S03.E08: Catch

[Whimsy]

Quote

Max is forced to examine the inequities in child labor for women of color. Bloom must deal with an overcrowded ED. Sharpe helps Dr. Agnes Kao with a gut-wrenching diagnosis. Reynolds finds himself experiencing something new on the job.

 

[SunnyBeBe]

I actually liked this episode.  Yes, they still had some issues like falsifying medical records, but overall I enjoyed it.  

I still don’t understand why a high risk mother would rather take chances with the life of her child, so she can feel fulfilled. 
 

Can’t they get the new mother who has to undergo cancer treatment a hazmat  suit, so she can hold her baby over the next few months?  

Glad the doctor camping in the storage closet has a real place to stay.  
 

 

Edited April 21, 2021 by SunnyBeBe

[Aliconehead]

Nurses also had an episode with radioactive isotope treatment for cancer.  Theirs had a 3 day isolation though.  This stuff is serious and you just must isolate and even doctors and nurses have to stay away. 
 

[ams1001]

Why does Floyd's mom need a "primary caregiver"? She was diagnosed with diabetes. She's not an invalid...

Maybe don't walk through the ward crowing about how much you're profiting from the patients around you?

Iggy's awfully chipper today. But it was nice to get a break from his personal issues and just see him doing his job. Which he wasn't terrible at tonight. (I assume the people she was watching through the window before she left were adopting her baby?)

Why the hell did you call for a psych consult if you're not going to give him time him talk to her? What is the big rush to force this woman to have a c-section? You think forcing her to have surgery via court order is going to help her psychological state?

It took this long for Bloom to think of offering her spare room instead of letting this poor woman sneak around sleeping in a closet?

I expected the Major Societal Issue of the Week to be some big sweeping thing Max was going to do. Was pleasantly surprised that he kept his focus on the one patient and giving her the chance to give birth the way she wanted to (with a plan to change the way they do things in the future).

[txhorns79]

17 minutes ago, ams1001 said:

Why does Floyd's mom need a "primary caregiver"? She was diagnosed with diabetes. She's not an invalid...

I really hate this storyline.  It makes no sense.  

On the positive side, Helen's house looked incredible even if I'm not certain of the layout.  I guess she gave her niece the bedroom, while dragging her enormous four post bed into the light filled living room?

[LexieLily]

46 minutes ago, ams1001 said:

Why does Floyd's mom need a "primary caregiver"? She was diagnosed with diabetes. She's not an invalid...

Right?! I'm so confused as to why Reynolds' mom having diabetes has apparently rendered her helpless to the point Reynolds had to move back to New York, break up with his fiancée, and last week at work his mom was calling multiple times a day. Diabetes isn't that complicated and Mom Reynolds didn't seem impaired in any way that she would need so much care. When she was in the hospital I think the only concern was that she was, at that moment, having trouble getting the needle in the vial, but either she could be taught or she could have a nurse administer her injections. She could have Floyd's sister do it. She doesn't need care 24/7, based on what we saw of her onscreen.

If they just wanted to break up Reynolds and Evie (and why was she blaming him for the breakup when SHE left him?) they could have come up with a better way.

[ECM1231]

I missed a good portion of tonight's episode because Mr. ECM kept pestering me with questions. The pregnant young woman from the shelter? I'm gathering she was raped and repress that memory. But by whom? Who was the person she went to live with? Closet lady is a doctor? How? When did we find this out? I missed last week's episode.

[Aliconehead]

6 hours ago, ECM1231 said:

I missed a good portion of tonight's episode because Mr. ECM kept pestering me with questions. The pregnant young woman from the shelter? I'm gathering she was raped and repress that memory. But by whom? Who was the person she went to live with? Closet lady is a doctor? How? When did we find this out? I missed last week's episode.

We knew closet lady was a doctor from her first episode where she diagnosed her ride share rider.  She was a doctor in Pakistan I think.  
Yes shelter women was raped, I thought I heard it was a cousin but maybe it was a friend who decided that she owed him something for living with him  

[circumvent]

8 hours ago, ams1001 said:

Why the hell did you call for a psych consult if you're not going to give him time him talk to her? What is the big rush to force this woman to have a c-section? You think forcing her to have surgery via court order is going to help her psychological state?

Some hospitals and some doctors do believe it is ok to take away the autonomy of a patient, specially if said patient is a woman, someone believed to be uneducated, or someone who is in distress and needs time to process what is happening. Not to mention that disabled people have no autonomy in a emergency situation, which is a big violation of their rights, still a common scenario. It is all about power and the time of the doctors.

8 hours ago, ams1001 said:

Why does Floyd's mom need a "primary caregiver"? She was diagnosed with diabetes. She's not an invalid...

This plot is so ridiculous and stereotypical. I know adults who are intellectually disabled and can manage their diabetes and insulin by themselves and really well. Unless mama Reynolds has a physical impairment that prevents her from giving herself insulin, there is absolutely no reason for a nurse fo caregiver at her side.

[ams1001]

8 hours ago, LexieLily said:

When she was in the hospital I think the only concern was that she was, at that moment, having trouble getting the needle in the vial, but either she could be taught or she could have a nurse administer her injections. She could have Floyd's sister do it. She doesn't need care 24/7, based on what we saw of her onscreen.

Plus there are other options besides the old-school vial and syringe (though I suppose it's good to know how to do it just in case). Aren't there auto-injector devices for insulin? Or an insulin pump. She'll have a learning curve, of course, and I could see him wanting to maybe be around for a few weeks until she gets the hang of things (and there are also people whose job it is to teach diabetes patients how to manage their condition and medications; my friend has had type 1 for roughly 30 years and she sees a diabetes educator periodically to make sure she's staying on track), but there was no other indication that she needs a "caregiver" in that episode.

1 hour ago, Aliconehead said:

We knew closet lady was a doctor from her first episode where she diagnosed her ride share rider.  She was a doctor in Pakistan I think.  
Yes shelter women was raped, I thought I heard it was a cousin but maybe it was a friend who decided that she owed him something for living with him  

Yeah, I think it was a relative she was staying with, who then lost his job with the pandemic and apparently decided to take it out on her. And she was traumatized and in denial.

How long before Max or what's-her-name (Karen?) arrange for Dr. Uber to do a residency at NA so she can get licensed in the US? 

[circumvent]

37 minutes ago, ams1001 said:

How long before Max or what's-her-name (Karen?) arrange for Dr. Uber to do a residency at NA so she can get licensed in the US? 

Are you talking real universe or the show's alternate universe where time is a bunch of loops?

[FnkyChkn34]

40 minutes ago, ams1001 said:

How long before Max or what's-her-name (Karen?) arrange for Dr. Uber to do a residency at NA so she can get licensed in the US? 

I'm amazed that they haven't yet already.  

[ams1001]

11 minutes ago, FnkyChkn34 said:

I'm amazed that they haven't yet already.  

Well they just found out about her so...next week, probably.

[amarante]

ER had a receptionist who turned out to be a Polish doctor. She similarly revealed herself as a crack surgeon when she performed life saving emergency surgery on someone.

The whole premise of Transplant which aired this summer was that a Pakistani doctor who was seeking asylum in Toronto was working as a waiter when he saved the life of the head of the hospital by drilling into his head after someone drove into the restaurant.

It seems to be a trope that eventually all medical shows will use.

Edited April 21, 2021 by amarante

[circumvent]

35 minutes ago, amarante said:

It seems to be a trope that eventually all medical shows will use.

What is not a trope is how low the bar is for creativity and originality in the writers' room

Maybe they just misunderstood the meaning and context of "recycling"

[jabRI]

I don't often, but right now I feel sorry for Helen.  Her niece is a piece of work.  Offering her cold pizza "I was going to throw it out anyway". Have some gratitude for a relative stranger opening their NYC home to you, how about?

[SunnyBeBe]

The niece was so emotional and needy sounding on the phone, but now that she’s here she seems distant and doesn’t give a flip. 
 

Ref.  the doctor’s mother who has Type I diabetes.  I’ve given this a lot of thought.  I have been Type I for many years. IMO, it’s  not easy.....Type I is quite a bit different from type II.  I wish the show had done a better job portraying what her options really are.  I will say that I think there is some validity to his mother having some support in the home, at least for a year.  For someone her age to get familiar with taking two kinds of insulin, counting carbs, adjusting insulin doses accordingly.....if there is any cognitive decline, she’s in trouble.  There is little room for error.  The thing is, her son being at work isn’t helping her. She needs someone with her to help monitor her calculations and blood sugar levels all day.  If it goes too low, she passes out. You can go into a coma and die.   You have to be constantly on top of it.
 

The needle they showed was crazy.  Imo, no one uses those, anymore.  Popular and better are screw on pen needles that attach to a pen cartridge.  I now use an insulin pump with a built in Continuous Glucose monitor, but they are a full time job.  To master using a pump late in life.....I can’t image it.  She might benefit from just a Continuous Glucose Monitor, but that requires a lot of work too.  It would be feasible, if she had an attendant to help her.  To me, Assisted Living would be a help for her.  She still would need an aid to help her getting her blood sugar levels adjusted and on a schedule. 
 

While Type II’s make take pills and maybe one shot a day, Type I’s take multiple shots a day....usually one or two long acting insulins, one short acting shot before each meal, plus one each for snacks and correction doses....additionally, she would do finger stick blood tests before each injection, plus finger stick check 2 hrs after each injection.  She would need a lot of training and practice.....anyone does really.  
 

The thing with Type I is that you can do everything right for days and then for no apparent reason, you feel funny...check your blood sugar and it’s 25.  That is very low.  I’ve had it happen to me several times.  Some people feel it coming on, others don’t.  Unawareness of lows can be fatal.  Some people can manage to get juice at that point...others pass out and die.   That’s why the CGM is helpful, but it requires a lot of expertise to insert the sensors under your skin, calibrate, monitor, etc. So, imo, she does need support, but around the clock.  
 

I think it’s easier for people who have managed type I for many years to do it as the get older.  I’m not sure how old the doctor’s mother is supposed to be.  This was a good opportunity for the show to have been realistic and provided accurate information on the condition.  Maybe, they will do that down the road.  

Edited April 21, 2021 by SunnyBeBe

[perkie1968]

Oh, where to begin,...

Woman with apendicitis:  That should have raised a flag on the bloodwork taken in the ER or in OB before it got to the point that it did.  Also, she was 31 weeks which means a 9 week premie who should have been much tinier and in the NICU, not hanging out with the moms at the end.  

Helen needs to give her neice some tough love and some rules otherwise that annoying brat will run all over her.  

[amarante]

5 hours ago, circumvent said:

What is not a trope is how low the bar is for creativity and originality in the writers' room

Maybe they just misunderstood the meaning and context of "recycling"

In the early days of television, the writers for comedy shows actually retained the right to some of the gags they wrote into the early sitcoms. That is because the medium was so new, there wasn't a sense of the shows being retained for posterity. in fact a lot of the earliest shows weren't even taped or filmed and so no copies exist or the existing copies were second or third generation. Desi Arnez who was a business savant actually had the inspiration that the television shows would be valuable for more than the initial broadcast and retained the rights - Desilu Studios was a huge success and thus the birth of the syndicated business model which still exists to some extent even with the advent of cable - still need 100 shows at least to make a valuable syndication deal.

There was a gag about an inflatable boat that Joan (from I Married Joan) hid in the closet which expanded to "comic" results which was then used in one of the I Love Lucy shows. Same writer who had retained rights to the gag.

[txhorns79]

12 hours ago, ams1001 said:

Yeah, I think it was a relative she was staying with, who then lost his job with the pandemic and apparently decided to take it out on her. And she was traumatized and in denial.

I was a little confused on the timeline of that story.  She came into the hospital, it was found she was pregnant, she gave birth, gave up her baby for adoption and left the hospital all in what seemed like a few hours?  And I'm not even going to get into Iggy's methods with her.  Tricking an already traumatized woman into thinking she wasn't having a baby just really bothered me.  

[statsgirl]

14 hours ago, circumvent said:

What is not a trope is how low the bar is for creativity and originality in the writers' room

Maybe they just misunderstood the meaning and context of "recycling"

Since being a foreign-trained doctor and trying to get re-established is what happened to both of my parents and several of their friends, I see it as reflecting real life unlike very much of what goes on in this show such as Max's solution to the opiod problem or his crusade to end racism.

Bash, the Syrian surgeon who is the title character on Transplant, was working as a cook while he applied for a medical position, and coming up against bureaucracy.

It Is something that frequently happens to immigrants especially in closed shop professions like medicine. But even novelist and publisher Anna Porter cleaned toilets when she first arrived. Getting overseas credits accepted in the new country can be a very difficult thing.

The big dramatic saves are just television doing its thing.

[bros402]

On 4/20/2021 at 11:00 PM, SunnyBeBe said:

I actually liked this episode.  Yes, they still had some issues like falsifying medical records, but overall I enjoyed it.  

I still don’t understand why a high risk mother would rather take chances with the life of her child, so she can feel fulfilled. 
 

Can’t they get the new mother who has to undergo cancer treatment a hazmat  suit, so she can hold her baby over the next few months?  

Assuming it is in the hospital, even the nurses can't go into the room often - her sweat is radioactive, her bedding will be radioactive
I wonder who the WORST DOCTOR OF THE WEEK will be?

along with my thoughts on the episode as I watch it

I'm guessing we're going to see "paralyzed arm during birth" couple at some point. I wonder what she was diagnosed with? Stroke during birth?

Huh, Iggy giving good advice to Reynolds about self care?

 

The OB floor is busy, I bet this is gonna lead to some stuff. The ER is busy too!

Woman who isn't pregnant has markers that says she is? If she is a virgin like she says, I'm pretty sure that is a tumor of some kind.

 

hey look it's paralyzed arm couple! Darn, it was cancer, not stroke - stage 3 thyroid isn't too bad - i'm pretty sure the 5 year survival is >70%. Oh hey, they actually have an oncologist there to talk about cancer, and she isn't doing non-oncology things!

uhhhh, I am pretty sure she wouldn't have to isolate for 4-5 months unless she was getting it daily. Although I don't know the specifics of radioactive iodine for thyroid, I imagine it'd be a few days in, get the yummy radioactive chemicals, isolate, then go home for a bit and be cautious.

Hey, Dr. New Neuro Head stepping in with good commentary!

 

um sharpe I don't think they can start today, you have to get insurance approval first

 

ooh what is Max going to do with super lawyer that shut down the other hospital's labor ward? is he going to walk her around the hospital

 

ooh we're back to immaculate conception! now is she gonna give birth to a giant tumor, or end up actually having a baby. oh darn she did an ultrasound and confirmed it's a baby

 

why would OB call Iggy for a consult if she's just going to get a court order anyway

ooh is the doctor with dwarfism gonna discover Bloom's stowaway - and is she going to figure out whatever is wrong with his patient?

ha ha, Reynolds getting ripped a new one by OB Doc. oh no are they going to be in a relationship now

reynolds don't be a dick to the OB doc after she told you the results of the testing, OB is more clogged than the ER

 

and patient interrupts with vomiting

 

and of course the lawyer checks out AMA - well at least that means she can't sue the hospital over something

 

oh max caught up with her is he gonna tell her his wife died after giving birth on their floor...NOPE! she has something on the way out that leads to her needing to go back in

 

is Iggy gonna be a decent psychiatrist in this episode?

 

wow that was the worlds quickest ruling by the judge, she didn't even have any representation before the judge, or the opinion of Master Therapist Iggy Frome

 

and of course Bloom's Stowaway was found

 

i bet 31 week pregnant appendix lady is gonna have to have that baby delivered - 31 weeks isn't too bad, lungs are mostly developed, just gonna be underweight and maybe need some steroids for those lungs

 

why is Dr. Neuro still acting as if the thyroid cancer patient is hers - shouldn't an endocrinologist be involved?

 

wow those doctors are bad at explaining things to the lawyer

 

um is this board member having someone give her up to the second updates on the lawyer's labor

 

so when the baby was being carried away from Thyroid Cancer... did they forget to make the volume on the crying lower as the baby was being carried away? It sounded like it only went away once they left the room

 

why is a board member interviewing bloom's stowaway? is the board member trying to compete for worst doctor of the week?

 

ummm iggy are you going with another "trick the patient" method?

 

wait...
why doesn't the pregnant woman who iggy is lying to have an IV?

 

wow that was a quick labor

 

yay, iggy seems to be helping the patient?

 

waaaait does Reynolds not know how to do infant CPR? you think he'd know that

 

wait was reynolds palm pushing on the fontanelle during CPR?

 

why does OB have her very expensive looking ring attached to her scrub pants???? don't they have lockers for that... or why not just keep a ring that nice at home?

 

Bloom is lonely and needs a friend? sounds like it'd be a bad spinoff

 

shapre she's been there for like a week, she's getting used to it too

 

hey, she didn't eat the pizza going to see the patient - so she won't have horrible pizza breath

 

wait what is iggy doing with that baby and what is the mom doing watching them? did she give it up for adoption?

 

also, the couple with the 31 week old, that baby was way too big for 31 weeks, and that did not look at like a NICU at all that they were in, that baby would be hooked up to a bunch of wires, at least for the first day

So, who is the worst doctor of the week?

Max didn't have much to do, neither did Bloom. Iggy did a halfway ok job. Reynolds mansplained. Dr. Neuro was just there. Sharpe was decent.

I think the worst honorary doctor of the week is... THE BOARD MEMBER! She was just like..... what

if she wanted to be a helicopter over the lawyer's birth, at least introduce yourself

[circumvent]

Again this show diagnoses and decides course of treatment at the same time, no time for the patient to think about, no options of treatment, no insurance approval. Patient's agency is out the window as soon as a diagnosis is given: it is this right now, or you will DIE!!!!!

At least they didn't force the attorney to have a c-section - which tells me a little bit about class privilege - because this thing about you must have c-sections in all pregnancies if you had one in your first is just a lie. There is a great documentary on Netflix about birth, how it used to be just a natural event to become a medical event, and how everything is done for the comfort of the doctors, not the parents (hint: when men got involved, things changed). I guess the name is Birth, Reborn.

The actress who played the rape victim (can't remember the name) was excellent. I hope she gets more parts everywhere. And no, doctor, forcing her to have a c-section is assault. Hiding behind a court order just makes it an assault by court order. It is just one example of what is wrong with the system. 

It was an ok episode, as this show sometimes does: good themes, real problems, not great solutions. It is like the writers get the theme correctly but cannot develop into a coherent and more realistic story

[morriss]

I have never watched a show with more dislikeable patients than this episode.

[amarante]

9 hours ago, statsgirl said:

Since being a foreign-trained doctor and trying to get re-established is what happened to both of my parents and several of their friends, I see it as reflecting real life unlike very much of what goes on in this show such as Max's solution to the opiod problem or his crusade to end racism.

Bash, the Syrian surgeon who is the title character on Transplant, was working as a cook while he applied for a medical position, and coming up against bureaucracy.

It Is something that frequently happens to immigrants especially in closed shop professions like medicine. But even novelist and publisher Anna Porter cleaned toilets when she first arrived. Getting overseas credits accepted in the new country can be a very difficult thing.

The big dramatic saves are just television doing its thing.

The lack of creativity is the trope that the doctor will miraculously reveal themselves in an emergency situation after going through 30 seconds of deciding whether to risk the consequences of practicing medicine without a license. 

[Granny58]

On 4/21/2021 at 12:00 AM, LexieLily said:

I think the only concern was that she was, at that moment, having trouble getting the needle in the vial, but either she could be taught or she could have a nurse administer her injections. She could have Floyd's sister do it. She doesn't need care 24/7, based on what we saw of her onscreen.

or have one of those pumps and need a needle stick only every few days.  

Edited April 22, 2021 by Granny58
Other people addressed the insulin pump before I read through all comments.

[Granny58]

I love medical dramas...but I like the medical mystery of it.  I don't need a social issue on every damn show I watch these days.  Writers, please...give it a rest.  Oh, and "mansplaining" is so offensive.  Just because a man explains something doesn't mean it diminishes a woman.  I understand it CAN happen, but it doesn't ALWAYS happen.  

[izabella]

Radioactive treatment for months!?!  Jeez, what is that going to do to the rest of her body?  We need better cancer treatments than this.

I was annoyed with the pregnant woman who just decided the best thing would be for her to leave the hospital in the middle of labor, but I was even more annoyed at her doctor.  It's not about YOU, Dr. Know It All! 

I know patient agency was the theme for this episode, and it had the intended effect of making my blood boil.  I hate when doctors act like the patient doesn't matter as much their own arrogant opinion.

[NYGirl]

So did Dr. Kapoor retire?   He was my favorite character.  :(

[ams1001]

28 minutes ago, NYGirl said:

So did Dr. Kapoor retire?   He was my favorite character.  :(

Yes, he sent a message to the neuro department on the day they were throwing a welcome back party for him (and Iggy flipped out about it).

(In real life he's in India with his wife, who is ill.)

[bros402]

15 hours ago, morriss said:

I have never watched a show with more dislikeable patients than this episode.

The only one who bordered on unlikable was the ornery lawyer, but that was just because the bad OB didn't want to even listen to her. Of course, her trying to leave in the middle of labor was dumb - she's rich, she could've just had non-emergency medical transport waiting right outside of the hospital.

8 hours ago, izabella said:

Radioactive treatment for months!?!  Jeez, what is that going to do to the rest of her body?  We need better cancer treatments than this.

I was annoyed with the pregnant woman who just decided the best thing would be for her to leave the hospital in the middle of labor, but I was even more annoyed at her doctor.  It's not about YOU, Dr. Know It All! 

I know patient agency was the theme for this episode, and it had the intended effect of making my blood boil.  I hate when doctors act like the patient doesn't matter as much their own arrogant opinion.

Radioactive Iodine isn't daily for months - https://www.thyroid.org/radioactive-iodine/

She would have to avoid being near others - maybe she lives in a small apartment and needs to be hospitalized so she doesn't irradiate her husband and newborn? But they'd still let her home for a bit in between treatment... her insurance would probably insist on it.

Yeah, those were some annoying doctors - one time, I was in the hospital and the hospitalist insisted on doing a transfusion because of low hemoglobin, when my oncologist had literally just said he didn't want to do a transfusion. A phone call by the nurse later and the transfusion was cancelled, to the chagrin of the hospitalist

[LittleIggy]

On 4/21/2021 at 10:04 AM, amarante said:

ER had a receptionist who turned out to be a Polish doctor. She similarly revealed herself as a crack surgeon when she performed life saving emergency surgery on someone.

The whole premise of Transplant which aired this summer was that a Pakistani doctor who was seeking asylum in Toronto was working as a waiter when he saved the life of the head of the hospital by drilling into his head after someone drove into the restaurant.

It seems to be a trope that eventually all medical shows will use.

Bash is Syrian. 
Helen needs to sit her niece down and read her the riot act. The girl is 16, right? She needs to be in school, virtual if necessary, not running around Manhattan with “friends.” 
I wish someone would bring me homemade buttermilk biscuits! 😋

[ams1001]

6 hours ago, LittleIggy said:

Helen needs to sit her niece down and read her the riot act. The girl is 16, right? She needs to be in school, virtual if necessary, not running around Manhattan with “friends.” 

I guess now we know why she was so amenable to leaving her friends to go to NY, when she didn't want to leave them to go to Dubai. She had internet friends to meet up with already. 

I find it interesting that she didn't want to call Helen by her first name because it was disrespectful, but she has no problem treating her apartment like it's a hotel and she doesn't feel the need to ask permission to do whatever she wants. And I, too, was wondering if she's in school.

[jabRI]

3 hours ago, ams1001 said:

I find it interesting that she didn't want to call Helen by her first name because it was disrespectful, but she has no problem treating her apartment like it's a hotel and she doesn't feel the need to ask permission to do whatever she wants.

This! Of course Helen set herself up by wanting to 'friend' her

[LittleIggy]

1 hour ago, jabRI said:

This! Of course Helen set herself up by wanting to 'friend' her

And be the “cool aunt,” too! 🙄

[statsgirl]

Why is a migraine who is having auras in the ER?  I just go to a dark room, take some pills and try to sleep it off.

I don't usually like what Iggy does but I have to give him credit here, he handled that young woman very well. I wish that she didn't have to go back to a shelter though.

On 4/22/2021 at 5:59 AM, circumvent said:

At least they didn't force the attorney to have a c-section - which tells me a little bit about class privilege - because this thing about you must have c-sections in all pregnancies if you had one in your first is just a lie.

That's not what Max said. He told her that there is only a 28% chance that she can have a successful VBAC and then they got into a discussion of why African-American and Latino women have lower odds than white women.  (According to a VBAC calculator, being African-American or Hispanic drops your odds of a successful VBAC by 20%.)  If I only had a 28% of a successful VBAC, for sure I wouldn't head back home.

Max was right not to use it because it is based on aggregate scores. The lawyer here may have been older and African-American but she probably was in good physical health for her age and took care during her pregnancy.

On 4/22/2021 at 10:09 AM, amarante said:

The lack of creativity is the trope that the doctor will miraculously reveal themselves in an emergency situation after going through 30 seconds of deciding whether to risk the consequences of practicing medicine without a license. 

The hesitancy is also is realistic to hesitate because of the personal liability and because the professional board is so strict. When you've been told all your professional life that if you don't follow rulings completely you'll lose any future ability to practice, it's nature to hesitate. I know doctors who won't put an MD designation on their license plates because they don't want to be held responsible if something happens.

And as a TV reveal, it's a lot more interesting than watching someone send endless letters to hospital looking for a residency.

The ER "Bob" story was in 1995, Transplant in 2020 (but it's the premise for the series), and and now this, that's 3 examples in 26 years.  Meanwhile Grey's Anatomy, The Good Doctor and The Resident have all had oopsie pregnancies among the medical staff in the last two seasons (repeatedly for Grey's), and I just saw the "woman who doesn't realize she's pregnant until she's in labour" in an episode of Call The Midwife (although from a couple of years ago). I agree that there is a lack of creativity on medical shows but the foreign doctor sudden reveal isn't one.,

[circumvent]

7 minutes ago, statsgirl said:

That's not what Max said

It wasn't Max. It was implied during the conversation between the other doctor and the patient (or about the patient between Max and the other doctor). In any case, the issue is pure fallacy and I thought it was important t emphasize that.

9 minutes ago, statsgirl said:

I agree that there is a lack of creativity on medical shows but the foreign doctor sudden reveal isn't one.,

It is not the reveal that is a trope. The trope is how they come to the reveal part, with an heroic deed, without proper equipment, no medical history of the patient, saving a life, diagnosing someone after no other doctor could do that. It doesn't take many to be a trope but I guess, to your previous point, they need to dial the drama to 11 because a doctor who is a refugee and engages in a dialogue with others until they realize that refugee is actually pretty good is "boring"

[statsgirl]

The VBAC calculator is a real thing. Putting in the lawyer's information as a white woman (normal weight and height, they said that she's a geriatric pregnancy so she's a minimum 40), it calculates her predicted chance of a successful vaginal birth at 66.8% if she's 40, 62.3% if she's 45). Change that to African-American and the numbers drop to 50.6 and 45.8% respectively. Maybe she had other risk factors as well or maybe the show was doing its usual thing and exaggerating down to 28%.

It's sheer CYA for the administrator to say that all decisions should be based on the numbers but if she didn't, what would Max have to fight against this episode?

[amarante]

1 hour ago, statsgirl said:

 

The ER "Bob" story was in 1995, Transplant in 2020 (but it's the premise for the series), and and now this, that's 3 examples in 26 years.  Meanwhile Grey's Anatomy, The Good Doctor and The Resident have all had oopsie pregnancies among the medical staff in the last two seasons (repeatedly for Grey's), and I just saw the "woman who doesn't realize she's pregnant until she's in labour" in an episode of Call The Midwife (although from a couple of years ago). I agree that there is a lack of creativity on medical shows but the foreign doctor sudden reveal isn't one.,

Well don't get me started on the ridiculous manner in which abortions are treated on shows because of fear of offending the "moral majority".

Beyond the fact that most professional women I know are pretty scrupulous about birth control and birth control is effective almost all the time.

So there is a slip up - maybe I know a particularly degenerate amoral group of women, but my friends all chose to have abortions - thankfully they were legal and accessible - when they found themselves pregnant at the start of their adult lives because realistically it was not the time to have a child. None of them are emotionally or physically scarred as all went on to have children by choice at a time when they were able to deal with it and with partners who they were sure they wanted to be the father of their children.

[circumvent]

19 minutes ago, statsgirl said:

The VBAC calculator is a real thing.

Who created it and who is behind it? I am asking because I suggested a documentary I watched on Netflix about natural births in Brazil and they tell the history of how births went from something done at home, with a midwife, and family/friends, to a medical procedure that positioned the woman for the comfort of a doctor - a male doctor at the time of the changes - and the overuse of unnecessary medical procedures. In the end it is about paternalism and capitalism. 

Whatever numbers the calculator comes up with it is based on the notion that birth is a medical procedure. Something created by the new system to benefit the runners of said system. It is the same with the need to turn a breech baby. It is not necessary, gravity does the job pretty well. Obviously, there are cases when a doctor is needed but I don't believe for a minute that being in a hospital and with a doctor, lying down and risking episiotomy (quite common in some places) is the rule.  If the mother has had an uncomplicated pregnancy, no reason for a doctor. My sister in law just had a baby, also a geriatric gestation, she didn't need any medical intervention. If I remember well, the lawyer lady didn't have any complications either, the issue was the time it was taking for her to get fully dilated. 

Call the Midwife is pretty accurate with the history too. 

[LittleIggy]

If I were a patient, I would be extremely pissed off if I was taken to a storage closet for an exam! On the other hand, at least it’s more private than a patient room that has big curtainless windows facing the corridors. 😏

[statsgirl]

6 hours ago, circumvent said:

Who created it and who is behind it?

According to that site

Quote

This calculator is based on the equation published in the article "Development of a nomogram for prediction of vaginal birth after cesarean" cited below. It is designed for educational use and is based on a population of women who received care at the hospitals within the MFMU Network. Responsibility for its correct application is accepted by the end user.
 
Grobman WA, Lai Y, Landon MB, Spong CY, Leveno KJ, Rouse DJ, Varner MW, Moawad AH, Caritis SN, Harper M, Wapner RJ, Sorokin Y, Miodovnik M, Carpenter M, O'Sullivan MJ, Sibai BM, Langer O, Thorp JM, Ramin SM, Mercer BM; National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU), "Development of a nomogram for prediction of vaginal birth after cesarean delivery," Obstetrics and Gynecology, volume 109, pages 806-12, 2007.

There may be newer, more refined ones. That's the one that popped up in my search.

It's true that in the US there are too many caesarians for the convenience of the doctor. I don't know if I'd want to try a VBAC though without a doctor close by.

[circumvent]

6 hours ago, statsgirl said:

It's true that in the US there are too many caesarians for the convenience of the doctor. I don't know if I'd want to try a VBAC though without a doctor close by.

Fair. Patient's choice. My issue is that, after listening to the history of modern birth, I feel like women are not given all the information and options. Birth becomes a scheduled event and there is fear mongering - like doctors who want to go on vacation so they schedule c-sections before their break. C-sections are surgeries. If women have the chance to allow their bodies to take their time, the experience might be richer for them and the babies.

something else that crossed my mind: if there really is a risk for vagina birth after c-section, those guidelines might be just a way for doctors to protect themselves, and it is not about the mother. Scar tissues after surgeries can make things harder to work around. It is not about the mother, it is still about the doctors and how much more time they would have to take to deliver a baby. That's something i would like to know more, it literally crossed my mind as I wrote the first paragraph.

 

[Whodunnit]

Dumb. Sooooo dumb.

When your pregnant patient starts bleeding profusely you put her under the knife. Neither age nor race has anything to do with it. Common sense does.

Imagine if she or the baby had died. The hospital would have gotten sued, rightfully.

[circumvent]

7 hours ago, Whodunnit said:

When your pregnant patient starts bleeding profusely you put her under the knife.

Medical intervention when the patient in conscious and capable requires consent, otherwise it is called assault. 

[cameron]

On 4/24/2021 at 5:31 AM, circumvent said:

Fair. Patient's choice. My issue is that, after listening to the history of modern birth, I feel like women are not given all the information and options. Birth becomes a scheduled event and there is fear mongering - like doctors who want to go on vacation so they schedule c-sections before their break. C-sections are surgeries. If women have the chance to allow their bodies to take their time, the experience might be richer for them and the babies.

something else that crossed my mind: if there really is a risk for vagina birth after c-section, those guidelines might be just a way for doctors to protect themselves, and it is not about the mother. Scar tissues after surgeries can make things harder to work around. It is not about the mother, it is still about the doctors and how much more time they would have to take to deliver a baby. That's something i would like to know more, it literally crossed my mind as I wrote the first paragraph.

 

Had a vaginal birth and didn't think that the experience was richer for my baby or myself.  Just wanted to get it over and done.

[circumvent]

3 hours ago, cameron said:

Had a vaginal birth and didn't think that the experience was richer for my baby or myself.  Just wanted to get it over and done.

So you were a patient who had a choice (I also said that for SOME women the experience MIGHT be richer). Many women who had c-sections and want to have a vaginal birth later are told outright (before any exams, studies, or actual conversations about pros and cons) that they cannot, it is not possible, it is dangerous. None of this is based on medical science, it is based on the convenience of the doctors the availability or an OR, the time someone needs to be in and out - and obviously the price they have to pay for the surgery

[LadyNebula]

Add me to the roster of people calling shenanigans on Reynolds's mother needing full time care. 

My mother is 66 and was diagnosed as Type 2 in her 40s. She managed it for years with oral meds, but this summer she ended up on life support when one of the meds built up in her system and pretty much shut her body down. I almost lost her several times in one week.

After she got out of ICU, they put her on 2 types of insulin. Now, my mom has many other issues: epilepsy, horrible anxiety, essential tremors, Aspergers (not that that would stop her, but the anxiety and epilepsy tie into that)... and she is managing to give herself 4 shots a day. I do call her on my lunch break every day, and she lives with me so I'm with her in the morning and at night. But she is perfectly capable of taking care of her shots, and of herself. 

There are also lots of options, like others said. Mom uses pen needles, plus she uses a Dexcom system, which constantly checks her sugar. 

Mrs. Reynolds has shown no prior signs of dementia or infirmity. Some shakiness when she tried to give herself an injection was all I saw. If my mother can do it herself with tremors, I'm sure Mrs. Reynolds can make do. 

[bros402]

11 hours ago, LadyNebula said:

Add me to the roster of people calling shenanigans on Reynolds's mother needing full time care. 

My mother is 66 and was diagnosed as Type 2 in her 40s. She managed it for years with oral meds, but this summer she ended up on life support when one of the meds built up in her system and pretty much shut her body down. I almost lost her several times in one week.

After she got out of ICU, they put her on 2 types of insulin. Now, my mom has many other issues: epilepsy, horrible anxiety, essential tremors, Aspergers (not that that would stop her, but the anxiety and epilepsy tie into that)... and she is managing to give herself 4 shots a day. I do call her on my lunch break every day, and she lives with me so I'm with her in the morning and at night. But she is perfectly capable of taking care of her shots, and of herself. 

There are also lots of options, like others said. Mom uses pen needles, plus she uses a Dexcom system, which constantly checks her sugar. 

Mrs. Reynolds has shown no prior signs of dementia or infirmity. Some shakiness when she tried to give herself an injection was all I saw. If my mother can do it herself with tremors, I'm sure Mrs. Reynolds can make do. 

I think Reynolds is mostly just an overreacting momma's boy

Or maybe there were signs of something going on that he and his siblings ignored while Reynolds was there because they figured out the doctor would realize it.

It's just silly.

[crowsworks]

On 4/20/2021 at 11:09 PM, ams1001 said:

Why does Floyd's mom need a "primary caregiver"? She was diagnosed with diabetes. She's not an invalid...

Maybe don't walk through the ward crowing about how much you're profiting from the patients around you?

Iggy's awfully chipper today. But it was nice to get a break from his personal issues and just see him doing his job. Which he wasn't terrible at tonight. (I assume the people she was watching through the window before she left were adopting her baby?)

Why the hell did you call for a psych consult if you're not going to give him time him talk to her? What is the big rush to force this woman to have a c-section? You think forcing her to have surgery via court order is going to help her psychological state?

It took this long for Bloom to think of offering her spare room instead of letting this poor woman sneak around sleeping in a closet?

I expected the Major Societal Issue of the Week to be some big sweeping thing Max was going to do. Was pleasantly surprised that he kept his focus on the one patient and giving her the chance to give birth the way she wanted to (with a plan to change the way they do things in the future).

well Max showing her how - my gosh - he did everything but hide the insulin inside a rubics cube. and that Needle....yikes

Points for Bloom having a friend. Nice. Of course they will do the suddenly i'm a lesbian storyline instead of renewing the Bloom/Reynolds love story his mom destroyed. Love it if he walked in on moms and a man. 

On 4/22/2021 at 12:21 AM, statsgirl said:

Since being a foreign-trained doctor and trying to get re-established is what happened to both of my parents and several of their friends, I see it as reflecting real life unlike very much of what goes on in this show such as Max's solution to the opiod problem or his crusade to end racism.

Bash, the Syrian surgeon who is the title character on Transplant, was working as a cook while he applied for a medical position, and coming up against bureaucracy.

It Is something that frequently happens to immigrants especially in closed shop professions like medicine. But even novelist and publisher Anna Porter cleaned toilets when she first arrived. Getting overseas credits accepted in the new country can be a very difficult thing.

The big dramatic saves are just television doing its thing.

one of the most novel was the Eastern European doc on ER. An anti-vaxer came in with a sick child and the American doctors were momentarily stumped until he said Measles. Of course the kid died, along with a couple folks in the ER on Chemo and with immune issues...and the pregnant doctor had to sweat it out.