S02: E12 14 Years, 2 Months, 8 Days

[Dowel Jones]

Sharpe has an important realization that will affect her career. Meanwhile, Max and Reynolds take on uncharted waters when a young patient comes to New Amsterdam with symptoms of a heart attack.

[Whimsy]

3 hours ago, Dowel Jones said:

Sharpe has an important realization that will affect her career. Meanwhile, Max and Reynolds take on uncharted waters when a young patient comes to New Amsterdam with symptoms of a heart attack.

Thanks.  I looked online where I usually get episode topics and it said the next episode was in 2 weeks.   Obviously, that was wrong!

[rove4]

What was Sharpe's important realization? 

Kapoor!  With hair!!  😁

[Madding crowd]

Would that patient really haves stayed in the exact same hospital room for fourteen years? I would think he would be moved to a nursing home or facility at some point. I get the point of not wasting time on a hope when real love is in front of you, but not sure how it related to the other stories which seemed to have different messages ( such as not giving up hope).

[doodlebug]

32 minutes ago, Madding crowd said:

Would that patient really haves stayed in the exact same hospital room for fourteen years? I would think he would be moved to a nursing home or facility at some point. I get the point of not wasting time on a hope when real love is in front of you, but not sure how it related to the other stories which seemed to have different messages ( such as not giving up hope).

No, he would've been placed in a nursing home once his condition was stable.  He might've been transferred to the hospital one of the umpteen times he developed pneumonia or infected bed sores over the years; but no, he would not have been in a regular hospital room.  He also would've had a tracheostomy to allow his airways to be suctioned and would have developed contractures of his joints due to lack of use, even if he had a regular physical therapy regimen.  He wouldn't have looked as good as the patient did on the show.  In general, if a coma lasts more than a week, the odds of a meaningful recovery are slim.  When you read about people miraculously awakening from comas after weeks and months, that is because it is so very rare.  Also, most patients don't end up in comas, they usually are in persistent vegetative states where they do open and close their eyes, move around and even make sounds; but show no signs of understanding the world around them, let alone communicating.  They even have wake and sleep cycles.

47 minutes ago, rove4 said:

What was Sharpe's important realization? 

Kapoor!  With hair!!  😁

That this show sucks?  I guess it was that she is not the sole judge and jury over everyone else's work and lives.  Max is.  I do not understand this show's obsession with experimental treatments and insistence that people are being cured by using unproven drugs and procedures while regular medical care is substandard.  Getting a patient into a clinical trial is fine, if there is no alternative, but Sharp and the other doc (cardiac surgeon?) commiserating because Mean Oncology Doc wouldn't automatically include their patients in her clinical trial was bizarre.  Clinical trials are usually strictly controlled and the person doing the trial doesn't pick and choose the patients; there are very rigid criteria that must be met or the patient cannot be entered.  As for the doctor limiting the number of patients to 15 rather than 50 (or whatever it was), why would she do that?  Clinical trials are based on statistics and probabilities and if the NIH funded the study based on 50 patients, that was because some numbers geek figured out that that was how many were needed to prove or disprove the theory.  If she never fills the study, it never gets published.  And the NIH is going to stop funding her research.

I presume we're going to get Sharpe playing Nancy Drew with Max as Joe Hardy and they will be tracking down Mean Oncology Doc and uncovering her nefarious scheme to take over the world by accepting NIH funding for incomplete studies.

Edited January 29, 2020 by doodlebug

[Boofish]

40 minutes ago, Madding crowd said:

Would that patient really haves stayed in the exact same hospital room for fourteen years? I would think he would be moved to a nursing home or facility at some point. I get the point of not wasting time on a hope when real love is in front of you, but not sure how it related to the other stories which seemed to have different messages ( such as not giving up hope).

If you like podcast, list to Room 20. In some states, this is not uncommon.

[doodlebug]

19 minutes ago, Boofish said:

If you like podcast, list to Room 20. In some states, this is not uncommon.

I haven't listened to the podcast, but it is true that, if a patient cannot be identified or next of kin found, that they may never get transferred out of the hospital to an extended care facility.  The hospital where I used to practice had one such patient who was there for years in a persistent vegetative state with a tracheostomy and a feeding tube.  He was in his 30's, visiting the US from the Middle East, no family here, when he suffered bleeding from a brain aneurysm.  His name was known, his family contacted, but no one was able to come to the US and assume responsibility for him.  He was in the hospital for years, transferred from unit to unit until he died from an infection.  The hospital absorbed all the costs for his care over that time, hundreds of thousands, maybe millions, of dollars.

Obviously, this was not the situation we saw on the show.

[LittleIggy]

I’m glad they didn’t have coma guy “wake up” miraculously. At least they skipped that cliche. “Chicago Med” did a kid vaping storyline last week.

[ams1001]

2 hours ago, doodlebug said:

If she never fills the study, it never gets published.  And the NIH is going to stop funding her research.

Thank you for explaining; that story didn't seem right to me.

I also thought the coma patient looked a little too healthy for having been like that for 14 years.

 

[Dowel Jones]

I felt a little bad for the actor playing the comatose father.  "Okay, you have one line.  Can you gurgle?"

They are going to push the coupling of Max and Mom, aren't they? It might work out for the plot.  Maybe he'll get a change of clothes once in awhile.

5 hours ago, rove4 said:

What was Sharpe's important realization? 

I think it was the fact that she's no longer in charge, and Mean Oncology Doctor can do what she wants.  When Max stepped on her complaint, it was as though she hit a brick wall.

[txhorns79]

I couldn't take the coma guy's storyline seriously.  If anyone watched 30 Rock, his wife was played by the same actress who played Kathy Geiss, the childlike adult daughter of Don Geiss, who really liked unicorns and Marky Mark.  

And what exactly is up with Iggy now?  He's suddenly developed an eating disorder for some reason? 

And I appreciate that this week's lesson is that doctors should commit insurance fraud in order to get the result they want for a patient.   

[Amethyst]

I recognized the coma guy's son from Sleepy Hollow.  Hey, Corbin's son!

I really don't care what's going on with Iggy.

I feel like all the loathing I had for Bloom has now transferred to Castro.  

[bros402]

Coma Guy sure looked healthy for a guy in a coma for 14 years!

Also, I sincerely doubt that they would push an update in the middle of the day, without testing it first on a test server to make sure it doesn't break the whole ER.

I also strongly dislike the episodes of medical shows where it is like "LOOK THIS PRAYER GROUP WAS HERE AND LOOK PATIENTS IMPROVED!!!!!!!!! NOW THEY DECLINED BECAUSE THEY LEFT!!!!"

[alexvillage]

20 hours ago, doodlebug said:

Clinical trials are usually strictly controlled and the person doing the trial doesn't pick and choose the patients; there are very rigid criteria that must be met or the patient cannot be entered.  As for the doctor limiting the number of patients to 15 rather than 50 (or whatever it was), why would she do that?  Clinical trials are based on statistics and probabilities and if the NIH funded the study based on 50 patients, that was because some numbers geek figured out that that was how many were needed to prove or disprove the theory.  If she never fills the study, it never gets published.  And the NIH is going to stop funding her research.

I presume we're going to get Sharpe playing Nancy Drew with Max as Joe Hardy and they will be tracking down Mean Oncology Doc and uncovering her nefarious scheme to take over the world by accepting NIH funding for incomplete studies.

That was my take too. They are writing the MOD as the bad guy, and the actress is not good at it, so she is relying on exaggerating cliches. 

And again, fraud is committed to help a patient who needs mental health counseling. As I usually complain here, the show comes up with important issues - lack of coverage, health insurance denials, lack of affordability - but with bad solutions. Although I have to say that I hate our Wealth System so much, sometimes I wish doctors are doing what Sharpe and Iggy did. On the other hand, the amount of our of pocket the woman would have to come up with would be impossible for her to have the surgery, so yeah, bad solutions.

[ams1001]

10 hours ago, txhorns79 said:

And what exactly is up with Iggy now?  He's suddenly developed an eating disorder for some reason? 

I think the implication was that he had issues with food in the past and the whole thing with his husband (which was his own doing..) brought it back up. When he was talking to the woman about her weight issues he said something along the lines of he'd been there, too. (I was annoyed by him dumping the donuts(?) in the trash, though. Just put them out at the nurses station; surely they'll disappear before you can binge on them.)

10 hours ago, txhorns79 said:

And I appreciate that this week's lesson is that doctors should commit insurance fraud in order to get the result they want for a patient.   

At first I thought she was really going to say the woman had cancer, so what she actually did was slightly better in comparison. But still. And I know insurance sucks a lot of the time but if a patient is getting repeated infections that send her to the ER and the obvious solution is to surgically remove the excess skin that's causing it, is there really not a code to cover that other than "it's cosmetic so no"? And from a financial perspective it's a hell of a lot cheaper to just remove the cause of the infection once than to treat the infection multiple times a year for the rest of her life. Like, there is a reason to do it beyond the fact that it causes psychological issues (which are not insignificant, either) or that it will simply look nicer.

You hear so many stories where insurance would rather pay for something cheaper many times (because it's bound to recur) instead of paying once for something more expensive that will cost a lot less in the long run and it makes no sense to me. ( Or pay for something that's not expected to help much before allowing something better. My dad needs a new hip. He had to go through a series of shots that he said don't even have a good track record of working and which his doctor didn't think would really help before they would approve surgery. So they spent all that money on shots which, surprise, didn't help, and now they're also paying for surgery, which he could have just done months ago. Sorry, end of rant.)

6 hours ago, bros402 said:

Also, I sincerely doubt that they would push an update in the middle of the day, without testing it first on a test server to make sure it doesn't break the whole ER.

That whole fiasco was a great illustration of why relying on paper charts and having to go somewhere else to log/retrieve information (even if it's in a computer) is not a better option than having the information you need right there at the patient's bedside. We got a little bit about why relying on computers too much isn't good (the resident who didn't know what to do next because the computer wasn't there to tell her) but the whole "five blind guys describing an elephant" approach is a great way to kill people while you're stumbling toward an epiphany when just the right people make just the right offhand comments at just the right time. (But Max won't see that, of course.) Yes, we can get a little too dependent on it sometimes but technology is a good thing, especially when people's health and lives are at stake.

6 hours ago, bros402 said:

I also strongly dislike the episodes of medical shows where it is like "LOOK THIS PRAYER GROUP WAS HERE AND LOOK PATIENTS IMPROVED!!!!!!!!! NOW THEY DECLINED BECAUSE THEY LEFT!!!!"

Ugh, I hate that. Hey, did you know you can pray while you donate blood or do something else actually useful to those you say you're trying to help?

Also, the whole "it doesn't work that way...the prayer doesn't fix the patient, it changes you" (or whatever the hell he said). So in other words, you're taking up space in the middle of a busy hospital lobby floor and bugging the employees to pray with you just to make yourself feel good.

(Disclaimer: I am not religious, but if you want to pray because it helps you get through your day, have at it. I get that it can have an individual benefit, just like meditation or other similar activities. But don't try to drag other people into it or insist that you are helping others by sitting on the floor and talking to an invisible being.)

[bros402]

14 hours ago, ams1001 said:

Ugh, I hate that. Hey, did you know you can pray while you donate blood or do something else actually useful to those you say you're trying to help?

Also, the whole "it doesn't work that way...the prayer doesn't fix the patient, it changes you" (or whatever the hell he said). So in other words, you're taking up space in the middle of a busy hospital lobby floor and bugging the employees to pray with you just to make yourself feel good.

(Disclaimer: I am not religious, but if you want to pray because it helps you get through your day, have at it. I get that it can have an individual benefit, just like meditation or other similar activities. But don't try to drag other people into it or insist that you are helping others by sitting on the floor and talking to an invisible being.)

Yeah, like if they had volunteered to donate blood or maybe help out the hospital chaplain and just sit with some patients, something aside from "take up the floor of the lobby"

[Lunula]

I am okay with the show turning Fromm into a binge eater, even though I completely 100% do not believe he has narcissistic personality disorder - BUT (big but there) I am pissed off that they had to make the statement that obesity is a "disease." 

Obesity is not a disease. Nor is addiction. Neither are eating disorders. Are they serious issues? Hell yes. But they are not diseases. They are conditions/disorders, not diseases. These people are not victims and do not "need" medical intervention. Telling people these are diseases keeps them trapped in the cycle, makes them believe it isn't their fault, tells them they need help in order to get over it. Cancer is a disease. Bacterial meningitis is a disease. Lupus is a disease. Multiple sclerosis is a disease. You may do things that activate or worsen the disease, but a disease is pathophysiological. 

I'm not saying, by any stretch, that these conditions aren't serious. That they can't make you miserable or even kill you. I'm also not saying that medical intervention can't/won't help people with disorders of this nature. But as someone who has struggled with eating disorders for 30 years, and serious depression even longer, who has been in and out of therapy for decades, has been on numerous drugs, read every self-help book/article/blog, gone to conferences and coaching sessions and beaten herself up over and over and over because these things didn't "work" - that what truly put me on the path to recovery was dispelling the myth that something external was going to "work" and I'd be "cured." These things were tools that could/might help me learn how to get myself out of the habits/compulsions that drive these conditions. That's it. 

Sorry. Trigger topic for me. I just wish TV shows would get this shit right for a change.

/steps off soapbox

[Updemocrat]

Sorry to see the show embrace the old cliche that an atheist (max) must have a "God shaped whole" that needs to be filled. Is it such a scary thought to have a lead character that is a non believer for solid, rational reasons? Not one so wobbly that coincidence sends him chasing down ministers and praying for help, offering to fill the emptyness inside of him...

[bros402]

16 hours ago, Lunula said:

I am okay with the show turning Fromm into a binge eater, even though I completely 100% do not believe he has narcissistic personality disorder - BUT (big but there) I am pissed off that they had to make the statement that obesity is a "disease." 

Obesity is not a disease. Nor is addiction. Neither are eating disorders. Are they serious issues? Hell yes. But they are not diseases. They are conditions/disorders, not diseases. These people are not victims and do not "need" medical intervention. Telling people these are diseases keeps them trapped in the cycle, makes them believe it isn't their fault, tells them they need help in order to get over it. Cancer is a disease. Bacterial meningitis is a disease. Lupus is a disease. Multiple sclerosis is a disease. You may do things that activate or worsen the disease, but a disease is pathophysiological. 

I'm not saying, by any stretch, that these conditions aren't serious. That they can't make you miserable or even kill you. I'm also not saying that medical intervention can't/won't help people with disorders of this nature. But as someone who has struggled with eating disorders for 30 years, and serious depression even longer, who has been in and out of therapy for decades, has been on numerous drugs, read every self-help book/article/blog, gone to conferences and coaching sessions and beaten herself up over and over and over because these things didn't "work" - that what truly put me on the path to recovery was dispelling the myth that something external was going to "work" and I'd be "cured." These things were tools that could/might help me learn how to get myself out of the habits/compulsions that drive these conditions. That's it. 

Sorry. Trigger topic for me. I just wish TV shows would get this shit right for a change.

/steps off soapbox

Epilepsy and autism are disorders

[alexvillage]

3 hours ago, bros402 said:

Epilepsy and autism are disorders

Autism is nit a disorder. It is treated as such because the medical model still wants to "fix" people and turn them into neurotypical people. It does't work because it has been proven that autistic brains react differently (proven via fMRI). What happens is that there are several co-occurrent conditions that sometimes are  seen in autistic people. Those are treatable. The only treatment for autism is respect the autistic. 

[Johnny Dollar]

OK, so the hospital has gotten rid of tablets, Bloom thinks the staff works better without the help of computers and Max relies on miracles to cure patients. When will the leeches be delivered?

Any resident who told their supervisor that they have to effectively use WebMD to make a simple diagnosis would be immediately shown the door.

Are brain dead patients that are in a coma typically kept in a hospital for fourteen years?  That’s got to be expensive. I thought they’d be in some kind of long term care facility.

That bitch Castro can leave at any time. 

[tinderbox]

I hope we see many more play “dates” between Max and the mom....and she’s only appeared in two episodes.   (Can’t remember the character’s name.)  She seems to have tons more chemistry with Max than any other female character who has been on the show, thus far.

[Brian Cronin]

5 hours ago, tinderbox said:

I hope we see many more play “dates” between Max and the mom....and she’s only appeared in two episodes.   (Can’t remember the character’s name.)  She seems to have tons more chemistry with Max than any other female character who has been on the show, thus far.

How is Alison Luff not already a big star? I mean, she's starting to get more roles (and it looks like she's the female lead in Stephen Amell's followup series to Arrow about wrestlers called Heels), but wow, she's so good! She's almost TOO good for a recurring love interest for Max. 

Edited February 2, 2020 by Brian Cronin

[bros402]

20 hours ago, alexvillage said:

Autism is nit a disorder. It is treated as such because the medical model still wants to "fix" people and turn them into neurotypical people. It does't work because it has been proven that autistic brains react differently (proven via fMRI). What happens is that there are several co-occurrent conditions that sometimes are  seen in autistic people. Those are treatable. The only treatment for autism is respect the autistic. 

Autism is a developmental disorder.

[alexvillage]

3 hours ago, bros402 said:

Autism is a developmental disorder.

Developmental Disability. The "disorder" term implies that it can be fixed. There is nothing to fix in a brain that functions in a different way. 

[apn85]

19 hours ago, tinderbox said:

I hope we see many more play “dates” between Max and the mom....and she’s only appeared in two episodes.   (Can’t remember the character’s name.)  She seems to have tons more chemistry with Max than any other female character who has been on the show, thus far.

I'm actually not counting too heavy on her having a huge role that'll span the seasons and become his next great love story mostly because the writer brought up Max having a rebound in the last interview I read of his. Ever since, I have been waiting on someone to be introduced. I will admit I thought she would have a little less baggage, but I suppose the widowed Mom angle does give them something in common. 

Who knows, I guess we'll see! I've been wrong before but I just can't shake that interview where he specifically mentioned a rebound. I thought it an odd choice of words if this new interest is gonna be around for a long time and the one he eventually moves on with. 

[doodlebug]

On 2/1/2020 at 11:13 AM, Johnny Dollar said:

 

Are brain dead patients that are in a coma typically kept in a hospital for fourteen years?  That’s got to be expensive. I thought they’d be in some kind of long term care facility.

That bitch Castro can leave at any time. 

Clarification:   Brain dead is not the same as comatose.  Someone who is brain dead shows no evidence of brain waves on EEG.  They cannot breathe, swallow, cough, yawn or perform any basic functions.  The only way someone who is brain dead can live is with full life support with a ventilator.  Turn off the ventilator and they will be dead dead within minutes.  Brain death is irreversible.  It occurs when someone is placed on life support but, at some point, their brain dies while the machines keep the heart going.

A coma is different, there is brain function and the patient has varying degrees of responsiveness.  They may open and close their eyes, respond to pain or touch, respond to voice or music.  People who have been in comas have reported varying degrees of awareness of their surroundings including being aware of the presence of loved ones and hearing conversations; many report being frustrated that they were unable to participate.  People in comas can also often breathe well enough to not need a ventilator and even swallow.  They can also possibly wake up at some point.

There is a tool called the Glasgow Coma Scale which is used to ascertain the degree of responsiveness of a patient who is unconscious.

https://www.glasgowcomascale.org/

And, yes, as discussed above, someone who is comatose and not improving does not need acute care in a hospital, most are eventually transferred to long term care facilities after weeks to months in the regular hospital.

 

Edited February 3, 2020 by doodlebug