S02.E05: The Karman Line

[Whimsy]

Quote

When Sharpe has a case that hits close to home, she and Max team up to make things right for the patient. Iggy and Bloom are forced to make a tough call on a unique situation.

Original airdate 10/22/19

[mojito]

That little psychopath needs to be locked up.

The insurance story was too far-fetched for my taste.

Kapoor's story wasn't interesting.

I didn't find that adrenaline rush with the astronaut to be very convincing. It seemed more like she momentarily blacked out than survived a 195 pulse. So that was an unsettling conclusion.

I hope we've heard the last of Helen and motherhood.

I'm glad Bloom is attending meetings, but I'm not interested in her private life. Wish they'd bring back the doctor who replaced her while she was in rehab. 

I did like Reynolds' understanding that he has to allow his fiance to follow her passion. That was pretty much all that I liked about this episode.

[bichonblitz]

I wanted to smack the entitled smug off that psycho kids face. 

[nixgirl28]

This show is getting more and more ridiculous. The writers are laughing all the way to the bank.

[SunnyBeBe]

You know as bad as this show is, it's still much better than Chicago Med.  lol 

I suppose that I must just not think too much about most of the stories they come up with.  With an insurance company, don't they have to announce the procedures they cover at the beginning of their enrollment period, so, the customer knows up front what they are signing up for the year.  I've never heard of them going against their own representations mid way through that period. I also was confused why the woman wanted to start a pregnancy with cancer.  Yes, she was getting treatments, but, nothing is 100%.  

I thought the child case was interesting.  There are kids like that and I think they do often end up as brilliant killers or politicians. lol 

[doodlebug]

43 minutes ago, SunnyBeBe said:

You know as bad as this show is, it's still much better than Chicago Med.  lol 

I suppose that I must just not think too much about most of the stories they come up with.  With an insurance company, don't they have to announce the procedures they cover at the beginning of their enrollment period, so, the customer knows up front what they are signing up for the year.  I've never heard of them going against their own representations mid way through that period. I also was confused why the woman wanted to start a pregnancy with cancer.  Yes, she was getting treatments, but, nothing is 100%.  

I thought the child case was interesting.  There are kids like that and I think they do often end up as brilliant killers or politicians. lol 

Health insurers never guarantee coverage for anything, especially newer or more expensive procedures.  I know of no comprehensive list of surgical procedures that would definitely be covered that you could refer to before signing up.  Anything covered depends not only on the coverage but also on the diagnosis, the doctor performing the procedure, the anesthesiologist and the hospital being on the insurance company's panel of providers.  There are also loopholes that let the insurance company refuse to pay if their team of consultants decides a cheaper procedure would've been adequate.

I live in a large midwestern city.  There has been a lot of controversy lately over people going to the ER for real emergencies at hospitals that are enrolled in their plans and then seeing an ER doc who is not part of the plan and ending up having to pay hundreds if not thousands, to the doctor when the insurance doesn't cover an 'out of network' physician even though he/she is working in a covered hospital and the policy holder had no choice.  Same thing can happen with surgery.  People have gone to the ER with broken bones, appendicitis and such, been referred to the 'on call' specialist for emergency surgery; only to discover postop that the surgeon or the anesthesiologist wasn't enrolled in their plan and they would have to pay those fees themselves.  I had a hip replacement a few years back.  The surgeon's fee was 6 grand, his assistant charged 4 g.  My insurance covered it all, but that is a huge hit if it doesn't.

[SunnyBeBe]

Some providers may be out of network, but, I've never heard of the insurance refusing to pay for standard medical treatment. 

[ams1001]

9 hours ago, mojito said:

That little psychopath needs to be locked up.

I read an article recently on the behavioral therapy Iggy referred to for psychopathic kids (the primary case they talked about was an 11-year-old girl...I wonder if the writers read the same article)...but (IIRC) it was at an actual psychiatric facility for children with a whole staff that has training for dealing with such kids, not the psych ward of a general hospital with a doctor who does not specialize in such treatment. The thought that they'd just admit her as an inpatient with Iggy treating her seems ludicrous.

9 hours ago, mojito said:

I didn't find that adrenaline rush with the astronaut to be very convincing. It seemed more like she momentarily blacked out than survived a 195 pulse. So that was an unsettling conclusion.

I'm guessing she'll get more medical tests much closer to the time she'd actually be going to space, so the fact that she "passed" a stress test over a year out probably doesn't mean much.

5 minutes ago, doodlebug said:

I live in a large midwestern city.  There has been a lot of controversy lately over people going to the ER for real emergencies at hospitals that are enrolled in their plans and then seeing an ER doc who is not part of the plan and ending up having to pay hundreds if not thousands, to the doctor when the insurance doesn't cover an 'out of network' physician even though he/she is working in a covered hospital and the policy holder had no choice.

The Daily Show had a bit (with Lewis Black) on this recently. He said that in some cases the ER is run by a contractor, so even though the hospital itself is in your network, the ER is a separate entity as far as the insurance company is concerned...but you have no way of knowing that until you get the bill. Such BS.

Edited October 23, 2019 by ams1001

[doodlebug]

2 minutes ago, ams1001 said:

I The Daily Show had a bit (with Lewis Black) on this recently. He said that in some cases the ER is run by a contractor, so even though the hospital itself is in your network, the ER is a separate entity as far as the insurance company is concerned...but you have no way of knowing that until you get the bill. Such BS.

This is quite true.  People often don't realize that the physicians who provide various in-hospital services such as ER, pathologists, anesthesiologists and the like are often not hospital employees but private practice physicians who work for their own medical corporations and contract with the hospital to provide services there.  The hospital can encourage them to take the same insurances, help them to apply; but, sometimes, insurance companies try to low ball doctors in small private practices and they end up not signing a contract because they cannot agree on the fee scale.

Insurance companies negotiate individual contracts with hospital systems, private practitioners, etc and do not pay the same amount for the same services to everyone.  In general, large hospital systems who employ their own docs will get paid more than the private practice groups for identical services simply because they have the leverage to get the better rate.

[ams1001]

25 minutes ago, doodlebug said:

This is quite true.  People often don't realize that the physicians who provide various in-hospital services such as ER, pathologists, anesthesiologists and the like are often not hospital employees but private practice physicians who work for their own medical corporations and contract with the hospital to provide services there.  The hospital can encourage them to take the same insurances, help them to apply; but, sometimes, insurance companies try to low ball doctors in small private practices and they end up not signing a contract because they cannot agree on the fee scale.

It's been a long time since I was last in the ER. I was in a car accident in 2002 and spent a few hours at the hospital, got some x-rays, and went home with prescriptions for muscle relaxers and (non-opioid) pain meds for severe whiplash (and I learned exactly where my seatbelt sat when I tried to sit up in bed the next morning...emphasis on "tried"). Everything was covered (the other guy's insurance even reimbursed me my deductible) but I was getting random insurance statements for one charge or another for many months afterward. It's insane how piecemeal the charge for even a relatively simple hospital visit is.

[Mia Nina]

I understand the season has only aired five episodes, but I find myself asking: why did they kill Georgia? Maybe it's just me but ever since the season opener the show has felt hollow. A drama needs conflict, but the way the first few episodes have gone the entire premise of full on optimism has felt forced and empty.

Watching Max doing the most every week, being kicked out of places (last week was the barbershop), harassing people in order to fix a problem, etc., has to be a sign of something more. He is not okay and needs some serious help. Every week he manages to "win" and solve the problem but not in any believable way. I mean, has he been checking up on the barbershops he's supposedly providing oversight to? The personal, professional and emotional toll of his 'ideas' is beyond unreasonable especially now that he has Luna to raise. What about Georgia's parents? Any friends or family who can help?

Georgia's angelic presence in this particular episode was evocative and heartbreaking. At one point she looked down, almost as if she felt sorry for Max. And she's a figment of his imagination. If the show doesn't find the right tone for Max going forward killing Georgia will end up being a mistake.

The insurance officer going to a trustee and presenting a case face to face and getting that exception doesn't come off as totally crazy, but the show is being crushed by a sense of devastation that might not be entirely intended. 

Iggy doesn't have the resources or training to help Juliette. 

Sharpe briefly mentioned wanting to adopt in a previous episode, perhaps it will come up later on.

[sadie]

So what’s his name psychiatrist recognizes the kid is a psychopath, but since he’s now taught her how to more effectively manipulate people all is well? When she murders her entire family in their sleep because she couldn’t watch the tv show she wanted do you think he’ll rethink his stupidity? The kid gave me chills. Why couldn’t this show just have her being committed and him helping the family accept it was for her and their good. Nope, he has to be the most super hopeful “up with people” shrink whose ever walked the earth. He sure worked hard to protect the little psycho but seemed completely unconcerned with the poor brother that GOT STRANGLED cause I’m sure THAT won’t leave any lasting mental scars. I guess he wasn’t concerned with him. 

[SunnyBeBe]

Max does seem to be quite manic as he jumps from mission to mission to help the impoverished. Maybe, he thinks the scrubs will help. I do think he is carrying about what the premise of the show is. But,  IDK.  I think the writers don't give it much thought.   Sort of like when he was running pushing his infant daughter in the running stroller.  He was wearing earphones.  Would you really want to distract yourself from anything while running with your daughter outside your eyesight?  Wouldn't you really want to hear car approaching, horns, daughter crying?  It just struck me as odd.  

I do think that it would be very reasonable for a professional in a position like his to have someone in the home to prepare meals, do housework, and help care for the baby in the evenings.  

[izabella]

6 hours ago, bichonblitz said:

I wanted to smack the entitled smug off that psycho kids face. 

1 hour ago, sadie said:

The kid gave me chills.

Kudos to that young actress!  I felt the same way - horrified and furious at the same time.

[NYCFree]

The trouble is that Max is really only changing the outcome for a few individuals, not reforming broken systems. This happened with the diabetic patient who will get a free lifetime supply of insulin, this episode’s fertility treatment, and even the barber shop guys are a fairly limited circle.

We originally watched Undercover Boss because it was marketed as a show where a CEO actually learns things that will enable him/her to make changes to their company to help those on the lower rungs of the ladder. Instead, it was a windfall bonus to one employee a week. I feel like Max’s “wins” could be arranged by a passionate social worker. I want to see changes that could only be made by the head of a large urban hospital. I actually liked the idea of the dedicated hospital buses that benefited a few hundred employees.

Edited October 23, 2019 by NYCFree

[LittleIggy]

16 hours ago, bichonblitz said:

I wanted to smack the entitled smug off that psycho kids face. 

I don’t think training her to be even more skilled at manipulation is going to make anyone safer. “Evil” had a child psychopath last week, and “fake it ‘til you make it” didn’t work there.

i wish they would quit wasting JJ Feild. 

[Dowel Jones]

Just as an aside, I had a cardiac ablation about two years ago for an irregular heartbeat.  What they did in this case was to cauterize the nodes on the heart that were firing with the electrical impulses and causing occasional extra contractions (a very basic explanation).  I don't know if there are other methods of ablation, but they definitely put me under anesthesia the whole time.  Fortunately it was an outpatient procedure and I went home that afternoon.  But I haven't been selected for any shuttle missions either, for that matter.

[bros402]

That insurance situation was..... interesting.

To the person above who asked if insurers give a list of what is covered at the start of the coverage period: nope, and they can change stuff at any time. Sometimes they give a warning, but usually not. I had this this summer with my seizure meds - prescription plan refused to deny paying for it like they usually do, and required a prior authorization in order to get them to refuse to pay for the medication so my medicaid could pick up the cost (Then the prescription plan approved paying $2800 a month for the medications, versus the $0 they were paying before so ????).

Some states, like New Jersey, have passed legislation against surprise billing (Going an in network ER, then getting billed thousands for an out of network doctor).

The little girl playing the psychopath was a good actress.

So, we all agree that the coffee lady is gonna keep the baby and Iggy is gonna adopt it, right? Or Max with anoint it the new mascot of new amsterdam

[alexvillage]

This episode was really confusing and full of holes.

Please correct me if you have insight information but one trustee would simply talk to a - assumedly - low level employee and be able to simply override a policy? If this is true, every single health insurance trustee is a jerk who doesn't care about human lives, or they would be doing this all the time.

I am also confused about insurance covering fertility treatments. I haven't looked at my policy, but I thought that one of the exclusions. The cancer part was also not well played, imo. I know that hysterectomy scares people, especially young women who want to have children  but I had full hysterectomy for pre-cancerous cells. It was the suggestion of my doctor too - which I didn't need since I had decided before he even spoke. But I am old, so maybe that's why it was easier for him to suggest that.

As for changing what they cover, they do this all the time and they don't really inform you. Blue Cross recently changed the pharmacy they work with for specialized meds and never informed the patient. The previous partner pharmacy claimed they weren't informed either, up to the time they tried to bill the medication. The result was that someone I know was without the medication for four days until things got resolved, and that's because people were on the phone demanding an overnight shipping. It was close to the weekend.

Psychopaths don't have empathy and they don't learn to feel empathy.  If there is anything similar to a treatment for children in real life (I guess children are not really diagnosed as psychopaths until a certain age, but I might be wrong) I am curious about it. Manipulation will only increase as they grow older and want more things. Behaviorism is one of the biggest overrated, oversold and overcharged practice out there. It is abused when used in children who do have diagnosis like Autism and ADHD. It forces them to act as if they are not who they are, to comply and please others, it causes PTSD and it can make them perfect targets for abuse (they are not allowed to say "no") - autistic people have been raging against the abuses for a long time. It is all about coercion and to make neurotypical people feel more comfortable around (mostly) autistic people. And it is based on the Gay Conversion Therapy, so there you have it.

Since the girl in the episode cannot feel empathy, and will never feel remorse, she will likely not have what is known as PTSD either. What she will become is even more manipulative and dangerous.

I did like that they cast asian actors though, not in the usual tokenized way.

[ams1001]

5 hours ago, bros402 said:

Some states, like New Jersey, have passed legislation against surprise billing (Going an in network ER, then getting billed thousands for an out of network doctor).

Well, that's nice to know. (Though hopefully I won't end up in the hospital any time soon.)

1 hour ago, alexvillage said:

If there is anything similar to a treatment for children in real life (I guess children are not really diagnosed as psychopaths until a certain age, but I might be wrong) I am curious about it.

This is the article I mentioned in my previous post:

https://www.theatlantic.com/magazine/archive/2017/06/when-your-child-is-a-psychopath/524502/

[alexvillage]

1 hour ago, ams1001 said:

This is the article I mentioned in my previous post:

Thanks!

It is interesting and maybe it will work for those who get the diagnosis due to the shit life throws at them - although plenty of people have shitty lives and never become not even close to a danger to others, so there must be some predisposition.

For the ones who show the callousness and lack of empathy since an early age, I put myself in the skeptical column. If something is "missing" (grey matter), can it be "found" as the kids grow and their brain and decision making evolves/develops? 

To this point, this part called my attention:

"Still, researchers stress that a callous child—even one who was born that way—is not automatically destined for psychopathy. By some estimates, four out of five children with these traits do not grow up to be psychopaths. The mystery—the one everyone is trying to solve—is why some of these children develop into normal adults while others end up on death row." **

It is easy to think of psychopaths as people who cause terrible harm to others, like  murderers and serial killers but there are those whose pleasure is in more than bodily harm, and they don't really cause that harm themselves, but manipulate others to do so. History is full of those. While I cannot prove that they were/are psychopaths, I think it is not a stretch to speculate about the possibility. It is not simply an assumption or "armchair psychiatry", which are dangerous if you diagnose someone by a few soundbites and one event. I am referring to a pattern of behavior that go beyond narcissism and that seem to escalate with each known event.

** I would add: while others even end up at higher offices of private companies and even governments.

[cardigirl]

The biggest hole I found in this episode is that Max would never be allowed to just wander the halls of a business, knocking on doors, looking for a human being to try to talk to. Every company has lots of security in place to avoid just that scenario of random people walking in and 'accosting' people.  In Max's case, he was trying to plead his case, but he could have been some aggrieved nutcase with a gun.  He would have never gotten past the first floor. 

[ams1001]

35 minutes ago, cardigirl said:

The biggest hole I found in this episode is that Max would never be allowed to just wander the halls of a business, knocking on doors, looking for a human being to try to talk to. Every company has lots of security in place to avoid just that scenario of random people walking in and 'accosting' people.  In Max's case, he was trying to plead his case, but he could have been some aggrieved nutcase with a gun.  He would have never gotten past the first floor. 

Good point. Especially in a health insurance company where they'd have all kinds of confidential, HIPAA-protected information.

I work in the office of a warehouse and you can't even get into the lobby of the building without a badge unless someone lets you in. Visitors have to buzz security with an intercom/camera setup (and the security guard sits maybe 20 feet away directly facing the door and can see you from the reception desk without the camera). There are also several badge-access points within the building.

Edited October 24, 2019 by ams1001

[Dowel Jones]

On 10/23/2019 at 5:40 AM, SunnyBeBe said:

I thought the child case was interesting.  There are kids like that and I think they do often end up as brilliant killers or politicians. lol 

Or creepy ghost-like avatars in a video reality game. 

[bros402]

19 hours ago, alexvillage said:

This episode was really confusing and full of holes.

Please correct me if you have insight information but one trustee would simply talk to a - assumedly - low level employee and be able to simply override a policy? If this is true, every single health insurance trustee is a jerk who doesn't care about human lives, or they would be doing this all the time.

I am also confused about insurance covering fertility treatments. I haven't looked at my policy, but I thought that one of the exclusions. The cancer part was also not well played, imo. I know that hysterectomy scares people, especially young women who want to have children  but I had full hysterectomy for pre-cancerous cells. It was the suggestion of my doctor too - which I didn't need since I had decided before he even spoke. But I am old, so maybe that's why it was easier for him to suggest that.

As for changing what they cover, they do this all the time and they don't really inform you. Blue Cross recently changed the pharmacy they work with for specialized meds and never informed the patient. The previous partner pharmacy claimed they weren't informed either, up to the time they tried to bill the medication. The result was that someone I know was without the medication for four days until things got resolved, and that's because people were on the phone demanding an overnight shipping. It was close to the weekend.

From what it sounded like, the low level agent somehow managed to wrangle a member of the board and got them to do a one time override, which was just like "what"

Insurance doesn't cover fertility treatments in most cases - but maybe the insurance wasn't going to cover her if she got pregnant with her sister's kid?

From what I understand, they try to avoid hysterectomies as long as possible in people of child bearing age - and some doctors refuse to do voluntary hysterectomies of women who know they never want to have children.

I'm switching to BCBS come January, it should be a super duper fun time!

[alexvillage]

3 hours ago, bros402 said:

From what I understand, they try to avoid hysterectomies as long as possible in people of child bearing age - and some doctors refuse to do voluntary hysterectomies of women who know they never want to have children.

I'm switching to BCBS come January, it should be a super duper fun time!

Yes, that's what I gathered by my conversations with doctors. To me, it was easy. Old and never really wanted kids. Of course, the whole situation was stressing but the decision itself was an easy one for me.

Good luck with BCBS. I am sorry to say, but you will need it.

[Higgins]

4 hours ago, bros402 said:

From what it sounded like, the low level agent somehow managed to wrangle a member of the board and got them to do a one time override, which was just like "what"

Insurance doesn't cover fertility treatments in most cases - but maybe the insurance wasn't going to cover her if she got pregnant with her sister's kid?

From what I understand, they try to avoid hysterectomies as long as possible in people of child bearing age - and some doctors refuse to do voluntary hysterectomies of women who know they never want to have children.

I'm switching to BCBS come January, it should be a super duper fun time!

No it won't. I worked for that company. The worst!

[Johnny Dollar]

It was unclear if the insurance company wouldn’t cover the IVF itself, the pregnancy or both. In my experience IVF is very rarely covered. As for pregnancy it really shouldn’t matter how someone gets pregnant. Also, was the sister with cancer not going to have a hysterectomy just so she could possibly have a baby later?  Wouldn’t they harvest the eggs now, freeze them and then perform the hysterectomy?

I never cared about the coffee lady and making her pregnant with Vijay’s grandchild doesn’t change my feeling. That whole story line has been uncomfortable from the beginning  

That kid was definitely a psycho and no manner of Iggy’s magic is going to change that.  It’s not a good sign for a doctor to not be able to recognize this.

[ams1001]

10 minutes ago, Johnny Dollar said:

That kid was definitely a psycho and no manner of Iggy’s magic is going to change that.  It’s not a good sign for a doctor to not be able to recognize this.

Also the fact that he looked so disturbed when he realized she was just manipulating him to get fake money. Why was he so surprised by that?

[cathmed]

On 10/22/2019 at 11:45 PM, mojito said:

That little psychopath needs to be locked up.

The insurance story was too far-fetched for my taste.

Kapoor's story wasn't interesting.

I didn't find that adrenaline rush with the astronaut to be very convincing. It seemed more like she momentarily blacked out than survived a 195 pulse. So that was an unsettling conclusion.

I hope we've heard the last of Helen and motherhood.

I'm glad Bloom is attending meetings, but I'm not interested in her private life. Wish they'd bring back the doctor who replaced her while she was in rehab. 

I did like Reynolds' understanding that he has to allow his fiance to follow her passion. That was pretty much all that I liked about this episode.

All I can say is Yep, Yep, Yep, Yep....

I'm not sure why they've dropped Helen's motherhood story.  She was so determined/focused on that for pretty much all S1, had a nice guy and now that's just fizzled due to the accident/near death experience?   I almost think that may have pushed her into wanting to have a child realizing how precious and short life can be.   Why did she and the bf break up anyway?  And I'm in the "no" camp for Max and her to get together.  It was so contrived in S1 and really didn't make any sense--at least to me.  They're professional colleagues and I never saw the romantic "entanglement" the writers are now trying to develop.  JUST.NO.

Ditto on Bloom

Agree about Reynolds and I hope they don't break up and he and Bloom get back together *UGH*.

I'm not sure what's going on with the medical shows this season but they're all terrible, e.g., Chicago Med, The Resident, and New Amsterdam.   I used to love watching these and now, pretty meh.

Edited October 25, 2019 by cathmed

[cathmed]

On 10/23/2019 at 2:30 PM, izabella said:

Kudos to that young actress!  I felt the same way - horrified and furious at the same time.

Yeah, I don't know how one would audition for a role like that (totally amoral and unremorseful) but she nailed it!   Great little actress but she needs to play a different character now or she'll be typecast forever!

[cathmed]

2 hours ago, ams1001 said:

Also the fact that he looked so disturbed when he realized she was just manipulating him to get fake money. Why was he so surprised by that?

Because for all his brilliant reasoning, logic and understanding, Iggy is an ignoramus

[Dowel Jones]

Iggy should have changed the rules in the middle of the game.  Maybe call out that every insult is worth 20 bucks.  And then keep changing the rules until she quits.

[starri]

13 hours ago, Johnny Dollar said:

It was unclear if the insurance company wouldn’t cover the IVF itself, the pregnancy or both. In my experience IVF is very rarely covered. As for pregnancy it really shouldn’t matter how someone gets pregnant. Also, was the sister with cancer not going to have a hysterectomy just so she could possibly have a baby later?  Wouldn’t they harvest the eggs now, freeze them and then perform the hysterectomy?

They had to have been talking about the IVF, because presumably if the sister got pregnant, her own insurance would have covered the pregnancy.  I know some insurances do cover IVF treatments, but if that's what they meant, they should have explained that.

What's a bigger headscratcher is that if they were trying to say they wouldn't pay a surrogate, contract surrogacy is already illegal in New York.  That's an oversight of storytelling that I could perhaps find forgivable, if they hadn't had that exact issue come up in an episode last season.

[bros402]

20 hours ago, alexvillage said:

Yes, that's what I gathered by my conversations with doctors. To me, it was easy. Old and never really wanted kids. Of course, the whole situation was stressing but the decision itself was an easy one for me.

Good luck with BCBS. I am sorry to say, but you will need it.

Sounds like a fun time to be had by all! I hope my BCBS plan will at least have a complex case management program like my medicaid plan (through Horizon) does, that might help cut through a bit of red tape.

I am fully expecting to get a pile of paperwork thrown at me come 1/1/20 - I am hoping the first pile of paperwork is something "easy" - like disability waiver paperwork where I have to prove, yes, I am disabled and cannot work because of cerebral palsy, anxiety, autism, and a weakened immune system due to cancer.

19 hours ago, Higgins said:

No it won't. I worked for that company. The worst!

hahahaha oh this should be fun - my parents haven't had to deal with BCBS since I was 10 or so. When I was born I racked up a 150k bill in 2 1/2 months - BCBS took months to pay that, and they only paid 100k of the bill before discounts.

[Higgins]

3 hours ago, bros402 said:

Sounds like a fun time to be had by all! I hope my BCBS plan will at least have a complex case management program like my medicaid plan (through Horizon) does, that might help cut through a bit of red tape.

I am fully expecting to get a pile of paperwork thrown at me come 1/1/20 - I am hoping the first pile of paperwork is something "easy" - like disability waiver paperwork where I have to prove, yes, I am disabled and cannot work because of cerebral palsy, anxiety, autism, and a weakened immune system due to cancer.

hahahaha oh this should be fun - my parents haven't had to deal with BCBS since I was 10 or so. When I was born I racked up a 150k bill in 2 1/2 months - BCBS took months to pay that, and they only paid 100k of the bill before discounts.

I was a Medicaid Case Manager. They gave us no tools to assist anyone with the "red tape". It was awful and disorganized.

[doodlebug]

On 10/24/2019 at 1:04 AM, Dowel Jones said:

Just as an aside, I had a cardiac ablation about two years ago for an irregular heartbeat.  What they did in this case was to cauterize the nodes on the heart that were firing with the electrical impulses and causing occasional extra contractions (a very basic explanation).  I don't know if there are other methods of ablation, but they definitely put me under anesthesia the whole time.  Fortunately it was an outpatient procedure and I went home that afternoon.  But I haven't been selected for any shuttle missions either, for that matter.

The medicine on this show is heinous.  The portrayal of the cardiac ablation as some sort of major emergency procedure was, of course, incorrect.  In real life, the woman would've perhaps been given some medication to prevent recurrent episodes and sent on her way back home to Houston to consult with a cardiologist there.  I believe they said this was her first episode ever of SVT, odds are good that they won't be happening that often.  As you know, most people with SVT don't pass out cold in the street or whatever this lady did to bring her to the ER.  They experience palpitations which make them feel anxious and uneasy.  In severe cases, they might get dizzy, fee nauseous, get some chest pain or shortness of breath; but remain conscious throughout.  Then, I have no idea what the mumbo-jumbo was about the ablation maybe damaging her heart and causing it to explode at launch.  Sounds like a totally fictional plot device.  As for doing a 'cardiac stress test' by injecting her with epinephrine until her heart raced, I have no words.  That proved nothing.  There is such a thing as a cardiac  stress test, but that wasn't it.  It also appeared to me that part of the reason that Reynolds was doing the procedure at New Amsterdam was because the astronaut intended to hide her cardiac problems from NASA; that she was afraid she'd be grounded.  So, Reynolds, who has absolutely no training or experience with aeronautical medicine (yes, there are people who do), gets to decide whether her bosses get to know that she had a significant cardiac problem and underwent a procedure?  Talk about unethical!  If she goes into space, has a cardiac problem and she or her fellow astronauts end up dead or injured, Reynolds should lose his license forever.  This is akin to not telling the DMV that someone has an active seizure disorder so they can continue to drive.  Just no.

I also noted during the 'stress test' scene that the continuity people on this show are just as skilled as the writers as the lady astronaut's nasal cannula magically appeared and disappeared from shot to shot as she went from semi-recumbent to lying flat from shot to shot, too.

As for the woman with uterine cancer being treated with radiation and chemo; I don't have any idea what sort of uterine cancer that would be.  It was especially confusing when the CT or ultrasound showed them that her tumor had grown and therefore she now needed a hysterectomy.  I've practiced gynecology for 35 years, no way. When Helen initially suggested that she could go ahead and get pregnant and carry successfully after undergoing pelvic radiation, I just laughed.  No, an irradiated uterus that was once cancerous is not going to be able to carry a pregnancy, dumba**. And, at her age, it is very likely the chemo would've put her into menopause anyway.  As for insurance covering surrogacy, not that I've seen.  I've dealt with the other end and delivered multiple women who were serving as surrogates for others.  In every case, her prenatal care and delivery charges were paid out of pocket by the parents who were going to receive the baby.  I presume the prospective parents also had to pick up the tab for the egg retrieval, fertilization and implantation.  I currently have a friend who had leukemia and is in premature menopause at 30.  She plans to use a donor egg and undergo IVF and have the egg implanted in herself.  She and her husband are trying to raise 30 grand to make it happen.  Both she and her husband are college graduates with excellent jobs and insurance, and still, much of it is not covered.

As for the low level insurance clerk being able to get into the office of someone with power and somehow convince him to change the rules and make an exception for this one person just because Max was so persuasive, are the writers smoking crack?  Complete fairy tale.

Edited October 26, 2019 by doodlebug

[starri]

They also can't quite tell the difference between a cardiothoracic surgeon and an interventional cardiologist.  That annoys me more than anything for some reason.

[doodlebug]

1 minute ago, starri said:

They also can't quite tell the difference between a cardiothoracic surgeon and an interventional cardiologist.  That annoys me more than anything for some reason.

Well, yeah, there is that.  We've also had Kapoor, a neurologist, doing brain surgery and Iggy treating both adults and children as a psychiatrist.

I thought the little girl did a good job playing a psychopath, but Iggy had no business being her primary shrink.  That kid needed a whole team of professionals and a locked facility.

[starri]

1 minute ago, doodlebug said:

Iggy treating both adults and children as a psychiatrist.

That's not uncommon, especially in New York City.  

[doodlebug]

34 minutes ago, starri said:

That's not uncommon, especially in New York City.  

I would expect a facility as large as New Amsterdam to have both pediatric and adult psychiatrists for inpatients, though.

[ams1001]

1 hour ago, doodlebug said:

The medicine on this show is heinous.  

I love it when real medical people comment on these shows. 🙂 I often assume the medicine is, let's say exaggerated, for the sake of drama, but it's always entertaining to see just how bad it is.

[txhorns79]

On 10/25/2019 at 8:39 AM, ams1001 said:

Also the fact that he looked so disturbed when he realized she was just manipulating him to get fake money. Why was he so surprised by that?

Iggy seemed pretty naive for someone who is supposedly the head of the department at the hospital.  On the one hand, I appreciated them showing that Iggy was way out of his depth and really had no idea what he was doing, but on the other hand, this whole storyline was ridiculous. 

[doodlebug]

2 hours ago, txhorns79 said:

Iggy seemed pretty naive for someone who is supposedly the head of the department at the hospital.  On the one hand, I appreciated them showing that Iggy was way out of his depth and really had no idea what he was doing, but on the other hand, this whole storyline was ridiculous. 

Not only was he naïve, he kept letting her get the upper hand and kept handing her the money every time she demanded it.  He is the adult, the therapist, the one in charge.  Tell her that the rules have changed and the game is over.  He let her have control over the entire situation which I am sure is the opposite of what any therapist would want to achieve with a manipulative psychopath.

[bros402]

20 hours ago, Higgins said:

I was a Medicaid Case Manager. They gave us no tools to assist anyone with the "red tape". It was awful and disorganized.

I have a medicaid case manager and she is pretty good. She was able to finally navigate an issue none of the phone reps were able to get through after 3 years.

15 hours ago, doodlebug said:

The medicine on this show is heinous.  There is such a thing as a cardiac  stress test, but that wasn't it.  It also appeared to me that part of the reason that Reynolds was doing the procedure at New Amsterdam was because the astronaut intended to hide her cardiac problems from NASA; that she was afraid she'd be grounded.  So, Reynolds, who has absolutely no training or experience with aeronautical medicine (yes, there are people who do), gets to decide whether her bosses get to know that she had a significant cardiac problem and underwent a procedure?  Talk about unethical!  If she goes into space, has a cardiac problem and she or her fellow astronauts end up dead or injured, Reynolds should lose his license forever.  This is akin to not telling the DMV that someone has an active seizure disorder so they can continue to drive.  Just no.

I also noted during the 'stress test' scene that the continuity people on this show are just as skilled as the writers as the lady astronaut's nasal cannula magically appeared and disappeared from shot to shot as she went from semi-recumbent to lying flat from shot to shot, too.

As for the woman with uterine cancer being treated with radiation and chemo; I don't have any idea what sort of uterine cancer that would be.  It was especially confusing when the CT or ultrasound showed them that her tumor had grown and therefore she now needed a hysterectomy.  I've practiced gynecology for 35 years, no way. When Helen initially suggested that she could go ahead and get pregnant and carry successfully after undergoing pelvic radiation, I just laughed.  No, an irradiated uterus that was once cancerous is not going to be able to carry a pregnancy, dumba**. And, at her age, it is very likely the chemo would've put her into menopause anyway.  As for insurance covering surrogacy, not that I've seen.  I've dealt with the other end and delivered multiple women who were serving as surrogates for others.  In every case, her prenatal care and delivery charges were paid out of pocket by the parents who were going to receive the baby.  I presume the prospective parents also had to pick up the tab for the egg retrieval, fertilization and implantation.  I currently have a friend who had leukemia and is in premature menopause at 30.  She plans to use a donor egg and undergo IVF and have the egg implanted in herself.  She and her husband are trying to raise 30 grand to make it happen.  Both she and her husband are college graduates with excellent jobs and insurance, and still, much of it is not covered.

As for the low level insurance clerk being able to get into the office of someone with power and somehow convince him to change the rules and make an exception for this one person just because Max was so persuasive, are the writers smoking crack?  Complete fairy tale.

Yesss, that was *so* not a cardiac stress test! She'd be running on a treadmill, not just pumping her full of epi until her heart wanted to explode!

Also, doctors in all states don't have to report if a patient has a seizure disorder. When I was doing driving lessons, my neurologist said he wasn't required to report my seizures to the state, and he said as long as I agreed to only drive with the instructor (an Occupational Therapist) he would not report it to motor vehicle.

I was also very surprised at what they were telling the uterine cancer patient! I mean I am male and I have a leukemia, but from everything I have heard about cancer & having kids, even if you just have chemo, you should wait at least 6 months after stopping chemo to try to get pregnant/get someone pregnant.

I was just going to say "maybe if they did hormone shots it could've preserved the ovaries" - but I bet uterine cancer loves hormones, so it would not be good to give a woman shots to preserve fertility.

I think the writers have mixed some acid into their coke - that's why they had the astronaut, so they should show space and be faaaar out

[doodlebug]

16 hours ago, bros402 said:

I have a medicaid case manager and she is pretty good. She was able to finally navigate an issue none of the phone reps were able to get through after 3 years.

Yesss, that was *so* not a cardiac stress test! She'd be running on a treadmill, not just pumping her full of epi until her heart wanted to explode!

Also, doctors in all states don't have to report if a patient has a seizure disorder. When I was doing driving lessons, my neurologist said he wasn't required to report my seizures to the state, and he said as long as I agreed to only drive with the instructor (an Occupational Therapist) he would not report it to motor vehicle.

I was also very surprised at what they were telling the uterine cancer patient! I mean I am male and I have a leukemia, but from everything I have heard about cancer & having kids, even if you just have chemo, you should wait at least 6 months after stopping chemo to try to get pregnant/get someone pregnant.

I was just going to say "maybe if they did hormone shots it could've preserved the ovaries" - but I bet uterine cancer loves hormones, so it would not be good to give a woman shots to preserve fertility.

I think the writers have mixed some acid into their coke - that's why they had the astronaut, so they should show space and be faaaar out

There are several different kinds of uterine cancer, none of which fit the scenario on the show; but, yes, the most common uterine cancer is stimulated to grow by estrogen which is why we do a hysterectomy and remove the ovaries when it is diagnosed and a women who has had uterine cancer should not be given hormone replacement therapy.  It is possible to retrieve eggs from the ovaries and freeze them prior to initiating chemo or doing a surgery to move them out of the way if pelvic radiation is going to be given, but it didn't seem like that was done in this case.

[bros402]

7 hours ago, doodlebug said:

There are several different kinds of uterine cancer, none of which fit the scenario on the show; but, yes, the most common uterine cancer is stimulated to grow by estrogen which is why we do a hysterectomy and remove the ovaries when it is diagnosed and a women who has had uterine cancer should not be given hormone replacement therapy.  It is possible to retrieve eggs from the ovaries and freeze them prior to initiating chemo or doing a surgery to move them out of the way if pelvic radiation is going to be given, but it didn't seem like that was done in this case.

Yeah, I don't know much about uterine cancer and I thought something was off (I have leukemia, I know a good amount about blood cancer now :P)

I did not get the impression that eggs were retrieved before treatment either - like I remember reading about how in extreme circumstances they have extracted ovarian tissue for preserving fertility, but I don't remember what the results of it were.

[Superpole2000]

On 10/24/2019 at 1:09 PM, cardigirl said:

The biggest hole I found in this episode is that Max would never be allowed to just wander the halls of a business, knocking on doors, looking for a human being to try to talk to. Every company has lots of security in place to avoid just that scenario of random people walking in and 'accosting' people.  In Max's case, he was trying to plead his case, but he could have been some aggrieved nutcase with a gun.  He would have never gotten past the first floor. 

And even if he could sneak in, wouldn't an intelligent professional in his position know that it's incredibly bad to do that? The writers have made Max a protocol-breaking dope. I am rarely on his side because he is always doing something dopey and breaking rules that inconvenience him.

The astronaut story was nonsense, the cancer patient was never going to have a kid in any real world scenario, and Bloom/Kapoor were uninteresting. The only highlight in this show was the manipulative kid. Her story was so interesting, and the acting was great.

[Dowel Jones]

3 minutes ago, Superpole2000 said:

The astronaut story was nonsense

I have to say this, I guess.  When I heard the "Karman Line" point uttered on the show, I had to reference the title for the episode, my first thought was a little South Park voice going "Goddammit, Kyle"...

[hookedontv]

Gah! This show! I’m binging on this season, I am months behind. These storylines and medical scenarios are ridiculous. 
 

I have SVT (supraventricular tachycardia).   I am not an astronaut so there’s no rush for me to get any surgical procedures and it’s more of a nuisance right now. I take a daily med. My heart rate shoots up to nearly 200 randomly, the cardiologist taught me techniques I can do to stop it, and I don’t lose consciousness (yet) and have a little space trip. There have been times where I haven’t been able to stop it and I go to the ER. A stress test is walking in a treadmill, not being pumped with meds. And if I was to have an ablation, the doctors told me I would definitely be under general anesthesia, there can be no movement whatsoever. What if she sneezed? 
 

Between this scenario and An unqualified Iggy treating a child psychopath, I have to take a break in my binging. A good doctor knows when he/she is over their head or when a patient needs to see a specialist. Iggy should have had enough insight to let a specialist treat the girl, in a locked facility. He thinks teaching her how to pretend to interact with people on a rewards basis? That’s not going to work, puts countless people at risk, just wait until she doesn’t get her way one day, she will kill someone. Ugh!