New Amsterdam (2018) s04e14 Episode Script

...Unto the Breach

1 A passing is not an ending.
In the words of the "Bhagavad Gita" "The soul cannot be cut down by any weapon "nor burnt by fire, drenched by water, "nor withered by the wind.
"We are not slain when our bodies are slain.
We have never not existed.
" Some of you, many of you, probably don't know about Vijay is that he was born before the separation of Pakistan and India, which led him to become an officer in the military, a soldier A soldier who became a healer.
- The healer who became - So slow.
And when I say slow, I mean the man was practically glacial, but those methods extended to his bedside manner.
He would talk to his patients, take his time, and not because he was slow but because he Listened, and he taught me that, uh you can search and search for the answers, but sometimes, sometimes all you need to do is just be still and be ready to receive the answers, to to catch them out of the air.
Like that fly ball that hit him right in the face.
Vijay was the absolute worst softball player in our league, but, man, Vijay running bases maybe it was from playing cricket back in the day, but the old dude Was the only doctor to say "hello" to me on my first day at New Amsterdam.
I think that he knew what it was like to be a new physician in a new country.
It was a simple gesture, really, but it meant the world to me to be seen, and I suspect Karen Brantley, you might want to leave the room for this one, but Vijay and I once snuck a patient into another hospital Yeah to get him the care that he needed.
And then we had to sneak him back.
I didn't realize that instead of ignoring me when I wanted answers he was actually preparing me leading me to not need him at all.
I just, uh Oh, God.
I, um Light and love to you.
You'll be forever in our hearts.
- I'm gonna miss your wisdom.
- Thank you for blessing us.
Goodbye, Vijay.
You know, he's still here.
We all carry him inside of us everywhere we go.
You can still honor him if you need to.
Got any prayers you recommend? I was thinking lunch.
The Hindu mourning tradition's a beautiful gesture.
By feeding others, we feed our own grieving souls.
There you go.
Hey, what about the other chaplains? Oh, what other chaplains? I'm all that's left.
What? What do you mean? What about Reverend Salazar or Rabbi Cohen? Reverend Salazar was so overworked by the pandemic, she resigned.
She did? Rabbi Cohen passed away while helping others.
- Here you go.
- But I do what I can.
What else can we do, right? - Ooh.
- You okay? Yeah, enough about that.
Tell me about jolly old England.
England is, uh it's great.
It's everything I hoped it would be, you know? And more, if I'm being honest.
I feel kind of guilty saying that, especially today, especially here.
Never apologize for embracing what life shows us, Max, especially joy.
I think that Vijay would approve.
I hope so.
I think I'm doing everything Vijay would've wanted.
You know, I'm slowing things down a little bit, spending more time with Luna, reading in the park, feeling the grass under our Be right back.
Hey, hey, you all right? Would you like a sandwich? - Thank you.
- Sure.
Help! Someone help! Chaplain Alpert.
- What happened? - I don't know.
He just fell.
Male, 30s, no ID.
Blood pressure is 210 over 135.
We pushed six milligrams of Ativan and got nothing.
- Okay, okay.
- Uh, Walsh, Turan, trauma one.
Turn him around.
One, two, and Push two milligrams of Ativan.
- Were maxed out.
- Levetiracetam? - Loading dose in.
- Starting a continuous drip.
- Okay, up his Phenytoin drip? - Last time the paramedics did that, his blood pressure crashed.
He won't survive another hypotensive episode.
Okay, I'm running out of options here, guys.
- Load Phenobarb.
- Seriously? - You want to induce a coma? - I don't see another option.
On it.
You know him? It's Rohan, Dr.
Kapoor's son.
Incoming! Help.
- Excuse me? - I got a 58-year-old.
Post collapse in the field.
He's stable for now.
Okay, triage this way.
Oh, uh, is Dr.
Bloom on? I can Triage this way.
This is not triage.
This is a waiting room.
I'm sorry.
This is Chaplain Alpert.
He needs a full workup, heart monitor, oxygen Okay, please use our automatic kiosk, where you can enter your insurance information, credit application, and an optional patient satisfaction survey.
Once we have all your information, we'll call your number based on a personalized seven-point evaluation.
Okay? So where did they, uh Where did they move the chemo lounge to? They didn't.
It was eliminated.
Eliminated? But the patients loved that lounge.
They used to play cards in there, listen to music, laugh even.
Fuentes thought the room took up prime floor space.
Prime floor space? For what? This Top-of-the-line surgical suite.
This used to be our hematological research lab.
And now it's a surgical suite.
Okay, so where did they put Dr.
Shaffer? Dr.
Shaffer got let go since we stopped all of our stem cell trials.
How did any of this get past Dr.
Wilder? Dr.
Wilder? She's been signing these changes away with a smile on her face.
I want to give you the benefit of the doubt, and I want to be respectful, but I'm not going to stand idly by while you gut the department that I built and love and And is still here, all of it, just hidden from view.
What do you mean? Welcome to the resistance.
Shut the door.
- Mr.
Ehrlich? - Inside.
I used to have one of these when I was a kid, but I remember it being more fun.
You're, uh You're Jack Ehrlich? Yeah, your 11:00.
Where are your parents? Did you did you bring them? They drove me, but I told them to grab a coffee.
They can be a little oppressive.
Oppressive? I really need your help, Doctor.
Okay, what seems to be the problem? - I want to be emancipated.
- Huh.
- How old are you? - Almost nine.
Which is eight.
Okay, sure, but hear me out.
I'm a straight-A student, spelling bee champ.
I've been playing the piano since I was two, so I'm ready.
Wouldn't living on your own require an income? No, because if you get emancipated before you're 18, your parents have to pay child support.
- That's, uh - I Googled it.
So you would buy your own clothes, your own food, do your own laundry.
I'd live close enough to my folks so they could help.
My mom would still do my laundry, and my dad could still cook me dinner.
I'm eight.
I'm not crazy.
You know, there's coffee inside? Uh, yeah.
Yeah, I just wanted to get some fresh air.
You're trying to avoid me.
Isn't that what you wanted? Us aside, what I don't want is for you to leave this hospital because of me.
This ED depends on you.
If you leave, this department and your patients will suffer.
I've been through breakups before.
I can handle you being here, us working together.
I have issues with you, but the way you run an ED isn't one of them.
Why are you doing this? Because I'm not gonna be your reason for leaving.
You're not.
It's me.
I'm not gonna let you quit, okay? I'll reapply for my residency.
I will find another hospital.
Then stay.
- What about Spotify? - No.
- Pandora? - Uh, let's get through this.
All right, there, the graft is holding.
Let's close up Mr.
This is Mr.
Wilson was three patients ago.
- Sorry, everyone.
- Cut yourself some slack.
Thanks to Veronica, I'm starting to feel like I'm on the line at a GM plant.
You know, I wouldn't mind if we got to do anything else, you know, like remove a tumor, stabilize a spine.
- Who do we got next? - Uh, Jason Forbes.
63 - Don't say it.
- CABG surgery.
Oh, come on.
Maybe you should talk to Veronica? And say what? That these symptoms could've been managed by low-cost medication, but, no, instead they're referring them to us for needless and expensive surgeries? That'd be a start.
58-year-old man, status post-cardiac arrest and resuscitation in the field.
Max? Chaplain Alpert needs our help.
Uh, Walsh, take the Chaplain to curtains for a full eval.
- What's with the jacket? - What's with the waiting room? The very first thing you ever said to me was get rid of it.
I was forced to reinstate it when she slashed pay.
Staff naturally left, and then Veronica cut the number of beds to match the decreased staffing levels.
Let me guess time to care went through the roof, so you had to put in a waiting room.
Then, ironically, I had to hire more people to staff it and, tragically, not the people that I fired.
So I ended up spending more time - and more money on training - Why didn't you tell me? Max, why would I? You're not here.
The Chaplain has severe carotid stenosis - with right-sided heart failure.
- Okay.
- Let's get surgery down here.
- I already called them.
- Hey, if you need anything - We're good.
It's good to see, Max, really.
- All right, what's the latest? - Scans and labs showed no sign of a brain bleed or multi-organ failure.
His BUN and creatinine levels, however, are through the roof with a bicarb of 18.
- Okay, let's correct that.
- Bicarb, right away.
All right, so emancipation.
Yes, and I'd prefer if you didn't try to talk me out of it.
Oh, no, no, not trying to.
Not my job, just trying to understand.
Come on, hit me back.
So, uh, were your parents abusive at all? - No.
- Okay.
Do you feel unsafe or threatened? Nope.
Any other member of your family make you feel unsafe? You're on the wrong track, Dr.
Thanks for that.
Um, okay, pivot Do you love your parents? Yep.
And they know that you want to leave? - They do.
- How do they feel about that? You're on the wrong track again, Dr.
All right, okay, I'm starting to get that.
Maybe you can steer me in the right direction? I'm not here to talk about my problems.
I'm here because on advice of counsel.
- You have a lawyer? - Two and they're total sharks.
They're gonna file a motion for emancipation in conjunction with my child-support action.
And they want a shrink to support their claim.
- I see.
- So, if I sense you're trying to steer me away from my stated goal, I'll shut down and run out the clock.
- You'd do that? - Try me.
The narrowing of his carotid arteries is obstructing the blood flow to his brain.
- Endarterectomy? - That's what he needs.
- So when can we schedule it? - I can't.
- I don't do them anymore.
- What since when? - Chaplain Alpert has been here - I know, for a long time.
And he's helped us through some of our darkest days.
He has, and now it's our turn to help him.
I want to, but it's out of my hands.
Out of your ha Floyd, you head the department.
- Are you seriously telling me - I'm telling you this.
I'm doing the best I can under the impossible circumstances to keep even the most basic procedures in this hospital If we don't act now, he's gonna die.
Well, then send him to Baptist.
- Baptist? - Baptist they'll do it, - and they'll do a good job.
- Baptist is a private hospital.
A surgery like this is gonna cost 100 grand you know that.
Even with insurance, he will never be able to afford it.
And if we can't take care of our own, then who the hell can? There is no "we" anymore, Max.
That's how it works around here now If it even works at all.
You're better than this.
Am I? - What the hell happened? - BP spiked.
He's going into SVT, Pushing beta blockers now.
No, wait.
He can't wait.
He'll go into heart failure Push six milligrams of adenosine instead.
- Why? - Just do it.
- I got your tox screen.
- Thanks.
There's a significant increase of amphetamines.
Apparent overdose.
If we had pushed beta blockers, we would've killed him.
Good call, Dr.
Yeah, good call.
So you're basically running a shadow hospital? Bingo.
What about our research lab? Oh, it's not gone.
It's just, uh, moved offsite.
Secretly folded into another lab that we outsource our biopsies to.
Look at you, you little rebel rouser.
I didn't know you'd be so clandestine.
Hey, we're just continuing the tradition that you and Max started.
How can I help? Chaplain Alpert needs an endarterectomy to save his life, but guess what - We don't do those anymore.
- You got my text.
You know, he's given everything to this hospital, and we can't give it back to him? We can't give him the dignity, the the Why are we in the morgue? Because we're gonna save the Chaplain's life.
We are? Welcome to the resistance.
Oh, there's my holistic-wellness chieftess.
- Please, have a seat.
- Thank you.
You saw my request.
How could I miss it, being as large and inflated as it is? I prefer to think of it as aspirational.
Well, wanting an entire floor of the hospital certainly qualifies.
What's wrong with your current situation? "Low ceilings and tiny rooms cramp the soul and the mind.
" Dostoevsky.
Yes, wow.
Um, oh, my gosh.
People usually just think I'm quoting Deepak Chopra.
Not me.
That's why I hired you.
So you want more space for acupuncture and for meditation.
That's a pretty big ask, but I think I can make that happen.
Really? Why ask if you didn't think I could? I no, I'm Wow, wow, that's that's great.
This is, um thank you.
This is a dream manifesting.
Good, good.
Now, while that's gonna help your department, I'm gonna ask a little something of you that's gonna help the whole hospital.
No, anything I can do to help push that rock up the mountain.
So what do you know about the so-called resistance? Yeah, it's funny that you should ask about that.
- You got the faster car, man.
- This isn't fair.
Come on, come on.
- Come on.
No! - Yes! Die, purple loser! That was very unkind.
- But it was fun.
- Yeah, yeah, it was fun.
Do your, uh do your parents let you play video games? Yeah, they're not monsters, but they think I'm wasting my time.
What would they rather you be doing? I don't know.
Accomplish things, I guess.
- You are accomplished.
- Not enough.
They're always worried about my future.
It's not like we're rich, you know? They want me to skip grades, be in the same class as 12-year-olds.
- 12-year-olds are weird.
- That's got to suck Feeling like you're giving it your all, but you're still not enough.
Which is why I figure it's better just to get out Better for me and better for my parents.
- Oh, you have a lot of games.
- Yeah, I do.
In fact, how would you feel about coming back next week and giving me another butt kicking? I see what you're doing, Dr.
We're just talking.
You're building a therapeutic alliance, hoping to lean me away from my desire to be emancipated.
Well, that is very astute, Jack, but you are dead wrong, all right? If we meet, I won't be leading you anywhere.
Whatever we do in here, whatever you want to play, we play.
Whatever you want to talk about, we'll talk about.
It's your time, not mine.
But what if nothing changes? There's no epiphany, no breakthrough? - Yeah, sometimes there isn't.
- Then it's just wasted time.
Who feels the need to accomplish now, you or your parents? One hour a week? One hour a week, just wasting time.
That's gonna be very challenging.
I know, right? - Hey.
- Hi.
How's Rohan doing? Better.
Yeah, he's gonna make a full recovery.
It's just a matter of time.
And how's Lauren? The truth? Preferably.
What are these? They are black beauties.
It's Rohan's.
- I didn't.
- Okay.
Okay, all right.
This whole place is like a trigger for me, you know? And not even my sobriety.
It's like my sanity.
I want to leave.
I mean, I need to leave.
But Leyla Leyla said that she would basically quit if I left that the ED needs me, New Amsterdam needs me.
Well, that that doesn't seem very fair.
Who says I deserve fair? Lauren, whatever you've done, you've got to let that go.
You have to forgive yourself.
I can't.
I don't want to.
So you just want to keep punishing yourself, do you? Because that's what I deserve.
Lauren look at me.
Come here, sweetheart.
Come here.
Now, you listen to me.
If you need to leave for your sobriety and for your sanity, then you go.
Do you understand? Because nothing is more important.
- Clamp.
- Hemostat.
What am I doing here? A CABG procedure on Ellen Greenfield? I'll make sure not to tell her you asked.
Meanwhile, Chaplain Alpert needs a surgery that I can do in my sleep.
- You did what you could.
- Did I? For every CABG we do, there are ten patients like Chaplain Alpert that get either transferred or ignored.
That's the definition of a bad system.
- It needs to stop.
- So stop it.
You're the chair of surgery, right? You don't think I've tried? Sponge.
World-class facility, resources, experience, and for what? So people can do jerry-rigged procedures in whatever empty room they can find? That's not really happening, is it? Forget I said anything.
I'm sorry, I got riled up.
Floyd, patients could get hurt.
Patients could die.
Unless we help them.
Kind of feels like you've done this before.
We have, but never a procedure this risky.
Uh, everyone, look at me, please.
I need you all to consent to the following.
You're all here of your own free will.
You are aware of the medical risks of this procedure.
And you know by performing surgery in this place under these circumstances, we are all putting our jobs on the line.
But every one of us here feels a duty to save this man's life.
Let's get him intubated.
It's okay.
It's Reynolds.
- How do you know for sure? - I know him.
He's here to help.
Thought you were gone.
When I heard the resistance was in the morgue, I thought, "Isn't that poetic?" And I just had to come and see it for myself.
And here you are.
How does that saying go? Uh, "Liberte.
Egalite" What's the other one? Busted? Welcome back, Chaplain.
How you feeling? I'm feeling like I just had surgery.
It's 'cause you did.
A very successful one.
I'll give you both some privacy.
Thank you, Dr.
Ah, nearly 30 years, you'd think I'd know every doctor in New Amsterdam.
- Well, you do.
- This isn't New Amsterdam.
This is Baptist.
You mean? You needed help that, uh we weren't able to give you.
I thought I could make it happen, but, um my hope for New Amsterdam was You needed the best care possible, and I got in the way.
Come on, it'd be sorry if I had died.
Then again, maybe I have, huh? This view And this bill No bill.
Excuse me? Baptist They started a fund for medical professionals Anyone who works in health care that can't get the care they need at their own hospital, which is systemic, unfortunately.
But this hospital They stepped up.
Max, thank you.
Now go live your life.
Embrace the blessings when they come.
Time to go home, Max.
How you feeling? Ashamed.
You know, part of me thinks you should feel that way.
This was a day about your father.
You made it about you.
Was that your intention? No.
Then I, uh, have to ask you a hard question.
Were you trying to end your life? Does it matter? - It does.
- Why? Nothing about me was good enough for him.
And he was right.
I was desperate for his love, and all I could do was disappoint.
He loved you very much.
No, he did.
He loved you.
It was just his It was his expectations that prevented him from showing it.
Showing it the way that you needed him to.
I miss him.
I know.
I know you do.
But I really do believe That if he had lived a little bit longer You two would've found your way back to each other.
I believe that, Rohan.
Well We'll never know, now, will we? I think that's up to you.
How? Everything your father was, everything that he could be that's in you.
No, it is.
It's inside of you.
His life is in yours.
How are you gonna live it? Sorry I'm late.
The "resistance.
" The resistance.
Ignoring mandates, conducting illicit surgeries, risking the accreditation of this hospital It was me! I authorized the Chaplain's surgery, and I was going to lead it, so you do not need to punish anyone else here.
Please accept my resignation.
No, Dr.
Wilder, I do not accept your resignation, because, unfortunately, your surgeries generate a staggering amount of revenue for this hospital.
Yeah, but I will not stay here under these conditions.
Well, actually, I think you might.
Otherwise, I'll have to report you to the AMA for what you did, and then they'll strip you of your license, and it will get very, very messy indeed.
No, no, that's enough.
Hey, you are entitled to call us out, that's fine, - but you don't get to - I don't get to what, Dr.
Frome? Do my job? Which unlike you, Dr.
Frome, I happen to take very seriously.
Oh, do you? And, actually, while I have you, let me ask you this.
How many scheduled patients did you see today? Um, scheduled? - Scheduled, yes, mm-hmm.
- One.
Well, actually, I know that, because while you were playing video games, the other five were rescheduled.
That's revenue straight out the door.
I just don't know how much longer I can drag you by the ear before I see some semblance of professional behavior from you.
I called each of those patients, and I rescheduled them.
As of now, you are no longer chair of your department.
Sorry, has to be done.
No, what? What? Dr.
Bloom, you were going to resign today as well.
Is that correct? I was going to but after everything I've seen today I'm staying.
Well, unfortunately, that's not your decision to make.
So I happily accept your resignation, and I sincerely thank you for everything that you've done for New Amsterdam.
Mia, Mia If you weren't the sole practitioner of holistic medicine, I would have no choice but to relieve you of your duties as well.
You had the chance to come to me and to tell me the truth.
And you chose not to.
But I'm going to give you a second chance, against my better judgment.
But I certainly hope you follow the lead of Dr.
Reynolds in the future.
You had the courage to come forward and to alert me about the resistance.
Not just for your patients, but for all the patients at New Amsterdam because you saw that there was a possibility of doing them harm, and our oath states that we must protect them at all costs.
And for that, I'm grateful.
So please send me a list of the surgeries you would like restored.
And let's certainly hope this never happens again.
And if you'll excuse me, I have a hospital to run.
Uh Flight of stairs - Hey.
- Floyd, have you seen Ma Out of the night that covers me.
Black as the pit from pole to pole.
Thank whatever gods may be for my unconquerable soul.
In the fell clutch of circumstance, I have not winced nor cried aloud.
Under the bludgeonings of chance my head is bloody but unbowed.
Beyond this place of wrath and tears looms but the horror of the shade.
And yet, diminished of the years finds and shall find me unafraid.
In matters not how straight the gate, how charged with punishments the scroll.
I am the master of my fate.
I am the captain of my soul.
- Heard about the meeting? - From everyone.
I keep thinking there's something I should do, but I try to remember that it's just not my fight anymore.
No? Let's grab Luna and go.
What is it? I can't let you.
I can't let you leave.
- Helen - Because you're wrong, Max.
Of course this is your fight.
After what I saw today This place these patients, our friends they're all losing.
They're fighting back, and they are losing because you're not here.
I did everything I could, Helen.
I did everything I could, and so did you to try to leave this place better when we And it didn't work out.
And I have to make peace with that.
No, forget peace.
This is war.
So you need to stay here, and you need to fight.
You need to fight alongside our friends.
You need to fight for this hospital.
You have to fight for my legacy and yours.
And when you win and you will win then you get your ass on a plane, and you come back to me, do you understand? What if I lose you? Losing me is impossible.
Now you get in there and you show them what you're made of.

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