
but because they feel ashamed.
Well, it's not like that.
Must be hard to hide your stash at home
what with Martin and the kids,
so where do you keep it?
- Nowhere, I don't have a
- Here in this office?
No.
Lauren, don't. Don't.
Oh, Iggy.
- Hey.
- It's
The left atrium's barely moving.
COVID really did a number on his heart.
Vijay said he got it
here at New Amsterdam?
- He's not the only one.
- Approaching the left atrium.
You too?
It was in the early days.
I wore the same mask day and
night for two weeks straight.
Then I was intubating a patient,
got a focused blast of exhaled air
right in my face.
I just felt the virus
coming through the mask.
Sure enough, three days later,
cough, fever, headaches.
Yeah. Vijay.
Why was he even here, you know?
I mean, his age, knowing
the risk, why even come in?
- How could he not?
- Vitals are stable.
We all felt a sense of duty,
of pride even.
What's that? You can't
Ah, sorry about that.
Hi, again.
There are quite a few of you
on this call,
and, well, you all have
something in common,
and that's that you are all victims
of New Amsterdam's
opioid policy that kept pain meds
from the people who need them the most.
We failed you
in the most fundamental way
a hospital can.
You came to us in pain,
you asked for our help, and we said no.
And what's worse,
is we shamed you for asking.
So I'm here to apologize
and to tell you that that cruel policy
ends now.
Yes!
Finally.
It's about damn time.
Yeah, all patients will get
the prescribed opioids they need
based on their pain levels,
and all have you to do
is swing by New Amsterdam
once a week to pick up your pills.
Easy as pie.
Wait, what?
- I can't do that.
- No, no.
We're gonna make it very, very simple.
We're gonna establish a special clinic.
What the hell's a special clinic?
I live in Long Island.
It's a three-hour trip if I'm lucky.
Excuse me, I have four kids and a job,
and you expect me
to spend my one day off
with you every week?
Okay, I'm hearing some concerns
about the policy that we were
all just very excited about.
But I'll just be honest.
The hospital has some concerns
about portion control.
Portion control? Like I'm five?
No, no, no.
It's just that these pills
are highly addictive,
and we do need to make sure
that nobody is using
or distributing these pills
inappropriately.
So now you think I'm dealing?
- No.
- You just said
the shaming of chronic pain
treatment was over.
And it is, but
- Are you serious, Max?
- Come on.
- That's not gonna work.
- No way.
Um
- What a joke.
- I'm outta here.
- Come on, Max.
- This is ridiculous.
- Thanks for nothing.
- I'm closing this window.
Thank you all for responding
to my multiple app requests.
I have some deliveries for you.
Addresses are grouped together
for maximum efficiency.
- Those burritos?
- They are not.
Are your items heat sensitive?
No, we're good. So if
you wanna grab your bag
Are dealing with breakable
items like figurines?
- Are they insured?
- Are we liable here?
I no, it's very simple.
Some of our patients
are having a hard time
getting to the hospital
to pick up their prescriptions,
so I am hiring all of you
to solve that problem.
So we're delivering drugs.
Technically, yes?
But uh
did I mention there's a 25% tip?
All right.
Yo, how many are we allowed to take?
Okay, okay.
That was smooth.
That was the alcohol swipe.
Getting started now.
Oh, my God. Distract me.
Uh, distract you?
Say something. Anything.
Um, okay.
Did you know that women blink
nearly twice as much as men?
Nope, something interesting.
Fine, fine. Okay.
Aah, it feels like a sword!
Like I'm literally
being stabbed by a sword!
All right, okay. Um
there's this gorgeous man,
this doctor that I was seeing.
- Yes, good.
- Am seeing.
Well, mmm, was seeing. I don't know.
I don't know.
But we started dating
just when the pandemic hit,
and I thought about him
for months during the lockdown.
I fantasized about him.
But then, the other day,
when he reached out
to touch me, I pulled away.
I recoiled like I was
physically repelled by him
And I don't know. I don't know.
Is it me?
Am I that scared
to be touched by someone,
or is it him?
Did what we have,
did it just sort of
No, keep going.
But fast forward
to the interesting part.
Did he dump you? Are you sad?
Aah!
Was that a contraction?
Mm-hmm. Mmm!
What? The epidural seems to be
- taking its sweet time.
- Yeah, it should've
kicked in by now. Unfortunately,
I think the catheter's tip
is in the sub-dural space.
It didn't work?
It didn't work?
Uh, can we try again the epidural?
It's too late, sweetheart.
You're too far along.
Ella, you're gonna have to do this
on your own.
No. No.
No, no, no, no, no, no.
All right, I know how this looks.
I do. Believe me.
But these are my dad's words.
They're his words,
and growing up, I had to
hear them practically every day.
My father struggled with
his weight his entire life,
and he didn't want me
to suffer the same fate.
So at an early age,
he took an interest in my weight.
An interest?
Mm-hmm, yeah.
It started around the third grade.
I filled out a little bit, and, uh,
he would make me go on crash diets
out of the blue,
skip meals, take meal
replacement bars to school.
As a nine-year-old?
Mm-hmm.
Yeah, and
he would make me take my shirt off
so he could take pictures of my body
to, um, put up on the wall
in the basement
next to the makeshift gym
that he'd built for me
to track my progress.
There was a body progress chart.
And if I would ever walk by him,
he would smack my gut and say,
"Jesus, look at that thing."
"Got a lot of work left to do,
don't we, buddy?"
And what's worse is,
if I ever had a good weigh-in,
which was not very often,
I, uh, I would be over the moon
because it would make me feel loved.
Then this one time,
I guess I would've been
in middle school by this point,
I just I
I hated everything about myself.
So I tried to hang myself.
What?
Jesus, Iggy.
No, it's okay.
It didn't work, obviously.
Ironically, I was too fat
for the rod in the basement closet
to hold me up,
and it crashed down on my head,
and my mom heard the sound
and came to help me.
What? What did your dad say?
Oh.
My dad, um, well,
that night at my weigh-in,
he just snapped
another polaroid for the wall
and acted like nothing ever happened.
That's my dad for you.
These are his words,
but they don't control me anymore.
They do not.
They serve as a reminder
of all of the things
that I have conquered, which is a lot,
and sometimes I look at these words,
and they remind that
I'm not that kid anymore
and that I'm making better decisions.
I'm making healthy decisions in my life.
And that I no longer need to
stand around with my shirt off
- and let others judge me.
- What?
You know that's not
what I was doing, right?
I'm fine.
I am more than fine.
You can rest easy.
Now if you'll excuse me,
I have patients to see.
No, I'm I'm being careful.
Yeah.
Ma, I'm gonna see you soon.
Okay, yeah. I love you too.
All right.
Heard you pulled off one hell of a TAVR.
Just this side of genius.
I accept your apology, Max.
You need anything else
while you're here?
Aw, no, just catching up
with some folks.
You know, I missed my favorite
scrub nurse in OR today, JJ.
- Devlin.
- Yeah.
He passed away a few months ago.
COVID.
That's too bad.
Everything's changed.
- Dr. Max Goodwin.
- That's me.
- You're under arrest.
- Whoa, what's going on?
For what?
For writing 700 Oxycodone prescriptions,
each one over 100 milligrams,
and distributing them
with bike messengers.
Oh, that.
It's nice to see some things
haven't changed.
BP's 80/40 and falling.
Push epi, I'm coming in.
I need an echo over here.
What happened?
The clip didn't hold.
His heart is failing.
The DA only agreed to not press
charges for narcotics trafficking
because you're an essential worker.
- Huh.
- Congratulations.
You're one of the select few
to benefit from COVID-19.
Thanks for getting me out.
I have half a mind
to leave you in there.
You know, pharmacies
mail opioids all the time.
Bike messengers are almost the same.
I wonder if you've ever
considered how exhausting it is
to be your boss.
All your wonderful ideas
that come with such chaos,
every single one.
It's funny.
The thing you're best at is the
part of my job I hate the most.
- You ignore reality.
- That's not fair.
Says the man who just
sent 70,000 milligrams of Oxy
out into the street via bike messenger.
I know it seems like a good idea.
Hell, it might even be a good idea,
but it's my job to deal
with the reality of your ideas,
in this case criminal reality.
Optics matter.
Patients matter.
I'm glad you're
helping people, Max, truly.
But your plan has no accountability.
You don't know where
these drugs are going.
You just don't.
And opioids, the potential for abuse,
it's a very emotional issue.
To many people,
opioids aren't pain medicine.
They're what killed someone they loved.
Wait. Iggy.
Iggy, I wasn't judging you.
You could've fooled me.
It was just people die
from what you're doing.
What did she say?
In here. In here.
Ig.
Ig, look, I'm sorry for making a scene.
You should be.
It's just
I've seen people in my ED
with eating disorders.
I mean, I've known people
with eating disorders.
Some of them
they're not here anymore.
Mm-hmm.
Look.
I know as well as anyone
that the truth is really difficult.
I'm sorry. What are you doing?
Are you comparing your issues
to mine right now?
Let me just mirror that back for you
so you can hear it out loud.
I'm on the Jimmy Kimmel diet,
and you almost killed a patient
because you are a drug addict.
- Not the same.
- That was way out of line.
I'm outta line? It's not hard, Lauren.
This is a hospital.
There's only one line that matters.
You were hurting patients. I am not.
Plain and simple!
Patients aren't
the only people you can hurt.
Oh, yeah? Well, I think the janitors
- are safe from my eating too.
- Yeah? What about your kids?
- Excuse me?
- You're starving yourself.
You think they don't notice that?
- You stop talking.
- How many meals have you had with them
- where you haven't eaten anything?
- Stop!
How many have you skipped altogether?
I mean, what kind of screwed up issues
are your kids gonna have
with food because of you?
Occupied!
It's a bad time, Gladys.
It's Dr. Kapoor.
The clip failed,
tore right through the valve leaflets.
I'm gonna have to crack open his chest
and put in an artificial valve.
That's a big surgery.
I thought you said you
couldn't sew into the muscle.
- What changed?
- Nothing. Not a damn thing.
But he'll make it through
the surgery, right?
That's why I thought
you should see him now,
and have one more moment with him
in case
I'm gonna go prep.
You're fully effaced and dilated,
but the baby's still
at minus three position.
Ella, the delivery isn't
progressing as I had hoped.
What does that mean?
When your contraction comes,
you need to push real hard.
Oh, my God, this is a disaster.
Maybe you could hold her hand.
E-Ella.
Look. Look.
Count them out with me, okay?
Here we go.
Give me the biggest push you got.
You can do this. Come on, come on.
No, I can't! Stop, I don't want to!
What if the baby's not okay?
What if I hurt it?
What I ate undercooked meat
and didn't know it?
And seven weeks ago I took a bath
right after the tub was cleaned,
and the water probably had bleach in it.
What kind of mom is that careless?
You are not careless.
You have a disorder that sends
your pregnancy into overdrive,
but you fought it,
and you've made it this far.
I cheated. I got scans all the time.
Sometimes two days in a row
in case something happened
while I was sleeping.
But then everything shut down,
and Vijay got sick,
and I don't know why,
but I just convinced myself
that the baby was going to be
okay as long as he was okay.
What if Vijay's not okay?
Ella! Everything on that monitor
says that your baby is going to be okay,
but you have to deliver it
No! Oh.
- Contractions peaking.
- Aah!
You can do it.
Your baby needs you to push now.
Aah.
Eh?
Yeah, yeah, buddy? What is it?
Hit me.
You're such a good dad.
Aw, I don't know. I
If this doesn't work out
Will you look after
Ella and the baby?
You've got this.
You can do it.
Hey.
And I am dying
What are you talking about?
Don't be silly.
You are going to be annoying her
for the rest of your life, okay?
Please.
If something happens, I
Yes.
Obviously.
Good.
Listen, Iggy.
- Lauren, I'm fine.
- No.
I never should've dragged
your kids into this.
I'm really sorry.
A couple nights ago, I was, uh,
I was wearing this nice new sweater
that Martin gave me, and, um
Harper told me that
I looked handsome in it.
Then I immediately grabbed my stomach,
and I told her that she was wrong.
It just popped out of my mouth.
I say things like that all the time.
And Vijay thinks
that I'm a great father?
I'm teaching my kids
that someone who looks like me
doesn't deserve to be loved.
That is the same lesson
that my dad taught me.
Aw, man.
He just used different words.
Iggy.
These aren't your dad's words.
You wrote this.
I know.
These are your words.
You're calling yourself this,
and you're gonna keep
suffering until you stop.
If I can't stop,
this note, that voice
It's the thing about myself
that feels the most true.
How do you stop believing that?
Well, you could try
talking to a therapist.
Hey, I did.
He saved my life.
Come here.
- Thank you.
- Yeah.
Ready to restart the heart.
Everything's solid.
Charging. Clear.
Suctioning.
Quarter's ready.
We did it.
Good job, everyone.
Ooh.
All right, let's close him up.
BP is dropping.
What?
- Heart valve's not holding.
- It's slipping.
Give me a 3-0 proline
on the needle driver.
Times two.
You work the septum,
I'll work the free wall.
I'm gonna have to get him
back on bypass.
We can't reestablish aortic cannulation.
As a backup, yes.
- My stitches aren't holding.
- Neither are mine.
- Trying 5-0.
- Suction needs to be higher.
I'm not getting any purchase.
Another bag.
Come on. Hold, damn it.
Flash sterilized.
Ansuya.
Ansuya.
Ansuya.
Vijay.
Eat this.
I don't need it.
All I need is you.
It will give you strength
for our granddaughter.
Granddaughter?
She needs her Dadaji.
Vijay?
He's waking up.
Oh, thank God. Vijay.
Welcome back, Dr. Kapoor.
Happy birthday, little one.
Uh, K-Karen!
- Are the cops chasing you now?
- Uh, I don't know,
but I did come up with a solve
for our opioid issue,
and I think you're really gonna like it.
And here I thought
we knew each other better.
Watermarking.
So every single opioid
that New Amsterdam sends out
into the world will be watermarked
with invisible, fluorescent fibers.
Every patient will have access
to the medicine they need
and without shame.
And they'll be able
to manage their pain,
and they'll be able to live
functional lives.
But if those pills ever do
end up in the street,
or in the wrong hands, we'll know.
There will be no drug trafficking,
and there will be accountability.
Oh, and I almost forgot the best part.
The Nylers are gonna pay for it.
Why would they do that?
They kinda have to.
Part of their settlement includes
donating millions of dollars
to public hospitals,
just like ours.
I don't know what to say.
It sounds like a well-thought-out
and realistic plan.
I know. Weird, right?
Karen.
Thank you for keeping me accountable.
That's my job.
And every once and a while,
it's worth it.
I'm not ready.
Okay.
I mean, I'm not ready to call it.
I should've been here.
Well, you're here now.