New Amsterdam (2018) s01e21 Episode Script

This Is Not the End

- Mm.
Yeah, well, the secret is, uh night sweats with aggressive vomiting.
Dose-dense treatment's a bear, yes.
But you can't knock these results.
Hit me, coach.
Your tumor is regressing, your polymorphonuclear cells are over 1,000 for the first time in a week, and your hemoglobin's in the normal range.
I'd stand and cheer but, uh, I think I'd, you know, fall over.
Max, you should feel good about this.
Well, yeah.
No, I do, I do.
I just didn't know that feeling this good would feel quite this bad.
Uh, Virginia? I'm, uh, cold all the time.
Is that Common side effect.
And we'll hook you up to some fluids.
This is all good news.
The chemo is working.
Sir, do you know what floor your room is on? I can call someone to get help.
Sorry, Dr.
I didn't recognize you.
Science is about progress.
Why are we still relying so heavily on methods developed 60 years ago? For the same reason we're still using penicillin and aspirin: because they work.
In the future, when new techniques have taken hold, we will look back and cringe at the barbarism of today's approach.
And immunotherapy is one of these new techniques.
- I think it will be.
- But when? Cancer patients need effective treatments now.
How much of the cancer population are your therapies actually helping 1%? - More like 5% - Ah.
But some clinicians are doing even better like Dr.
Valentina Castro.
She even practiced at New Amsterdam before Dr.
Sharpe doubled down on older treatments - Because they worked.
- And forced Dr.
Castro out.
- Because hers didn't.
- Dr.
Helen - Dr.
Sharpe, please.
- Dr.
Can you tell us how you view Dr.
Panthaki's methods? With pleasure.
[BOTH MOANING] I can't believe how much I missed that.
It used to be such a big part of my life.
It was my life.
You should come to Brussels with me.
What, now? 'Cause I kinda thought we were in the middle of something.
Well, next week I'm presenting at a conference, but you should be up there with me.
- Presenting? - Doing what we just did in that studio - Debating.
- [BOTH CHUCKLING] More like wiping the floor with you.
Pretty sure I just eviscerated your life's work with my life's work.
[SAUCY MUSIC] [MOANS] Then I challenge you to a rematch.
In Brussels.
As long as we get to keep making out like this.
[DRAMATIC MUSIC] Luke Bauer, previously healthy 17-year-old, status: post fall.
Now complaining of left arm weakness and blurred vision.
Normal and stable heart rate and BP.
- Take him to trauma one? - Tell me which came first: the blurred vision or the fall? Uh, I tripped because I couldn't see.
Take him to curtains.
We're gonna take good care of you, Luke.
All right, let's go.
Yesterday I was handing out flyers, but I kept dropping 'em.
Thought maybe I was just hungry, so I got a hotdog.
Took one bite, and I started choking.
You know, I could barely swallow.
After I woke up, everything looked blurry, and that's when I tripped and fell.
- Back off, dude! - Sorry, uh Max Goodwin.
I'm the, uh, medical director.
Just grabbing a quick thirst-quenching beverage.
Uh, all the symptoms that you are experiencing are from a toxin produced by the botulism bacteria that is growing somewhere inside your body.
Who knew talking could be this tiring? That adds up.
I'll order the antitoxin.
Yeah, I'll take care of him.
Who's gonna take care of you? You're welcome to have a look yourself, but the concerns are pretty clear.
You're being accused of forming a non therapeutic alliance with your patient, Avi Mantell.
- Yeah.
- As Deputy Medical Director, all personnel complaints come to my desk, so I'll be conducting the initial review.
And after that? Let's hope there isn't anything after that.
Yeah, okay.
I trust the process.
I, uh, pulled all the case files and therapy notes for Avi.
Everything's there.
- Great, thank you.
- Yeah, you got it.
We'll talk soon.
Helen, hey, hey.
I didn't, uh, you know I mean, I didn't do anything wrong, right? [SOLEMN MUSIC] We'll talk soon.
[SOFTLY] Okay.
What's wrong with you? Uh, throat cancer.
That sucks.
Really does.
Oh, here we go.
This is where the botulism bacteria is.
Growing in this cut is how it got under your skin.
How'd you get this? Uh, I was dumpster diving a couple weeks back, and let's just say my execution wasn't a perfect ten.
I see that.
Hey, what what are you doing? I'm just outlining the infection so that we can track its, uh, progression or hopefully lack thereof.
Why didn't you come in sooner? Don't have insurance.
That shouldn't have stopped you.
Come on, you know how it works.
You walk up to the desk, they ask you for a card.
Without one, no one even looks at you.
It's embarrassing.
Being invisible is almost worse than being sick.
[MELANCHOLY MUSIC] Did you know Luke's had that infection for two weeks? Not surprised.
Back then it could have been treated in a clinic, you know? A few stitches, some antibiotics.
Cheap fix.
But instead, he waited.
He ended up much sicker and in the E.
with inefficient, complex, and very expensive care.
All solid points I'd love to discuss when I'm not slammed.
All because he didn't have insurance.
I bet half the people in this E.
don't have insurance.
Probably more than half, but there's nothing we can do.
You know what, there is.
There is something that we can do.
We can get every hospital administrator down here right now.
Why would I do that? So they can enroll everyone in a proper insurance plan.
This is what the ACA set out to do to give everyone access to health insurance they can afford.
- Isn't that complicated? - Yes.
But it's hurting our patients, and it's costing us money, and this could maybe fix both.
Health insurance is available to these people, and we're gonna get each and every one of them enrolled.
Helen Sharpe, Deputy Head of Medicine at New Amsterdam, presiding over an internal investigation into Dr.
Ignatius Frome.
Also present is Ms.
Tiara Dobbs.
This inquiry alleges that you, Dr.
Frome, violated hospital policy ADMN #23.
This policy addresses non therapeutic relationships, including ones where members of staff are overly invested in a child or family's care.
I I've always tried to provide the best care possible.
Your intentions aren't in question.
Oh, good.
Your methods are.
Have you ever shown favoritism towards a particular patient? No.
You've never bought gifts for a patient? Um, birthdays, maybe.
And and sometimes I might see a little something that I know a kid would respond to really well or like in particular.
Uh, but I wouldn't, uh, I wouldn't call it favoritism.
So your answer is yes.
Have you ever brought special food into the hospital for patients? Uh-uh, no.
W-uh, wait, yes.
But the the patient specifically mentioned s'mores in session, so - That's a yes also.
- Yes.
But w-we all go the extra mile around here.
This inquiry isn't about everyone else, Dr.
It's about you.
[TENSE MUSIC] [SIGHS] Have you ever initiated uninvited physical contact? I've never made anyone uncomfortable, if that's what you mean.
That isn't a no.
Frome, have you ever hugged, kissed, or otherwise touched a patient without invitation? No, I have never kissed a patient.
Have you ever hugged or touched a patient without invitation? Yes.
And you understand that that is outside the bounds of a normal therapeutic relationship? Yes.
[SHAKY INHALE] [SIGHS] [INDISTINCT CHATTER] I'm looking for my consult, a seizure patient.
- Feng Shen? - Follow the noise.
- He needs you! - [OVERLAPPING CHATTER] Yes, yes.
I see.
Excuse me.
Hello, Feng.
I'm Dr.
[COUGHING] Has Feng lost weight recently? [OVERLAPPING CHATTER] - One at a time.
- Yes.
[MELLOW MUSIC] Feng does not want to eat.
Not at all.
Prep Feng for a lumbar puncture right away.
[OVERLAPPING CHATTER] You are staring awfully hard at that screen.
[BOTH LAUGH] Yeah, this might be an awkward time to tell you, but I'm in love with coronary artery bypass surgery.
- Mm-hmm.
- What are you doing out here? Uh, I was actually trying to see you.
Oh, that's cool.
I was on my way to see you.
[GASPS] Oh, do tell.
Well, I want you to come to Sunday dinner.
Meet my family.
- Or not? - [SMALL LAUGH] I was gonna surprise you, but I got invited to this salon in Harlem to see Ta-Nehisi Coates, and you were gonna be my plus-one.
- No way.
- Yes! - Oh, you know that's my boy.
- I know! That's why I was so excited.
But I can meet your family next Sunday, right? Oh, my mom will look at me sideways if I miss Sunday dinner, and then my sisters will pile on.
So you've never missed a Sunday dinner? - College.
- [LAUGHS] Then you deserve to have Ta-Nehisi sign your "Black Panther" comic.
I do, don't I? [INHALES] I'm in.
BEEPS] - Phone number? - No phone.
Address? Wherever we are right now.
Do you have a PO box or something? Yeah, for all my Amazon deliveries.
Oh, well, then I suppose there's no way to mail you your insurance card.
Um [CLICKS TONGUE] I'll be right back.
Sorry to bother you, Dr.
My patient doesn't have a social security number, - and it's required for ACA.
- The family I just tried to sign up all gave me the same name.
- They're a family.
- The same first name.
Okay, give me give me a second.
Curious: is this better or worse than what you had in mind? Luke Bauer's cellulitis has progressed to necrotizing fasciitis.
He may have already seeded his heart valves.
I'll page Reynolds and book an O.
- Okay.
Hmm? - Dr.
I can't tell if my patient is a good fit for this insurance plan because I can't decipher the plan myself.
[PUNCHY PERCUSSION MUSIC] I've gotta hand it to you, boss.
You have outdone yourself this time.
- Did I? - The entire hospital and I mean the entire hospital have been talking about your insane plan to sign every single patient up for health insurance.
Uh, seriously, what were you thinking? Max? Max! Yeah, I'm right behind you.
You want me to have someone bring you up a wheelchair? No, no, I'm totally good.
I'm just much slower.
You got lapped by a 92-year-old - with a walker.
- Ouch.
But you're not wrong.
The, um, insurance thing was flawed, but you, uh, know why? Um, it's hard to narrow down exactly which joke to make here.
This is a public hospital, right? Our help is free to the public.
That's the whole thing.
People don't need insurance to be treated here, and most people right now don't know that.
And how do you expect to fix that problem? Um, let me see this.
This is how we fix it.
And what exactly is included in the New Amsterdam Family Plan? Um, just about everything.
And how much will people pay for it? - Kinda like nothing.
- Yeah? - That's what I thought.
- Yeah, I'm gonna need copies.
Maybe what do you think, 500,000 to start? Yeah, sure.
And then what? We hide them in chocolate bars? No, I was thinking we might hand them out to every resident of New York City.
[SIGHS] Have you and Dr.
Frome ever been alone in the same room together? Yeah, during session.
And during session has Dr.
Frome ever initiated physical contact? Why are we talking about this? Ms.
Dobbs told me that she witnessed Dr.
Frome touch you on your head, neck, and face.
It's okay.
[TENSE MUSIC] Like, a hand on my shoulder, I guess.
Or on my knee sometimes.
How did it make you feel? [SIGHS] This is stupid.
I'm sorry.
I am sorry, but it it's important.
How did it make you feel? I don't want to talk about that, okay? Does physical contact make you feel uncomfortable sometimes? Avi? Have you ever been touched inappropriately by Dr.
Frome or anyone else? Honey.
I didn't know how to tell you.
[SMALL SOB] Avi, we're gonna protect you.
Can you tell us who? I wanna talk to Dr.
- [MONITOR BEEPING] - [AIR HISSING] Injecting dye.
Dye filling chamber.
Right there.
You see that, Max? [INHALES] Small vegetation on Luke's bicuspid valve.
Got it.
- You okay up there? - Mm.
Numbers never been better.
That's surprising, seeing as you've never looked worse.
- No offense.
- None taken.
Reynolds? Dr.
Kapoor's requesting a consult.
I'm done here.
Oh, Max? I took a look at Luke's calf.
The, uh, general surgeon's on the way.
All right, tell them he's been injecting heroin under the skin.
He said he got it dumpster diving.
Then he lied.
[SOMBER MUSIC] Pulmonary and meningeal tuberculosis.
- Very troubling.
- Well, TB happens.
We just gotta isolate the boy, zap him with antibiotics, and Bob's your uncle.
Yes, if only it was just Bob.
Their entire family lives in a multi-family home in Queens.
I've asked them to come for testing.
[TENSE MUSIC] All of them.
[SIGHS] - [ELEVATOR BELL DINGS] - Iggy! You need to think about this.
What's there to think about? A patient asked to talk to me.
He's no longer your patient.
Well, those darn doctor-patient boundaries.
Famously a weakness of mine.
There's been hearings about it and everything.
- You were there.
- Iggy, you are a kind man, but if you talk to this boy your kindness is gonna be used against you.
Every word you say is gonna be placed under a microscope.
I hear you.
I understand, and I know you're trying to help me, but if I'm not there for my patients when they need me the most, what am I doing here? Why even do this job at all? Avi has something to say to me, I'm going to listen, no matter the consequence.
- Iggy - That's it! End of story.
[QUIET MUSIC] [NO AUDIBLE DIALOGUE] [NO AUDIBLE DIALOGUE] [INDISTINCT CHATTER] Please, everyone, let's let's just stay calm, okay? TB is a very treatable disease.
But when can they come home? TB likes to play hide-and-seek, so the process of eradicating the disease from the body can be lengthy.
Ann and Feng will need to pass three negative sputum tests in a row.
How long will that take? [INDISTINCT CHATTER] Three to nine months.
[CHATTER STOPS] Surgery went well.
We managed to remove all of the infection.
Few weeks of pills and you should be you should be fine.
Um, this is well, it's just like insurance.
And you can use this to get, uh, follow-up care here at New Amsterdam.
You just walk up to any of these desks and you flash this baby, and and they'll honor it.
And they'll treat you with respect.
And you won't get a bill.
Seriously? Yeah.
And you can use it also at, uh [POIGNANT MUSIC] - At one of our rehab clinics.
- What And you should, Luke, because what you're doing to yourself - I knew it.
- Luke, I just Just forget your stupid card.
I'm not coming back here so you can talk down to me, accuse me of things I didn't do.
You're just like everyone else.
- Wait - Just back off, okay? [TENSE MUSIC] Hey.
I know this is weird, but but it, um This is a bad idea.
You know what? This is unusual.
I get it.
Don't even look at them, all right? Just hang with me.
It's just me and you, like always.
Okay? [INHALES, EXHALES] What's up? How you feeling? Messed up.
Okay, that's a good start.
What's messed up? Like they asked if if you touched me.
And and you do, right? And that's, like, okay, because when you do, I feel loved or whatever.
But then it's like, what do I know? Because, you know times in my past before you, I, uh Have you ever felt differently when someone else touched you? Well, n-no.
I don't know that's what's so messed up.
Yeah, yeah, I get it.
It sounds confusing.
Why why don't we Let's simplify.
Where were you first time this happened? I was in Missouri.
- Watching TV.
- What was on TV? - A soap.
- A soap? - She liked them.
- Okay.
Tell me about her.
She'd watch me while my mom was at work.
You know, I'd sit on her lap and she'd scratch my back.
And then one day she asked if I if I wanted to kiss.
You know, like they did on the TV.
And we did.
And then she asked me to lie on top of her.
- How old were you? - Five.
That must have been really scary.
It wasn't.
She was nice to me.
I just I couldn't.
[STAMMERS, SIGHS] You looked forward to it.
I'm sick.
- I'm disgusting.
- No, no.
Avi, you are not disgusting.
The only disgusting thing here is a woman in a position of power taking advantage of a kid.
Of a child.
Not you.
[SNIFFLING] Why didn't you tell me? Why didn't you tell your mom? It's okay.
You'll feel better if you say it.
She's my aunt.
[SIGHS] Care to explain this latest scheme? Um, I wouldn't really call it a scheme.
Uh, nothing on that card is a lie.
We are a public hospital and, uh, [INHALES] we do treat everyone whether or not they have, uh, insurance.
- So you're advertising.
- Yeah, exactly.
I mean, do you know do you know how many people don't even know that they can come to us for free? How many of these did you make? Um I don't think you want to know that.
If everyone in the city knew they could just walk in here without insurance, the whole system would crumble.
Agree to disagree.
I think the more patients that we can help and the earlier we can help them, then the better the system will be.
A public hospital only survives because so many people don't realize they can use it.
If everyone started coming in here when they were sick, this hospital would run out of money.
Well, good thing I'm talking to the one person who can actually get us more funds.
Are you trying to singlehandedly socialize medicine? Public hospitals are socialized medicine.
It already happened, it's already here, and it had nothing to do with me.
So why don't we just call some things like we see it, right? The U.
military largest and most funded socialist program in the entire world.
We have public schools and and public libraries, and the police department and the fire department.
And we can all get behind socialism there, but just not in our hospitals.
Is this the hill you want to die on? [LIGHT LIGHT] [TAPS ON DESK] Despite all appearances, I am not dying anytime soon.
[SUSPENSEFUL MUSIC] So, how are things with you and Evie? - [LAUGHING] - (G-What?) You you just went right there, didn't you? I'm sorry, okay? I just don't have the headspace for small talk anymore.
All right, well, we're good, you know? We're we're really good, thanks to you.
You taking her home to meet the family yet? - Not yet.
- Why not? - You should get on that.
- [LAUGHS] You know, it's good to have you back.
- "Back.
" - Yeah.
You're back, aren't you? I was actually here to talk to Max about extending my leave.
Oh, for how long? Like forever.
Is there any chance I can change your mind? No.
Any chance, I mean, Max can change your mind? No, which is why I wanted to talk to him in person.
Have you seen him? - What, it's that bad? - [SIGHS] It's way worse.
Jeez, I thought I was the liability.
Hey, Lauren? You know I got you, right? [SIGHS] Hey, whoa.
Is there a problem? Caught this guy stealing these from the hospital.
[INDISTINCT CHATTER] Uh, no, he he didn't steal those.
Uh, I I gave them to him.
It was part of a needle exchange program.
[SOLEMN MUSIC] [SIGHS] Well, it's, uh it's all out in the open now.
Hannah told us that her sister was a victim of abuse as well.
But she never imagined her sister would do that to someone else, let alone a member of her family.
I'll call Child Protective.
Great, thank you.
Will they be okay? Yeah, I think so.
Just it'll take a little time, you know? [BITTERSWEET MUSIC] - Thank you.
- For what? Being you.
Yeah, I'm not sure that's a good thing anymore.
[CLEARS THROAT] [ALL SPEAKING MANDARIN] Feng starts kindergarten in two weeks.
- He was so excited.
- I understand, but active TB is highly contagious.
If you go home or Feng goes to school, you risk infecting a great many people.
You can infect your entire family.
I want NaiNai.
[ALL CHATTERING] [CANE THUMPING] Will they get the best care here at the hospital? Yes.
[SPEAKING MANDARIN] Bao Bao, NaiNai is here.
And I'm not leaving.
[SPEAKING MANDARIN] [SINGING IN MANDARIN] Ann and Feng need more than just antibiotics.
- They need their family.
- Right.
Then their family can come during visiting hours.
How do you think that 80-year-old woman can sit on that stool? Or for any one of them can stare at their loved ones through that glass wall? The family will adapt.
That's what I'm scared of.
They will adapt to a life without each other.
Look, there's nothing we can do, all right? Ann and Feng have to stay in isolation.
Goodwin, can I get you a wheelchair? Yes, thank you.
- Could you give me a hand? I don't remember this slope being so steep.
Max, you need to stop.
Why? No.
The Community Care office needs these.
They're gonna help pass them out.
How long has it been since you could swallow your own saliva? - Few days.
- Can you get dressed? - Shower by yourself? - Look, the chemo's working.
It's working.
Stauton said it could be as little as as three months.
"Three months"? You won't make it three weeks.
You're wasting away.
Look, I just need to hang on a little bit longer.
The numbers don't lie.
The cancer will be cured, but we will run the last course of chemo into your dead body.
You are dying, Max.
Well, then this may be one of the last things I do.
Just just Max! Oh No, it's okay.
We're fine, thank you.
It's over, you are done.
No more chemo.
- You're not my doctor.
- I am now.
I am your doctor, Max.
I'm taking you off the chemo and radiation.
I'm gonna find you a different regimen, and I'm gonna save your life.
But first thing I'm gonna do is send you home.
It's time for you to go home, Max.
You're going home to stay alive.
[SOFT EMOTIONAL MUSIC] This is not the end.
Frome? I'm sorry to have put you through this.
Are you serious? You put my entire medical practice in jeopardy, and now you're just gonna what? You're just gonna let me off the hook? I realize you were just trying to help him.
But I didn't.
You were right about me.
Frome Do you do you have any idea how many patients I have held in my arms? How many kids I've bought clothes for? Books for? I try so hard to make them feel safe Make them feel the love that they should have gotten somewhere else.
I can see that now.
What you did for Avi only you could do that for him.
That's the problem.
If you hadn't filed your report, Avi would have gone on to some therapist and he would have had a huge setback because he couldn't speak his truth to anybody but me.
If I'm only teaching patients to speak to me and not to deal with the world after they leave my care, well the phrase I would use for that is "non therapeutic relationship.
" The rules exist for a reason, and I broke them repeatedly.
Now the only thing for me to do is to be a different therapist.
Different therapist than I want to be.
Than I know how to be.
There's nothing more to do for the Shins.
Ansuya and I were a love match.
But my parents didn't approve So we saw them less and less.
Along the way, we made many little decisions that added up to A big distance between us.
Soon family meant only me Ansuya And Rohan.
So you don't see them anymore? We haven't spoken to each other for a [SIGHS] Long, long time.
[SIGHS] We won't let that happen to the Shins, will we? No.
We won't.
Ta-Nehisi may be my boy, but I have a whole family who still thinks of me as their boy.
So we won't go this Sunday.
Well, that's the thing.
I'm not saying no to this Sunday.
I'm saying no to every Sunday.
That's how important my family is, and I think I was afraid to admit that.
Why? Well, there's a whole part of me outside this hospital that you don't know.
You know, like church, my aging mom, my sisters ganging up on me, you know? What if you didn't like that part of me? Or them? - How could I not? - You don't know my family.
Well, you're right.
I don't.
So I'd better be meeting them this Sunday.
I don't have an appointment, but I'm hoping you can fit me in.
Well, I will have to check my books.
[LAUGHS] Our hotel I can't wait for you to see it.
It is in the center of the historic district.
Three Michelin-starred restaurants in walking distance.
But you won't be joining me, will you? I can't.
Akash, I am so sorry.
Right now, I can't imagine sitting on a panel defending traditional chemotherapy when my day has been one long, crushing example of precisely how traditional chemotherapy can fail.
This is about Max.
Yes, it is.
Max helped me rediscover my love of medicine and got me back in the hospital.
And it's not just me.
You can see it on the faces of all the doctors.
All the nurses.
All the staff.
He has helped them all so much, so profoundly.
And now it's our turn to help him.
[IRON & WINE'S "CALL IT DREAMING"] Say it's here where our pieces fall in place Any rain softly kisses us on the face Any wind means we're running We can sleep and see 'em coming Where we drift and call it dreaming We can weep and call it singing We get a chance to say Before we ease away For all the love you've left behind You can have mine [MUFFLED VOICE TALKING] - [KNOCKING] - Max.
You're not answering your phone, so [OMINOUS MUSIC]